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  • Incision or insertion makes a medical intervention invasive. Commentary on ‘What makes a medical intervention invasive?’

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Commentary
Incision or insertion makes a medical intervention invasive. Commentary on ‘What makes a medical intervention invasive?’
  1. Paul Affleck1,
  2. Julia Cons2,
  3. Simon E Kolstoe3
  1. 1 University of Leeds Faculty of Medicine and Health, Leeds, UK
  2. 2 University of Nottingham, Nottingham, UK
  3. 3 School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
  1. Correspondence to Mr Paul Affleck, University of Leeds Faculty of Medicine and Health, Leeds, UK; p.a.affleck{at}leeds.ac.uk

https://doi.org/10.1136/jme-2023-109733

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    De Marco and colleagues claim that the standard account of invasiveness as commonly encountered ‘…does not capture all uses of the term in relation to medical interventions1 ’. This is open to challenge. Their first example is ‘non-invasive prenatal testing’. Because it involves puncturing the skin to obtain blood, De Marco et al take this as an example of how an incision or insertion is not sufficient to make an intervention invasive; here is a procedure that involves an incision, but it is regarded as non-invasive. However, this ignores the context, and the term should really be understood in reference to the fetus. It is hard to believe healthcare professionals regard taking blood to measure, for example, ferritin levels as invasive but taking blood to look for fragments of fetal DNA as not. If anyone uses the term thinking it is not invasive to the mother, the solution would be to call it invasive, not redefine what is invasive.

    Is electroconvulsive therapy invasive?

    De Marco and colleagues’ second example is describing electroconvulsive therapy (ECT) as invasive. However, this is not borne out by their referenced papers. The first cited source is about non-invasive brain stimulation2 and only contains a single sentence about ECT. This sentence may suggest that their view is that ECT …

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    Footnotes

    • Contributors All authors have contributed to the writing of the commentary.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PA is a programme manager for the UK Colorectal Cancer Intelligence Hub, which is supported by Cancer Research UK (grant C23434/A23706). He is also a Specialist Ethics Adviser and Co-Deputy Chair of the Interim Data Advisory Group at NHS England and a lay member of the Ministry of Defence Research Ethics Committee. JC is a Vice Chair of the Ministry of Defence Research Ethics Committee, an Independent Chair of NHS England’s Individual Funding Request Panel, a Commissioner on the Commission on Human Medicines and a Vice Chair of NHS England’s Specialised Commissioning Patient and Public Voice Assurance Group. SEK chairs research ethics committees for the UK’s Ministry of Defence, Health Research Authority and Health Security Agency. He receives income from consulting, writing, teaching and lecturing in research ethics.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    Linked Articles

    • Feature article
      What makes a medical intervention invasive?
      Gabriel De Marco Jannieke Simons Lisa Forsberg Thomas Douglas
      Journal of Medical Ethics 2023; 50 226-233 Published Online First: 18 Sep 2023. doi: 10.1136/jme-2023-109301

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