New Book Explores the Ethics of Medical Screening Programmes

In a new book published by Springer, Christian Munthe, Professor of practical philosophy, and Niklas Juth (Karolinska Institute) present a seminal overarching analysis of the ethical and political issues that are actualised of so-called screening programmes in health care and medicine.

In a screening programme, medical test are offered to large groups of people that are not normally aware that they may run increased risks of various health problems. A well-known example is the blood samples taken from newborns in all developed countries since the 1960's, with the purpose of discovering a number of rare genetic diseases. But also programmes designed to monitor the development of children run in most countries are screening. Examples of debated screening programmes are prenatal diagnostic investigations offered to all pregnant women, mammography and screening for prostate cancer.

The title of the book is The Ethics of Screening in Health Care and Medicine: Serving Society or Serving the Patient? and starts off from what is special about screening compared to other ways of organising health care interventions. The analysis shows that screening is based on a tension between two partly conflicting perspectives: one health care ethical and one public health ethical. Within that frame, well-known health care ethical problems are becoming more severe, such as respecting the autonomy and self-determiniation of patients. Screening also brings salient risks of effecting more harm than good. At the same time, screening is attracting a particular pull on medical professionals and institutions, since being in charge of a screening programme means that society makes considerable resources available. The authors present a model for ethical analysis built on looking at screening programmes as institutions in themselves that transgresses the borders of different societal sectors. It is argued that society should be quiet restrictive against letting the use of tests in the routine health care situation expand into screening programmes.

The book is also published in an e-book version and a sample of the book can be found at Google Books.