Earth, air, fire and water : moral responsibility and the problem of global drug resistance

Thesis (DPhil)--Stellenbosch University, 2004.ENGLISH ABSTRACT: In this dissertation, I grapple with the problem of global drug resistance and moral responsibility which, as far as I am aware, has so far not been presented as a topic of ethical inquiry. It represents a conundrum involving three major factors: microbial adaptation and change, human social factors and environmental changes. Drug resistance is a phenomenon in which certain microorganisms, when exposed to antimicrobial agents, may acquire the beneficial trait of drug resistance which ensures a better potential for their survival. The acquired trait of drug resistance I argue renders such microorganisms 'supra-natural '. Supra-natural is a term I coin for entities that have been imposed upon nature by human design; they do not follow the natural evolutionary processes of adaptation and change. Drug resistance is classified as an emerging infectious disease. Human social factors and environmental change (particularly population growth, density and consumerist practices) enhance the rise of emerging infectious diseases. Through such increasing destructive practices, stress is placed on the environment. Environmental stress facilitates the rise of new and old infectious diseases and the spread of drug resistant supra-natural microorganisms. Thus, our ability to treat successfully illnesses and injuries in humans, animals and plants is increasingly impaired. Morally, we are responsible for the problem of global drug resistance. Drug resistant microorganisms exist in nature and concerning this, we can do nothing. At best, we can only try to control the problem using prudential measures. The problem of global drug resistance represents both a biomedical ethical and an environmental ethical issue. Is there a way out of the human-nature debate? Through Bryan Norton's enlightened anthropocentrism, I identify the ways in which his thesis may be applied to the problem of human and environmental concerns and show its applicability in broadening the parameters of biomedical ethics education to include environmental concerns.AFRIKAANSE OPSOMMING: In hierdie proefskrif bespreek ek die probleem van die verskynsel dat mikroorganismes op 'n globale skaal weerstand begin bied teen mediese middels (globale middel-weerstandigheid) en die morele verantwoordelikheid wat dit oproep - 'n probleem wat, na my beste wete, nog nooit aangebied is as 'n tema van etiesfilosofiese ondersoek nie. Dit verteenwoordig 'n kompleks van drie belangrike oorwegings: mikrobiese aanpassings en veranderinge, menslike sosiale faktore, en omgewingsveranderinge. Middel-weerstandigheid is 'n verskynsel waarin sekere mikro-organismes, wanneer hulle blootgestel word aan antimikrobiese agente, die (vir hulself) voordelige kenmerk kan bekom van weerstandigheid teen die middel; iets wat 'n beter potensiaal vir hul eie oorlewing verseker. Hierdie bekomde kenmerk (middel-weerstandigheid) maak, volgens my argument, sulke mikro-organismes 'supra-natuurlik'. Supra-natuurlik is 'n term wat ek munt vir entiteite wat aan die natuur blootgestel is as gevolg van menslike ontwerp; hulle volg nie die natuurlike evolusionêre prosesse van adaptasie en verandering nie. Middel-weerstandigheid word geklassifiseer as 'n opkomende aansteeklike siekte. Menslike sosiale faktore en omgewingsveranderinge (veral bevolkingsgroei, -digtheid and verbruikerspraktyke ) vergroot die opkoms van aansteeklike siektes. Deur sodanige toenemende destruktiewe praktyke word stres geplaas op die omgewing. Omgewingstres fasiliteer die opkoms van nuwe en ou aansteeklike siektes asook die verspreiding van weerstandige supra-natuurlike mikro-organismes. Ons vermoë om siektes en beserings van mense suksesvol te behandel, word gevolglik toenemend ondermyn. Moreel gesproke is ons verantwoordelik vir die probleem van globale middelweerstandigheid. Middel-weerstandige mikro-organismes bestaan in die natuur, en aan daardie feit as sodanig kan ons niks doen nie. Ons kan, ten beste, probeer om die probleem te beheer deur middel van verstandige maatreëls. Die probleem van globale middel-weerstandigheid verteenwoordig sowel 'n biomedies-etiese as 'n omgewingsetiese kwessie. Is daar 'n uitweg uit die mens-natuur debat? Ek identifiseer, met 'n beroep op Bryan Norton se swak antroposentrisme, maniere waarop sy tese toegepas sou kon word op die probleem van menslike en omgewingsoorgwegings Ek wys ook op die toepaslikheid daarvan vir die verbreding van die parameters van biomediese etiek-opvoeding ten einde omgewingsoorwegings deel van 19.te maak

Earth, air, fire and water : moral responsibility and the problem of global drug resistance

Thesis (PhD)--Stellenbosch University, 2004.ENGLISH ABSTRACT: In this dissertation, I grapple with the problem of global drug resistance and moral responsibility which, as far as I am aware, has so far not been presented as a topic of ethical inquiry. It represents a conundrum involving three major factors: microbial adaptation and change, human social factors and environmental changes. Drug resistance is a phenomenon in which certain microorganisms, when exposed to antimicrobial agents, may acquire the beneficial trait of drug resistance which ensures a better potential for their survival. The acquired trait of drug resistance I argue renders such microorganisms 'supra-natural '. Supra-natural is a term I coin for entities that have been imposed upon nature by human design; they do not follow the natural evolutionary processes of adaptation and change. Drug resistance is classified as an emerging infectious disease. Human social factors and environmental change (particularly population growth, density and consumerist practices) enhance the rise of emerging infectious diseases. Through such increasing destructive practices, stress is placed on the environment. Environmental stress facilitates the rise of new and old infectious diseases and the spread of drug resistant supra-natural microorganisms. Thus, our ability to treat successfully illnesses and injuries in humans, animals and plants is increasingly impaired. Morally, we are responsible for the problem of global drug resistance. Drug resistant microorganisms exist in nature and concerning this, we can do nothing. At best, we can only try to control the problem using prudential measures. The problem of global drug resistance represents both a biomedical ethical and an environmental ethical issue. Is there a way out of the human-nature debate? Through Bryan Norton's enlightened anthropocentrism, I identify the ways in which his thesis may be applied to the problem of human and environmental concerns and show its applicability in broadening the parameters of biomedical ethics education to include environmental concerns. Key words: biomedical ethics, environmental ethics, drug resistance, Supra-natural' microorganisms, ethics education, enlightened-anthropocentrism.AFRIKAANSE OPSOMMING: In hierdie proefskrif bespreek ek die probleem van die verskynsel dat mikroorganismes op 'n globale skaal weerstand begin bied teen mediese middels (globale middel-weerstandigheid) en die morele verantwoordelikheid wat dit oproep - 'n probleem wat, na my beste wete, nog nooit aangebied is as 'n tema van etiesfilosofiese ondersoek nie. Dit verteenwoordig 'n kompleks van drie belangrike oorwegings: mikrobiese aanpassings en veranderinge, menslike sosiale faktore, en omgewingsveranderinge. Middel-weerstandigheid is 'n verskynsel waarin sekere mikro-organismes, wanneer hulle blootgestel word aan antimikrobiese agente, die (vir hulself) voordelige kenmerk kan bekom van weerstandigheid teen die middel; iets wat 'n beter potensiaal vir hul eie oorlewing verseker. Hierdie bekomde kenmerk (middel-weerstandigheid) maak, volgens my argument, sulke mikro-organismes 'supra-natuurlik'. Supra-natuurlik is 'n term wat ek munt vir entiteite wat aan die natuur blootgestel is as gevolg van menslike ontwerp; hulle volg nie die natuurlike evolusionêre prosesse van adaptasie en verandering nie. Middel-weerstandigheid word geklassifiseer as 'n opkomende aansteeklike siekte. Menslike sosiale faktore en omgewingsveranderinge (veral bevolkingsgroei, -digtheid and verbruikerspraktyke ) vergroot die opkoms van aansteeklike siektes. Deur sodanige toenemende destruktiewe praktyke word stres geplaas op die omgewing. Omgewingstres fasiliteer die opkoms van nuwe en ou aansteeklike siektes asook die verspreiding van weerstandige supra-natuurlike mikro-organismes. Ons vermoë om siektes en beserings van mense suksesvol te behandel, word gevolglik toenemend ondermyn. Moreel gesproke is ons verantwoordelik vir die probleem van globale middelweerstandigheid. Middel-weerstandige mikro-organismes bestaan in die natuur, en aan daardie feit as sodanig kan ons niks doen nie. Ons kan, ten beste, probeer om die probleem te beheer deur middel van verstandige maatreëls. Die probleem van globale middel-weerstandigheid verteenwoordig sowel 'n biomedies-etiese as 'n omgewingsetiese kwessie. Is daar 'n uitweg uit die mens-natuur debat? Ek identifiseer, met 'n beroep op Bryan Norton se swak antroposentrisme, maniere waarop sy tese toegepas sou kon word op die probleem van menslike en omgewingsoorgwegings Ek wys ook op die toepaslikheid daarvan vir die verbreding van die parameters van biomediese etiek-opvoeding ten einde omgewingsoorwegings deel van lg. te maak. Kembegrippe: biomediese etiek, omgewingsetiek, middel-weerstandigheid, 'Supra- . natuurlike' mikro-organismes, etiek-opvoeding, swak antroposentrisme

Those different from us : ethical thoughts arising from disability and difference

Thesis (MPhil) -- University of Stellenbosch, 1999.ENGLISH SUMMARY: This assignment grapples with ethical aspects concerning those disabled, 'abnormal', visibly different living in a Procrustean society where to be visibly different is to be marginalised. In the first section, creating narratives, I introduce the reader to The Elephant Man, Joseph Merrick. The purpose of this introduction is to create a bond between the reader and the disfigured subject, to give a human face to one who is deformed. In the second section I place Merrick, deformed and disabled, in the status quo position of the slippery slope argument: we prohibit the killing of deformed or disabled members of our society. But are there any reasons why this position should be maintained? To answer this question I pivot the arguments of Professor Peter Singer, challenging this position and identify complaints rising from disabled agents concerning his hiring by Princeton University. Because the emotional arguments focus on the claim that if the acceptance of Singer's stance is accepted, then the result will be eugenics, personified in another Holocaust, I explore the eugenics movement. Finally, I conclude that Singer does not advocate the killing of disabled humans who live their lives in accordance to their wishes. Yet, I caution that to avoid the final moral degradation in the emotive form of the slippery slope argument we must realise with Foucault: "My point is not that everything is bad, but that everything is dangerous, which is not the same as being bad. If everything is dangerous, then we always have something to do. So my position leads not to apathy but to a hyper and pessimistic activism."AFRIKAANSE OPSOMMING: Hierdie opdrag worstel met die etiese aspekte aangaande die kwessie van diegene wat gestremd, abnormaal en sigbaar verskillend lyk, maar wat leef in 'n Procrustiaanse samelewing waar diegene wat duidelik verskillend is, gemarginaliseer word. In die eerste deel van die opdrag stel ek die leser bekend aan die Olifantman (The Elephant Man), Joseph Merrick. Die doel van hierdie inleiding is om 'n band te smee tussen die leser en die misvormde (verminkte) subjek, met die doel om 'n menslike gesig te gee aan die misvormde individu. In die tweede deel plaas ek 'n misvormde en gebreklike Merrick in die status quo posisie van die slippery slope-argument, naamlik dat ons die doodmaak van misvormde en gestremde lede van die samelewing verbied. Is daar egter enige redes waarom hierdie posisie gehandhaaf behoort te word? In antwoord op hierdie vraag, fokus ek op die argumente van Peter Singer, daag ek in die proses sy posisie uit en identifiseer klagtes wat na yore gebring is deur gestremde individue, na aanleiding van sy aanstelling by die Universiteit van Princeton. Die emosionele argumente fokus op die aanspraak dat eugenetika of rasverbetering die gevolg sal wees indien Singer se posisie aanvaar word. In die lig van hierdie argumente ondersoek ek dus die eugenetiese beweging. My gevolgtrekking is dat Singer nie voorstel dat gestremde mense wat hulle lewe volgens hulle eie wense lewe, doodgemaak word nie. Om egter die finale morele degradasie, in die emotiewe vorm van die slippery slope-argument, te vermy, moet ons saam met Foucault besef: "My point is not that everything is bad, but that everything is dangerous, which is not the same as being bad If everything is dangerous, then we always have something to do. So my position leads not to apathy but to a hyper and pessimistic activism.