Journal article
Ethical Implications of Active Surveillance Cultures and Contact Precautions for Controlling Multidrug Resistant Organisms in the Hospital Setting
Public Health Ethics, Vol.1(3), pp.235-245
11/2008
DOI: 10.1093/phe/phn014
PMID: 17549981
Abstract
Healthcare-associated infections due to multidrug-resistant organisms continue to increase in incidence. To control the transmission of these pathogens, such as methicillin-resistant Staphylococcus aureus, some have advocated active surveillance cultures of all hospitalized patients, followed by institution of contact precautions. While there has been extensive debate about the effectiveness of this approach in reducing infections, little attention has been given to the ethical issues raised by the intervention. Active surveillance for multidrug-resistant organisms is a quality improvement measure and ethical implications arise through the potential to inadvertently cause harm. Unintended adverse effects may include decreased contact with healthcare workers, increased depression and anxiety, and increased rates of noninfectious adverse events among patients placed in contact precautions. The potential risks and benefits are not distributed fairly; patients placed in contact precautions are exposed to the risks, while those not isolated experience the benefit. Ethical challenges involve a conflict between the interests of the individual patient and the patient population not already colonized with the organism. For healthcare systems, active surveillance increases the complexity of bed management, exacerbating problems with patient placement, patient throughput, emergency department overcrowding and ambulance diversion for some hospitals. It also poses ethical dilemmas regarding societal resource allocation. Investing in an unproven or marginally beneficial quality improvement activity such as this must be balanced against other public health priorities competing for scarce resources.
Details
- Title: Subtitle
- Ethical Implications of Active Surveillance Cultures and Contact Precautions for Controlling Multidrug Resistant Organisms in the Hospital Setting
- Creators
- Michael Edmond - Virginia Commonwealth UniversityLaurie Lyckholm - Virginia Commonwealth UniversityDaniel Diekema - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Public Health Ethics, Vol.1(3), pp.235-245
- Publisher
- Oxford University Press
- DOI
- 10.1093/phe/phn014
- PMID
- 17549981
- ISSN
- 1754-9973
- eISSN
- 1754-9981
- Language
- English
- Date published
- 11/2008
- Academic Unit
- Infectious Diseases; Pathology; Internal Medicine
- Record Identifier
- 9983905532002771
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