Ethics of Screening: The act of screening is used to identify and detect people who have a disease.
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Epidemiologist use screening as a way of preventing the spread of disease, which has positive health outcomes. Epidemiologists implement different tests, exams, and other procedures in order to diagnose a disease that can be screened. Yet screening can have a controversial side as well. Distinguish between primary, secondary and tertiary prevention and emphasize the role of screening in secondary prevention. The key characteristics of diseases appropriate for screening will be identified as will the characteristics of a good screening test. Issues related to the evaluation of a screening program and biases that can be associated with a screening program are also reviewed. Ethics of Screening The decision about whether or not to screen for a condition can be quite controversial. However, even in the case of noncontroversial screening programs, such as blood pressure screening, there will always be factors that argue for and against the implementation of the screening program. In preparation for this week’s Discussion, consider the following controversial screenings: genetic screening for breast or prostate cancer, mandatory HIV screening, and obesity screening of school-aged children. Consider the pros and cons of screening for each of these health issues. a response to the following: Please describe the topic selected and give some background about factors that contribute to a decision whether or not to implement the screening program within the population at large or within a subgroup of the population. Choose and “claim” a side to argue—either pro or con—and provide an argument, supported by scholarly evidence and properly referenced, for the side you chose. (I choose genetic breast cancer) Course Text: Essentials of Epidemiology in Public Health Chapter 16, “Screening in Public Health Practice” Chapter 16 provides an overview of issues related to screening. It also explains the history of disease and the stages of prevention. It also identifies appropriate diseases for screening. Optional Activity Population Screening http://cphp.sph.unc.edu/training/HEP_POPSC/certificate.php In this module from the North Carolina Center for Public Health Preparedness, you will learn more about the requirements of screening programs, reliability and validity in screening, calculating sensitivity and specificity, and how to calculate predictive values. Optional Resource Article: Fields, M. M., & Chevlen, E. (2006). Ovarian cancer screening: A look at the evidence. Clinical Journal of Oncology Nursing, 10(1), 77–81. This article examines the effectiveness of screening for ovarian cancer. The problems are discussed along with the various screening options. Hargreaves, K. M., Stewart, R. J., & Oliver, S. R. (2005). Informed choice and public health screening for children: The case of blood spot screening. Health Expectations, 8(2), 161–171. Researchers in this study explore parent attitudes toward newborn screening. The pros and cons of screening are presented along with the differences among participant attitudes toward screening.
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