The Ethics of Screening in Health Care and Medicine

"The description of the different types of screening offered to the population is characterized by a high level of completeness and exhaustive documentation. It includes the most recent developments in this field, offering even to non-expert readers the possibility of acquiring a good level of knowledge. ... All the chapters of the book are full of complete and updated information from the scientific literature, using language accessible to non-experts, and integrated with useful notes." (Lorenzo Simonato, Theoretical Medicine and Bioethics, Vol. 36, 2015) "The book that came into being is the first comprehensive work on the ethical issues related to screening in medicine. ... The Ethics of Screening in Health Care and Medicine is practical philosophy at its best: scientifically well informed, balanced, carefully argued and highly relevant for the practice of medicine and health care." (Pekka Louhiala, Medicine, Health Care and Philosophy, February, 2012) "This book broadly investigates the ethics associated with screening programs done in both clinical and public health settings. ... The audience may include advanced ethics students, scholars, practitioners, and especially health policymakers (particularly those involved in the establishment and evaluation of screening programs). ... This book may be of interest to individuals searching for more guidance on Wilson and Jungner's principles ... ." (Bradley Steven Olsen Thornock, Doody's Review Service, March, 2012)

Acknowledgements Chapter 1: Introduction 1.1 The Wilson and Jungner Criteria 1.2 Point and Plan 1.3 The Concept of Screening Chapter 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 Autonomy 2.3.1 Respecting and Promoting Autonomy 2.3.2 Promoting Autonomy through Screening 2.4 Justice 2.5 Summary Chapter 3: Screening - What, When and Whom? 3.1 Diseases and Groups 3.1.1 Prenatal Screening 3.1.2 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 Maker 3.1.4 Adult Screening 3.2 Testing and Analysis 3.2.1 Safety3.2.2 Validity 3.2.3 Predictive Value 3.3 Treatments 3.3.1 Abortion as Treatment 3.3.2 Counselling as Treatment 3.4 Summary Chapter 4: Screening - How? 4.1 Informed Consent 4.2 Counselling 4.2.1 Genetic Counselling as a Template 4.2.2 Expansion: Shared Decision Making 4.3 Funding and Participation 4.4 Summary Chapter 5: Case Studies 5.1 Non-Invasive Prenatal Diagnosis 5.2 Neonatal Screening for Fragile X 5.3 Mammography Screening 5.4 PSA Screening for Prostate Cancer Chapter 6: Serving Society or Serving the Patient? 6.1 Summary of the Analysis So far 6.2 The Public Health - Health Care Tension Area 6.3 The Relevance of a Social Science Perspective 6.4 An Institutional Approach to health-related Ethics: A Sketch 6.5 Applying the Institutional Approach: Three Cases 6.5.1 Institutions, Functions and Ethics: Reproductive Care vs. Communicable Disease 6.5.2 Direct to Consumer Genetic Testing: The Limits of Context Relativity 6.5.3 Screening and Justice: The Case Against Allocating Health Care Resources to Screening 6.6 Revisiting the Wilson and Jungner Criteria for Screening 6.7 Closing