The Ethics of Screening in Health Care and Medicine: Serving Society or Serving the Patient?

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