The Ethics of Screening in Health Care and Medicine (eBook)

Serving Society or Serving the Patient?
eBook Download: PDF
2011 | 2012
X, 182 Seiten
Springer Netherland (Verlag)
978-94-007-2045-9 (ISBN)

Lese- und Medienproben

The Ethics of Screening in Health Care and Medicine - Niklas Juth, Christian Munthe
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Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs.

This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs. It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise - both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole?

These questions are addressed by applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to a large number of ongoing and proposed screening programs which makes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public.


Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs. This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs. It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise - both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole? These questions are addressed by applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to a large number of ongoing and proposed screening programs which makes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public.

AcknowledgementsChapter 1: Introduction 1.1 The Wilson and Jungner Criteria  1.2 Point and Plan 1.3 The Concept of ScreeningChapter 2: Why Screening? 2.1 Screening, Treatment and Prevention: Preliminary Remarks 2.2 Health: Life and Well-being 2.2.1 Health and Counselling 2.2.2 The Good of People and of the Population 2.3 Autonomy2.3.1 Respecting and Promoting Autonomy2.3.2 Promoting Autonomy through Screening 2.4 Justice 2.5 SummaryChapter 3: Screening – What, When and Whom? 3.1 Diseases and Groups3.1.1 Prenatal Screening3.1.2 Neonatal Screening  3.1.2.1 Reasons for Screening in the Neonatal Period  3.1.2.2 Neonatal Screening and Parental Informed Consent  3.1.2.3 Expanding Neonatal Screening – How Far?3.1.3 Child and Adolescent Screening  3.1.3.1 Stigmatisation  3.1.3.2 The Child as Decision Maker3.1.4 Adult Screening3.2 Testing and Analysis3.2.1 Safety3.2.2 Validity3.2.3 Predictive Value3.3 Treatments3.3.1 Abortion as Treatment3.3.2 Counselling as Treatment 3.4 SummaryChapter 4: Screening – How?4.1 Informed Consent4.2 Counselling4.2.1 Genetic Counselling as a Template4.2.2 Expansion: Shared Decision Making4.3 Funding and Participation 4.4 SummaryChapter 5: Case Studies5.1 Non-Invasive Prenatal Diagnosis5.2 Neonatal Screening for Fragile X5.3 Mammography Screening5.4 PSA Screening for Prostate CancerChapter 6: Serving Society or Serving the Patient?6.1 Summary of the Analysis So far6.2 The Public Health – Health Care Tension Area6.3 The Relevance of a Social Science Perspective6.4 An Institutional Approach to health-related Ethics: A Sketch6.5 Applying the Institutional Approach: Three Cases6.5.1 Institutions, Functions and Ethics: Reproductive Care vs. Communicable Disease 6.5.2 Direct to Consumer Genetic Testing: The Limits of Context Relativity6.5.3 Screening and Justice: The Case Against Allocating Health Care Resources to Screening6.6 Revisiting the Wilson and Jungner Criteria for Screening 6.7 Closing 

Erscheint lt. Verlag 20.9.2011
Reihe/Serie International Library of Ethics, Law, and the New Medicine
International Library of Ethics, Law, and the New Medicine
Zusatzinfo X, 182 p.
Verlagsort Dordrecht
Sprache englisch
Themenwelt Geisteswissenschaften Philosophie Allgemeines / Lexika
Medizin / Pharmazie Allgemeines / Lexika
Medizin / Pharmazie Medizinische Fachgebiete Medizinethik
Studium Querschnittsbereiche Geschichte / Ethik der Medizin
Studium Querschnittsbereiche Prävention / Gesundheitsförderung
Naturwissenschaften Biologie
Schlagworte Autonomy through Screening • Ethics of Screening • Future health problems • Medical Screening • Medical screening programs • neonatal screening • professional medical ethics • Public health screening • Screening in Health Carea • Screening in Medicine
ISBN-10 94-007-2045-9 / 9400720459
ISBN-13 978-94-007-2045-9 / 9789400720459
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