The Role of Fear in Overdiagnosis and Overtreatment

Chapter
First Online:
Part of the Current Clinical Urology book series (CCU)

Abstract

Existential fear, systematically exacerbated in the interests of corporate profit and professional and political advancement, is driving medicine to deliver significant harms alongside undoubted benefits. The inflation and exploitation of risk drive overdiagnosis and overtreatment which cause harm to patients, undermine the role of doctors and threaten the viability of healthcare systems.

Keywords

Fear Risk Wishful thinking Vested interest Profit Overdiagnosis Overtreatment 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Sen A. The idea of justice. London: Allen Lane; 2009.Google Scholar
  2. 2.
    Agathon 448–400 BCE. Quoted by Aristotle in Poetics, 335BCE.Google Scholar
  3. 3.
    Illich I. Limits to medicine. London: Marion Boyars Publishers; 1975.Google Scholar
  4. 4.
    Freemantle N, Hill S. Medicalisation, limits to medicine, or never enough money to go around? BMJ. 2002;324:864–5.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Eliot G. Daniel Deronda. 1876.Google Scholar
  6. 6.
    Butler K. What broke my father’s heart. The New York Times. June 18, 2010.Google Scholar
  7. 7.
    Callahan D. The Difficult Child of Medical Progress. Bioethics Forum. 2012.Google Scholar
  8. 8.
    Royal College of Psychiatrists. Vulnerable patients, vulnerable doctors: good practice in our clinical relationships. London: Royal College of Psychiatrists; 2002.Google Scholar
  9. 9.
    Lupton D. Risk as moral danger: the social and political functions of risk discourse in public health. Int J Health Serv. 1993;23(3):425–35.CrossRefPubMedGoogle Scholar
  10. 10.
    Forster EM. Howards end. 1910.Google Scholar
  11. 11.
    Sen A. Health: perception versus observation. BMJ. 2002;324:860–1.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Korzybski A. Science and sanity: an introduction to non-Aristotelian systems and general semantics. New York: International Non-Aristotelian Library Publications; 1933.Google Scholar
  13. 13.
    Schön DA. The reflective practitioner: how professionals think in action. New York: Basic Books; 1983.Google Scholar
  14. 14.
    Pakman M. On imagination: reconciling knowledge and life, or what does Gregory Bateson stand for? Fam Process. 2004;43(4):413–23.CrossRefPubMedGoogle Scholar
  15. 15.
    Kleinman A. Patients and healers in the context of culture. Berkeley: University of California Press; 1980.Google Scholar
  16. 16.
    Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366. doi: 10.1136/bmj.g366.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Esserman L, Shieh Y, Thompson I. Rethinking screening for breast cancer and prostate cancer. JAMA. 2009;302(15):1685–92.CrossRefPubMedGoogle Scholar
  18. 18.
  19. 19.
    Scheffler RM, Hinshaw SP, Modrek S, Levine P. The global market for ADHD medications. Health Aff. 2007;26(2):450–7.CrossRefGoogle Scholar
  20. 20.
    Gawande A. Letting Go. New Yorker. 27 July 2010.Google Scholar
  21. 21.
    Conrad J. The Nigger of the ‘Narcissus’. 1897.Google Scholar
  22. 22.
    McCormick J. Health promotion: the ethical dimension. Lancet. 1994;344:390–1.CrossRefPubMedGoogle Scholar
  23. 23.
    Bauman Z. Alone again: ethics after uncertainty. London: Demos; 1994.Google Scholar
  24. 24.
    Williams J. Stoner. New York: The Viking Press, 1965.Google Scholar
  25. 25.
    Bellow S. Mr Sammler’s Planet. New York: The Viking Press, 1970.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Royal College of General PractitionersLondonUK

Personalised recommendations