Screening asymptomatic citizens and expanding disease definitions

In their bmj article of 9th May 2016, ‘“Informed Choice” in a time of too much medicine – no panacea for ethical difficulties’, Minna Johannson and colleagues discuss issues of patient autonomy and over-medicalisation; they illustrate the dangers of diagnostic ‘cascade’ (where one test leads to eg a series of tests or interventions) and explain how ‘preventive medicine and expanding disease definitions have changed the ethical premises of informed choice’ and can lead to overmedicalisation.

They warn: ‘informed choice implicitly suggests that information is inherently good’, however: ‘in medical reality, the choice is often undermined by biased information giving weight to the potential benefits and downplaying the risk of harm from false positive results and overdiagnosis’.

“Informed Choice” in a time of too much medicine – no panacea for ethical difficulties. Minna Johannson, Karsten Juhl Jorgensen, Lynn Getz, Ray Moynihan

BMJ 2016;353:i2230


About bmitzi

Medical writer, author, artist. Cancer campaigner. Aiming always to improve health services and bring compassion into health care.
This entry was posted in Breast Cancer, breast screening, Campaigns, citizen safety, Compassion in healthcare, harms, healthcare modernisation, information, informed consent, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, patient safety, patient/doctor communication, personal autonomy, Public safety, rarer and uncommon cancers, Screening, Screening Mammography, screening prostate cancer and tagged , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

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