University of Sydney, Sydney, NSW
University of Notre Dame, Sydney, NSW.
Med J Aust. 2015 Oct 19;203(8):335. doi: 10.5694/mja15.00164.
To elicit the views of well informed community members on the ethical obligations of general practitioners regarding prostate-specific antigen (PSA) testing, and what should be required before a man undergoes a PSA test.
Three community juries held at the University of Sydney over 6 months in 2014.
Forty participants from New South Wales, of diverse social and cultural backgrounds and with no experience of prostate cancer, recruited through public advertising: two juries of mixed gender and ages; one all-male jury of PSA screening age.
In contrast to Royal Australian College of General Practitioners guidelines, the three juries concluded that GPs should initiate discussions about PSA testing with asymptomatic men over 50 years of age. The mixed juries voted for GPs offering detailed information about all potential consequent benefits and harms before PSA testing, and favoured a cooling-off period before undertaking the test. The all-male jury recommended a staggered approach to providing information. They recommended that written information be available to those who wanted it, but eight of the 12 jurors thought that doctors should discuss the benefits and harms of biopsy and treatment only after a man had received an elevated PSA test result.
Informed jury participants preferred that GPs actively supported individual men in making decisions about PSA testing, and that they allowed a cooling-off period before testing. However, men of screening age argued that uncertain and detailed information should be communicated only after receiving an elevated PSA test result.
了解知情社区成员对全科医生在前列腺特异性抗原（PSA）检测方面的道德义务的看法，以及在男性进行 PSA 检测之前应要求哪些内容。
2014 年在悉尼大学进行的为期 6 个月的三次社区陪审团。
来自新南威尔士州的 40 名参与者，具有不同的社会和文化背景，没有前列腺癌的经验，通过公开广告招募：两个混合性别和年龄的陪审团；一个 PSA 筛查年龄的全男性陪审团。
与澳大利亚皇家全科医生学院的指南相反，三个陪审团得出的结论是，全科医生应该与 50 岁以上无症状男性开始讨论 PSA 检测。混合陪审团投票赞成 GP 在进行 PSA 检测之前向男性提供有关所有潜在的后续益处和危害的详细信息，并赞成在进行检测之前有冷静期。全男性陪审团建议采用分阶段的方法提供信息。他们建议向有需要的人提供书面信息，但 12 名陪审员中有 8 名认为医生应该在男性接受 PSA 检测结果升高后才讨论活检和治疗的益处和危害。
知情陪审团参与者更喜欢 GP 积极支持个别男性做出 PSA 检测决策，并允许在检测前有冷静期。然而，筛查年龄的男性认为，只有在收到 PSA 检测结果升高后，才能传达不确定和详细的信息。
