ETHICAL CONSIDERATIONS IN THE PROVISION OF CONTROVERSIAL SCREENING-TESTS

Although preventive services are a cornerstone of primary care medicin e, few currently used screening tests have been demonstrated to be ben eficial. Insurance organizations, the media, public advocacy groups, a nd patient concerns often pressure physicians to provide screening tes ts of controversial value. Ethical analysis provides the basis for res ponding to screening requests in a responsible way. Physicians may use an evidence-based medicine strategy to approach controversial screeni ng tests. When physicians educate patients on the relative benefits an d harms of controversial screening tests, it is prudent to emphasize t hat a screening test can assure neither a disease-free nor a risk-free stale, Such preventive ethics efforts could discourage against the us e of controversial. screening tests. Physicians may articulate the bou ndaries of their own professional integrity in this process, for patie nts cannot compel physicians to render services that run counter to th eir best professional and ethical judgment.