Hernández-Marrero Pablo, Martins Pereira Sandra, de Sá Brandão Patrícia Joana, Araújo Joana, Carvalho Ana Sofia
1 Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal.
2 UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal.
J Int Med Res. 2017 Dec;45(6):1787-1793. doi: 10.1177/0300060517697595. Epub 2017 May 1.
Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.
引言
抗菌药物耐药性（AMR）是一个具有挑战性的全球公共卫生问题，引发了生物伦理挑战、考量因素及策略。
目标
本研究方案提出一个概念模型，旨在为抗生素使用、AMR制定一个基于实证的生物伦理框架，并设计出在伦理上稳健的策略以保护人类健康。
方法
将采用混合方法研究，并将其具体实施为五个子研究。生物伦理框架将涵盖并整合两个理论模型：全球生物伦理和伦理决策。
结果
作为一项研究方案，本文报告了计划中的和正在进行的研究。
结论
基于数据收集、未来的研究结果，并采用全面、综合、基于证据的方法，将为（i）医疗保健中抗生素的合理使用和（ii）降低AMR的策略设计制定一个循序渐进的生物伦理框架。这将需要分析和解释来自几种生物伦理理论的方法，包括道义论和结果论方法，以及不确定性对这些方法的影响。
