The Medical Ethics and Public Health Frameworks of Pediatric Antibiotic Prescriptions for Suspected Acute Otitis Media
Open Access
- Author:
- Sternick, Mykaihla
- Area of Honors:
- Interdisciplinary in Bioethics and Medical Humanities and Philosophy
- Degree:
- Bachelor of Arts
- Document Type:
- Thesis
- Thesis Supervisors:
- Jonathan Harold Marks, Thesis Supervisor
Jonathan Harold Marks, Thesis Honors Advisor
Michele L Mekel, Faculty Reader
Brady Bowman, Thesis Honors Advisor - Keywords:
- Medical ethics
bioethics
public health
ethics
pediatrics
medicine
acute otitis media - Abstract:
- This thesis aims to use public health ethics in conjunction with individualized medical ethics to find a solution to the ethical problem of the large number of unnecessary antibiotic prescriptions for pediatric patients, specifically those with acute otitis media (AOM), the common ear infection which resolves spontaneously in 80% of cases. The medical ethical tenets of beneficence and non-maleficence are questioned when antibiotics are prescribed inappropriately, though there are many factors that go into this including time constraints, emotional parents, and difficulty in diagnosing AOM definitively. In doing so, the larger issue of antibiotic resistance is brought to the surface. By understanding this as a public health intervention, it must be justified to ask physicians to lessen the amount of antibiotics that they prescribe, against what a parent may ask for. In AOM infections, antibiotics are many times a futile or harmful treatment, and thus rarely have a place as a treatment. Public health ethics frameworks from Nancy Kass, Ross Upshur, The American Public Health Association, and the Nuffield framework were used to identify a reasonable, ethical solution. It was determined that the stakeholders, including the physician, the patient, the parent, the medical profession, the pharmaceutical industry, pharmacists, and the government are called to action to increase public education and awareness. Also included in the solution is a streamlined watchful waiting process, increased empathetic communication dealing with risks of antibiotics, implementation of stewardship initiatives, understanding of conflicts of interest or commitment, investment in the social contract, and increased research for alternative treatment options for AOM. This solution ethically preserves both the health of the patients and the reserve of antibiotics.