'Zero Tolerance' of Avoidable Infection in the English National Health Service: Avoiding the Redistribution of Burdens

Public Health Ethics 6 (1):50-59 (2013)
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Abstract

‘Zero tolerance’ of avoidable infection events is explicit in UK and international policy documents describing strategies for the control of healthcare-associated infection. I consider what principles governing avoidable infections acquired in healthcare institutions might be reasonably rejected from the contractualist perspective of Thomas Scanlon. Many hospital infections can be cost-effectively avoided. There would seem to be additional reasons to take the prevention of avoidable infection acquired in hospitals seriously in addition to optimizing the cost-effectiveness of healthcare. These include the irretrievable nature of the harm of some of the infections; the reasonable rejection of avoidable harm when the patient could not rationally consent to the risk of harm and the social consequences such as loss of trust in healthcare providers. Despite these reasons, a principle of ‘zero tolerance’ has implausible implications, promotes unrealistic patient expectations and can be reasonably rejected from the perspective of those who will suffer unacceptable opportunity costs. However, the contractualist perspective would also seem to reject a principle of tolerance of harm when there is a feasible reconfiguration of institutional arrangements that reduces the risk of harm without a redistribution of a proportionate or greater burden to others

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Michael Millar
Queen Mary University of London

Citations of this work

A Capabilities Perspective on Healthcare Associated Infection.Michael R. Millar - 2013 - American Journal of Bioethics 13 (8):53-54.

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References found in this work

What we owe to each other.Thomas Scanlon - 1998 - Cambridge, Mass.: Belknap Press of Harvard University Press.
Moral dimensions: permissibility, meaning, blame.Thomas Scanlon - 2008 - Cambridge, Mass.: Belknap Press of Harvard University Press.
Disadvantage.Jonathan Wolff & Avner de-Shalit - 2007 - Oxford University Press.
Towards Justice and Virtue.Onora O'neill - 1999 - Philosophical and Phenomenological Research 59 (4):1103-1105.

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