ReviewCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1996
Prevention. How much harm? How much benefit? 4. The ethics of informed consent for preventive screening programs.
Review in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Non-maleficence and the ethics of consent to cancer screening.Journal of medical ethics · 2020Article
- Article
- Shared decision making in preventive health care: What it is; what it is not.Canadian family physician Medecin de famille canadien · 2017Article
- Mass screening for celiac disease from the perspective of newly diagnosed adolescents and their parents: a mixed-method study.BMC public health · 2011Article
- Screening and the family physician.Canadian family physician Medecin de famille canadien · 2009Article
- Using disease risk estimates to guide risk factor interventions: field test of a patient workbook for self-assessing coronary risk.Health expectations : an international journal of public participation in health care and health policy · 2002Article
- Physician-patient discussions of controversial cancer screening tests.American journal of preventive medicine · 2001Article
- Preventive medicine in people at high risk for chronic disease: the value of identifying and treating diabetes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999Article
- The folly of population screening for type 2 diabetes.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999Article
- Primary prevention of heart disease and stroke: a simplified approach to estimating risk of events and making drug treatment decisions.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1997Review
- National evidence on the use of shared decision making in prostate-specific antigen screening.Annals of family medicineArticle
Corrections and comments
- Commented on by
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Preventive interventions may have few or unproven benefits, or they may even be harmful. Since three of the fundamental precepts of Western biomedical ethics are beneficence, non-maleficence and respect for individual autonomy, failure to obtain truly informed consent for many current preventive interventions may be unethical. However, there are many impediments to obtaining such consent. Physicians need to be aware of an immense amount of up-to-date, complex information. It may be difficult for patients to assimilate this information, and there is rarely time for physicians to become informed and to inform their patients. Clinical practice guidelines may be helpful, but not all are based on evidence, and recommendations are often conflicting. Medical institutions, as well as individual clinicians, can help solve these dilemmas. Authors and journal editors can make a commitment to report and publish well-referenced evidence-based guidelines. Organizations such as the Canadian Task Force on the Periodic Health Examination and the US Preventive Services Task Force can develop balanced, evidence-based patient-information material. Faculty at all levels of medical education can increase their emphasis on the ethics of prevention. Individual clinicians should avoid making clinical decisions on the basis of relative reductions of morbidity or mortality, should use evidence-based clinical practice guidelines rather than those based on authority whenever possible, should make use of patient-information material and, most important, should have a consistent policy of obtaining informed consent from patients before they participate in potentially harmful preventive programs.
Indexed as
Identifiers
8752062PMC1488063What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.