Abstract
Medical screening programmes are amongst the most debated aspects of health care practices in medical ethics as well as health policy discussions. There are many explanations for this, but a chief one is the fact that screening programmes affect large numbers of people. This, in turn, connects to the history of screening, which is strongly linked to the development of the area of public health (as opposed to individual health care) during the twentieth century, and thus to the use of medical knowledge and technology for societal aims that transcend those considerations that arise in the context of a health care professional interacting with an individual patient. For this reason, screening is an interesting case for the study of what becomes of medical and health care ethics in situations where medical professionals act primarily as servants of society. However, it also serves to partially explain the nature of the ethical controversies surrounding screening and to highlight gaps in state of the art health care ethics perspectives that may be filled by ethical deliberation based on a public health perspective.
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- 1.
See, e.g., Dawson and Verweij (2007a).
- 2.
- 3.
- 4.
Linnane et al. (1999).
- 5.
See e.g. WHOs latest contribution in this area (Andermann et al. 2008).
- 6.
Wilson and Jungner (1968).
- 7.
Wilson and Jungner (1968, p. 11) thus underlines that a “…screening test is not intended to be diagnostic. Persons with positive or suspicious findings must be referred to their physicians for diagnosis and necessary treatment.”
- 8.
Although the characteristic of screening as a selection procedure is sometimes mentioned also in relation to genetic testing (Shickle, 1999, p. 1).
- 9.
The Danish Council of Ethics (1999), chapter 2.2.
- 10.
Hoedemaekers (1999), pp. 209–211.
- 11.
- 12.
It is, for example, commonplace in the medical literature to find talk about screening cells (when analysing them in a laboratory), of screening the organs of one single individual (e.g. in obstetric ultrasound), or even when referring to the application of any testing procedure on a single person in order to perform a diagnosis or risk assessment.
- 13.
Chadwick et al. (1999).
- 14.
Ioannou (1999).
- 15.
Marteau and Richards (1996).
- 16.
Sutton (2002).
- 17.
Gregg and Simpson (2002).
- 18.
Chadwick et al. (1999).
- 19.
This has been called an “inwards-out” approach to screening (Shickle and Harvey, 1993).
- 20.
- 21.
ESHG (2003), p. 5.
- 22.
- 23.
Kinzler et al. (2002).
- 24.
Wilson and Jungner (1968), pp. 35–37.
- 25.
Hoedemaekers (1999), p. 224.
- 26.
See Section 4.2.
- 27.
Shickle (1999), p. 11.
- 28.
In this definition, we are presupposing a broad sense of treatment, including e.g. dietary recommendations or counselling (see Section 2.1).
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Juth, N., Munthe, C. (2012). Introduction. In: The Ethics of Screening in Health Care and Medicine. International Library of Ethics, Law, and the New Medicine, vol 51. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2045-9_1
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