筛查的伦理问题：“筛查狂热症”是一种不治之症吗？
The ethics of screening: is 'screeningitis' an incurable disease?
作者信息
Shickle D, Chadwick R
机构信息
Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff.
出版信息
J Med Ethics. 1994 Mar;20(1):12-8. doi: 10.1136/jme.20.1.12.
Abstract
Screening programmes are becoming increasingly popular since prevention is considered 'better than cure'. While earlier diagnosis may result in more effective treatment for some, there will be consequent harm for others due to anxiety, stigma, side-effects etc. A screening test cannot guarantee the detection of all 'abnormal' cases, therefore there will be false reassurance for some. A proper consideration of the potential benefit and harm arising from screening may lead to the conclusion that the programme should not be offered. A modified utilitarian approach may be used for allocation of scarce resources in health care. Ethics has an important role in this evaluation.
摘要
由于预防被认为“优于治疗”，筛查项目正变得越来越受欢迎。虽然早期诊断可能对一些人带来更有效的治疗，但对另一些人来说，由于焦虑、污名化、副作用等原因，会随之产生伤害。一项筛查测试无法保证检测出所有“异常”病例，因此会让一些人得到虚假的安心。对筛查所产生的潜在益处和危害进行适当考量，可能会得出不应提供该项目的结论。一种改良的功利主义方法可用于医疗保健领域稀缺资源的分配。伦理学在这一评估中发挥着重要作用。
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本文引用的文献
1
Response to: What counts as success in genetic counselling?对《基因咨询中的成功标准是什么？》的回应
J Med Ethics. 1993 Mar;19(1):47-9. doi: 10.1136/jme.19.1.47.
2
The William Allan Memorial Award Address: evolution of a palatable multifactorial threshold model.威廉·艾伦纪念奖演讲：一个易于接受的多因素阈值模型的演变
Am J Hum Genet. 1980 Nov;32(6):796-813.
3
Why is preventive medicine exempted from ethical constraints?为什么预防医学不受伦理约束？
J Med Ethics. 1990 Dec;16(4):187-90. doi: 10.1136/jme.16.4.187.
4
Is non-directive genetic counselling possible?非指导性遗传咨询是否可行？
Lancet. 1991 Oct 19;338(8773):998-1001. doi: 10.1016/0140-6736(91)91849-p.
5
Priority setting: lessons from Oregon.优先事项设定：来自俄勒冈州的经验教训。
Lancet. 1991 Apr 13;337(8746):891-4. doi: 10.1016/0140-6736(91)90213-9.
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