Informed Decision-Making and Capabilities in Population-based Cancer Screening.

IF 1.4 3区哲学 Q2 ETHICS Public Health Ethics Pub Date : 2022-10-03 eCollection Date: 2022-11-01 DOI:10.1093/phe/phac023

Ineke L L E Bolt, Maartje H N Schermer, Hanna Bomhof-Roordink, Danielle R M Timmermans

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Abstract

Informed decision-making (IDM) is considered an important ethical and legal requirement for population-based screening. Governments offering such screening have a duty to enable invitees to make informed decisions regarding participation. Various views exist on how to define and measure IDM in different screening programmes. In this paper we first address the question which components should be part of IDM in the context of cancer screening. Departing from two diverging interpretations of the value of autonomy-as a right and as an ideal-we describe how this value is operationalized in the practice of informed consent in medicine and translate this to IDM in population-based cancer screening. Next, we specify components of IDM, which is voluntariness and the requirements of disclosure and understanding. We argue that whereas disclosure should contain all information considered relevant in order to enable authentic IDM, understanding of basic information is sufficient for a valid IDM. In the second part of the paper we apply the capability approach in order to argue for the responsibility of the government to warrant equal and real opportunities for invitees for IDM. We argue that additional conditions beyond mere provision of information are needed in order to do so.

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基于人口的癌症筛查中的知情决策和能力。

知情决策（IDM）被认为是人群筛查的一项重要伦理和法律要求。提供此类筛查的政府有责任让受邀者就参与筛查做出知情决定。对于如何定义和衡量不同筛查计划中的知情决策，存在不同的观点。在本文中，我们首先探讨的问题是，在癌症筛查的背景下，哪些内容应属于 "知情决策 "的一部分。从对自主价值的两种不同解释--作为一种权利和一种理想--出发，我们描述了在医学的知情同意实践中如何操作这一价值，并将其转化为基于人群的癌症筛查中的 IDM。接下来，我们具体说明了 IDM 的组成部分，即自愿性以及披露和理解的要求。我们认为，披露应包含所有被认为相关的信息，以实现真正的知情同意，而理解基本信息则足以实现有效的知情同意。在本文的第二部分，我们运用能力方法来论证政府有责任保证受邀者有平等和真实的机会参与国际移民管理。我们认为，要做到这一点，除了提供信息之外，还需要其他条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health Ethics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-MEDICAL ETHICS

CiteScore

3.10

自引率

9.50%

发文量

审稿时长

>12 weeks

期刊介绍： Public Health Ethics invites submission of papers on any topic that is relevant for ethical reflection about public health practice and theory. Our aim is to publish readable papers of high scientific quality which will stimulate debate and discussion about ethical issues relating to all aspects of public health. Our main criteria for grading manuscripts include originality and potential impact, quality of philosophical analysis, and relevance to debates in public health ethics and practice. Manuscripts are accepted for publication on the understanding that they have been submitted solely to Public Health Ethics and that they have not been previously published either in whole or in part. Authors may not submit papers that are under consideration for publication elsewhere, and, if an author decides to offer a submitted paper to another journal, the paper must be withdrawn from Public Health Ethics before the new submission is made. The editorial office will make every effort to deal with submissions to the journal as quickly as possible. All papers will be acknowledged on receipt by email and will receive preliminary editorial review within 2 weeks. Papers of high interest will be sent out for external review. Authors will normally be notified of acceptance, rejection, or need for revision within 8 weeks of submission. Contributors will be provided with electronic access to their proof via email; corrections should be returned within 48 hours.