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Informed choice requires information about both benefits and harms
K J Jørgensen1, J Brodersen, O J Hartling
1The Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark. kj@cochrane.dk
Journal of Medical Ethics
|April 1, 2009
Summary
Women are content with mammography screening invitations, but these paternalistic messages omit harms, violating informed consent. Invitations should offer balanced information, not encourage participation, respecting women's autonomy.
Area of Science:
- Public Health
- Medical Ethics
- Health Communication
Background:
- Mammography screening programs aim to reduce breast cancer mortality.
- Current invitations often use paternalistic language and pre-specified appointments.
- Participant satisfaction with screening programs has been observed.
Purpose of the Study:
- To critically evaluate the content and impact of mammography screening invitations.
- To assess whether current invitations facilitate informed decision-making and respect patient autonomy.
- To propose improvements for screening invitation materials.
Main Methods:
- Qualitative analysis of screening invitation content.
- Ethical review of communication strategies in public health programs.
- Review of legislation concerning informed consent.
Main Results:
- Women express satisfaction with current mammography screening invitations.
- Invitations are biased, omitting significant harms and encouraging participation.
- This approach undermines informed decision-making and violates patient autonomy.
Conclusions:
- Screening invitations must present benefits and harms equitably.
- Invitations should offer participation rather than encourage it, respecting the choice not to attend.
- Separating program management from information dissemination is crucial for ethical practice.
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