Davide Fumagalli

This paper vindicates using the harm principle (HP) to justify restricting consumer’s access to meat products in light of the impact that it has on the development of antibiotic resistance (ABR). In particular, the study claims that, since an individual instance of consumption, or purchase of meat, meaningfully contributes to the development of ABR in farming environments, a state intervention limiting consumer freedom would be legitimate. The causal impact of individuals in greater-scale problems has long been debated and dismissed as not relevant. The study analyzed two possible formulations of the inconsequentialist objection. While the first formulation, which maintains that individuals have no impact, can be rejected independently of the context of application, rejecting the second formulation, which maintains that this impact is insufficient to warrant applying HP, is more difficult. In order to successfully respond to this version of inconsequentialism, the paper vindicates the value of considering ABR and ABR-related harm within a more traditional expected utility arguments.

We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We demonstrate how this principle may take different forms, and show that a commitment to sustainability is supported by considerations internal to the ethical principles already guiding healthcare resource allocation. We also consider two objections. The first of these, we argue, is either based on implausible assumptions or begs the question, whereas the second can be adequately accommodated by the principle we propose.