Screening in the Dark: Ethical Considerations of Providing Screening Tests to Individuals When Evidence is Insufficient to Support Screening Populations

American Journal of Bioethics 9 (4):3-14 (2009)


During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions.

Download options


    Upload a copy of this work     Papers currently archived: 72,856

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library


Added to PP

25 (#461,226)

6 months
1 (#386,040)

Historical graph of downloads
How can I increase my downloads?

Similar books and articles

The Ethics of Krabbe Newborn Screening.R. H. Dees & J. M. Kwon - 2013 - Public Health Ethics 6 (1):114-128.
The Ethics of Genetic Screening in the Workplace.Joseph Kupfer - 1993 - Business Ethics Quarterly 3 (1):17-25.