Question

8) What ethical considerations should be taken to determine whether any given mass screening should take place?

Answer 1

8) What ethical considerations should be taken to determine whether any given mass screening should take place?

Answer: Screening is characterized as diagnostics on a large scale. The aim can be focused primarily on the individual or community and will often be a combination of the two approaches. Screening procedures ' morals can vary accordingly.

Screening can be split into three classes or categories to examine the ethical issues involved.

1. The first class involves screening as part of large-scale scientific projects aimed at determining the impact and benefit of the diagnostic intervention, or screening implemented as large-scale diagnostics without being part of a scientific project. As a fundamental part of the usual doctor-patient or patient / healthy volunteer-scientist relationship, informed consent is not accessible in the form of a positive response from individuals, only as a right to abstain at its best. In addition, both the informative and consenting aspects of this definition may be undermined in countries and regions with subtle infrastructure, analphabetism problems, etc., requiring informed consent from proxies. Even the demarcation of scientific prevention projects from traditional clinical projects is not always easy, and they share major ethical concerns, regardless of the number of patients or subjects involved. And while the numbers involved in large-scale diagnostic studies may be very high, particularly in multi-center projects within and between countries, sometimes the numbers involved in centrally administered prevention programs may be very low.

2. Depending on the level chosen, the second category of screening includes risk groups, pre-illness groups, and early morbid cases. Here the ethics will vary considerably, approaching the ethical demands of clinical practice when one moves to groups of early morbid cases from groups with minor risk. The presuppositions, information, and consent (at least the right to say no) are also crucial in this type of screening. There are possible ethical problems with the preventive or therapeutic consequences of diseases included in the screening program. If there are no preventive or therapeutic solutions, only prognostic advantages remain. In such cases, it must be considered whether knowledge of a serious prognosis will not be an intolerable burden on a patient, outweighing the benefits of allowing him or her to plan the remaining life according to this prognosis.

3. The third possible classification distinguishes testing in pre-natal and post-natal screening, not according to the nature of the illness but according to the course of life, with the latter further split into screening for children and adults. Again, category by category, the ethical issues vary considerably. Depending on different situations, special ethical issues can arise in prenatal screening. A screening program may target all pregnant women-that is, virtually a non-risk group, apart from the small overall pregnancy-related risk in a developed country. It is further influenced by the possibility of the pregnant woman refusing to participate, and by the balance between the gain of society through saved costs and attempts to protect the genetic mass on the one hand, and the individual's autonomy on the other. The moral dilemma can be compounded if concern emerges in the case of diagnosis of a congenital defect from diminished assistance from society to a family that rejects ante-natal testing or abortion. Mass screening in the worst case could induce a shift in the attitude of a particular society towards severe congenital malformations from the idea of Fate to that of a man-controlled, avoidable event involving an element of guilt.

In conclusion, we may conclude that ethical aspects of screening procedures and services will have to be dealt with and extended to the patient-doctor relationship and clinical research in keeping with the same ethical principles that have already been established.