Challenges of informed choice in organised screening
Context:Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives:To explore the decision-making process among women invited to a mammography screeni...
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| Veröffentlicht in: | Journal of medical ethics 2008-09, Vol.34 (9), p.e5-e5 |
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| creator | Østerlie, W Solbjør, M Skolbekken, J-A Hofvind, S Sætnan, A R Forsmo, S |
| description | Context:Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives:To explore the decision-making process among women invited to a mammography screening programme.Setting:Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program (NBCSP) in 2003.Methods:Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged 50–69 years.Results:The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion:In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. |
| doi_str_mv | 10.1136/jme.2008.024802 |
| format | Article |
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They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion:In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine.</description><identifier>ISSN: 0306-6800</identifier><identifier>EISSN: 1473-4257</identifier><identifier>DOI: 10.1136/jme.2008.024802</identifier><identifier>PMID: 18757624</identifier><identifier>CODEN: JMETDR</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and Institute of Medical Ethics</publisher><subject>Aged ; Attitude to Health ; Bioethics ; Breast cancer ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - prevention & control ; Brochures ; Decision making ; Decision Making - ethics ; Female ; Focus groups ; Humans ; Informed consent ; Informed Consent - ethics ; Mammography ; Mammography - ethics ; Mass Screening - ethics ; Medical screening ; Middle Aged ; Norway ; Personal Autonomy ; Qualitative research ; Risk Assessment ; Time Factors ; Womens health</subject><ispartof>Journal of medical ethics, 2008-09, Vol.34 (9), p.e5-e5</ispartof><rights>2008 BMJ Publishing Group Ltd and the Institute of Medical Ethics</rights><rights>Copyright: 2008 2008 BMJ Publishing Group Ltd and the Institute of Medical Ethics</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b396t-9082a1e1c77e242e75c1256bf41c8e948e2efb3c2da9352c90ca1906e942927c3</citedby><cites>FETCH-LOGICAL-b396t-9082a1e1c77e242e75c1256bf41c8e948e2efb3c2da9352c90ca1906e942927c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jme.bmj.com/content/34/9/e5.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jme.bmj.com/content/34/9/e5.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77343,77374</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18757624$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Østerlie, W</creatorcontrib><creatorcontrib>Solbjør, M</creatorcontrib><creatorcontrib>Skolbekken, J-A</creatorcontrib><creatorcontrib>Hofvind, S</creatorcontrib><creatorcontrib>Sætnan, A R</creatorcontrib><creatorcontrib>Forsmo, S</creatorcontrib><title>Challenges of informed choice in organised screening</title><title>Journal of medical ethics</title><addtitle>J Med Ethics</addtitle><description>Context:Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives:To explore the decision-making process among women invited to a mammography screening programme.Setting:Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program (NBCSP) in 2003.Methods:Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged 50–69 years.Results:The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion:In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine.</description><subject>Aged</subject><subject>Attitude to Health</subject><subject>Bioethics</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - prevention & control</subject><subject>Brochures</subject><subject>Decision making</subject><subject>Decision Making - ethics</subject><subject>Female</subject><subject>Focus groups</subject><subject>Humans</subject><subject>Informed consent</subject><subject>Informed Consent - ethics</subject><subject>Mammography</subject><subject>Mammography - ethics</subject><subject>Mass Screening - ethics</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Norway</subject><subject>Personal Autonomy</subject><subject>Qualitative research</subject><subject>Risk Assessment</subject><subject>Time Factors</subject><subject>Womens health</subject><issn>0306-6800</issn><issn>1473-4257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>AVQMV</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>K50</sourceid><sourceid>M1D</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1rGzEQhkVpqB23596KodBDYJ3RaFcfx-AmacAkl9Q9Cq08a6-zH45kQ_PvI7OmgVyqyyDNM--Ih7GvHGacC3m5bWmGAHoGmGvAD2zMcyWyHAv1kY1BgMykBhix8xi3kA5q84mNuFaFkpiPWT7fuKahbk1x2lfTuqv60NJq6jd97Sndp31Yu66O6S36QNTV3fozO6tcE-nLqU7Y75vrx_mvbPFweze_WmSlMHKfGdDoOHGvFGGOpArPsZBllXOvyeSakKpSeFw5Iwr0BrzjBmRqoUHlxYT9GHJ3oX8-UNzbto6emsZ11B-ilSkDwfAEfn8HbvtD6NLfLFeagxLIVaIuB8qHPsZAld2FunXhxXKwR5026bRHnXbQmSa-nXIPZbLyxp_8JSAbgDru6e-_vgtPViqhCnu_nFu-1D__wPLWLhJ_MfBlu_3v9lfXEYpc</recordid><startdate>200809</startdate><enddate>200809</enddate><creator>Østerlie, W</creator><creator>Solbjør, M</creator><creator>Skolbekken, J-A</creator><creator>Hofvind, S</creator><creator>Sætnan, A R</creator><creator>Forsmo, S</creator><general>BMJ Publishing Group Ltd and Institute of Medical Ethics</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>AABKS</scope><scope>ABSDQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AVQMV</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K50</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1D</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>200809</creationdate><title>Challenges of informed choice in organised screening</title><author>Østerlie, W ; Solbjør, M ; Skolbekken, J-A ; Hofvind, S ; Sætnan, A R ; Forsmo, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b396t-9082a1e1c77e242e75c1256bf41c8e948e2efb3c2da9352c90ca1906e942927c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Attitude to Health</topic><topic>Bioethics</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - prevention & control</topic><topic>Brochures</topic><topic>Decision making</topic><topic>Decision Making - ethics</topic><topic>Female</topic><topic>Focus groups</topic><topic>Humans</topic><topic>Informed consent</topic><topic>Informed Consent - ethics</topic><topic>Mammography</topic><topic>Mammography - ethics</topic><topic>Mass Screening - ethics</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Norway</topic><topic>Personal Autonomy</topic><topic>Qualitative research</topic><topic>Risk Assessment</topic><topic>Time Factors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Østerlie, W</creatorcontrib><creatorcontrib>Solbjør, M</creatorcontrib><creatorcontrib>Skolbekken, J-A</creatorcontrib><creatorcontrib>Hofvind, S</creatorcontrib><creatorcontrib>Sætnan, A R</creatorcontrib><creatorcontrib>Forsmo, S</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>Philosophy Collection</collection><collection>Philosophy Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Arts Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Art, Design & Architecture Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Arts & Humanities Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Social Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of medical ethics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Østerlie, W</au><au>Solbjør, M</au><au>Skolbekken, J-A</au><au>Hofvind, S</au><au>Sætnan, A R</au><au>Forsmo, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Challenges of informed choice in organised screening</atitle><jtitle>Journal of medical ethics</jtitle><addtitle>J Med Ethics</addtitle><date>2008-09</date><risdate>2008</risdate><volume>34</volume><issue>9</issue><spage>e5</spage><epage>e5</epage><pages>e5-e5</pages><issn>0306-6800</issn><eissn>1473-4257</eissn><coden>JMETDR</coden><abstract>Context:Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives:To explore the decision-making process among women invited to a mammography screening programme.Setting:Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program (NBCSP) in 2003.Methods:Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged 50–69 years.Results:The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion:In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and Institute of Medical Ethics</pub><pmid>18757624</pmid><doi>10.1136/jme.2008.024802</doi></addata></record> |
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| subjects | Aged Attitude to Health Bioethics Breast cancer Breast Neoplasms - diagnostic imaging Breast Neoplasms - prevention & control Brochures Decision making Decision Making - ethics Female Focus groups Humans Informed consent Informed Consent - ethics Mammography Mammography - ethics Mass Screening - ethics Medical screening Middle Aged Norway Personal Autonomy Qualitative research Risk Assessment Time Factors Womens health |
| title | Challenges of informed choice in organised screening |
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