Theoretical Medicine and Bioethics

, Volume 29, Issue 6, pp 371–386 | Cite as

Consenting to uncertainty: challenges for informed consent to disease screening—a case study

  • Mark Greene
  • Suzanne M. Smith


This paper uses chronic beryllium disease as a case study to explore some of the challenges for decision-making and some of the problems for obtaining meaningful informed consent when the interpretation of screening results is complicated by their probabilistic nature and is clouded by empirical uncertainty. Although avoidance of further beryllium exposure might seem prudent for any individual whose test results suggest heightened disease risk, we will argue that such a clinical precautionary approach is likely to be a mistake. Instead, advice on the interpretation of screening results must focus not on risk per se, but on avoidable risk, and must be carefully tailored to the individual. These points are of importance for individual decision-making, for informed consent, and for occupational health.


Informed consent Clinical uncertainty Environmental health Occupational health Occupational disease Disease screening Risk Risk control Beryllium disease Disease prevention BeLPT Beryllium lymphocyte proliferation test Beryllium sensitization Rational decision-making 


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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  1. 1.Department of PhilosophyUniversity of DelawareNewarkUSA
  2. 2.CADDRE Education and Outreach ManagerUniversity of Pennsylvania School of NursingPhiladelphiaUSA

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