Consenting to uncertainty: Challenges for informed consent to disease screening—a case study [Book Review]

Theoretical Medicine and Bioethics 29 (6):371-386 (2008)
Abstract
This paper uses chronic beryllium disease as a case study to explore some of the challenges for decision-making and some of the problems for obtaining meaningful informed consent when the interpretation of screening results is complicated by their probabilistic nature and is clouded by empirical uncertainty. Although avoidance of further beryllium exposure might seem prudent for any individual whose test results suggest heightened disease risk, we will argue that such a clinical precautionary approach is likely to be a mistake. Instead, advice on the interpretation of screening results must focus not on risk per se, but on avoidable risk, and must be carefully tailored to the individual. These points are of importance for individual decision-making, for informed consent, and for occupational health.
Keywords Informed consent  Clinical uncertainty  Environmental health  Occupational health  Occupational disease  Disease screening  Risk  Risk control  Beryllium disease  Disease prevention  BeLPT  Beryllium lymphocyte proliferation test  Beryllium sensitization  Rational decision-making
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