[Screening induced by health services: impact and consequences. Ethical issues]

Area of Science:

• Public Health
• Preventive Medicine
• Health Policy

Background:

• Screening identifies individuals likely to benefit from primary or secondary preventive interventions.
• Early diagnosis and treatment improve prognosis, while recognizing risk factors aids disease prevention.
• Effective screening requires systematic assessment beyond good intentions, considering health impacts and service delivery.

Purpose of the Study:

• To emphasize the necessity of systematically assessing screening interventions.
• To highlight the importance of evaluating effectiveness, safety, efficiency, and equity.
• To underscore the ethical considerations in public health screening programs.

Main Methods:

• Review of existing screening assessment practices.
• Analysis of ethical principles (autonomy, benefit, safety, justice) applied to screening.
• Exploration of citizen participation in setting preventive priorities.

Main Results:

• Limited systematic assessments of screening benefits and harms exist, particularly in Spain.
• Current assessments often focus on processes rather than health outcomes.
• Ethical principles are vital for designing and implementing screening policies.

Conclusions:

• Screening programs must be rigorously evaluated for effectiveness, safety, efficiency, and equity.
• Programs failing to meet ethical standards should be discontinued.
• Active citizen participation is recommended for prioritizing and assessing screening interventions.