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Just caring: screening needs limits
  1. Leonard Michael Fleck
  1. Center for Ethics, Michigan State University, East Lansing, MI 48824, USA
  1. Correspondence to Professor Leonard Michael Fleck, Center for Ethics, Michigan State University, East Lansing, MI 48824, USA; fleck{at}msu.edu

Abstract

This personal narrative tugs at the heart strings. However, personal narratives are not sufficient to justify public funding for any screening policy. We have to take seriously the ‘just caring’ problem. We have only limited resources to meet virtually unlimited health care needs. No doubt, screening tests often save lives. The author wants public funding for prostate-specific antigen screening for prostate cancer. However, why only prostate cancer? Numerous cancers at various stages can be screened for. Are all of them equally deserving of public funding? What about screening for a very long list of other life-threatening medical disorders? There is nothing ethically special about cancer. Where does the money come from to pay for all these screening tests? Do we reduce expensive life-prolonging care for patients in late-stage diseases? Ultimately, a balance must be struck between saving statistical lives through screening and saving identifiable lives in the intensive care unit. Achieving a just balance requires rational democratic deliberation as justification for these choices, not personal narratives.

  • justice
  • genetic screening
  • cancer
  • statistical lives
  • democratic deliberation
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Footnotes

  • Contributors I am the sole author of this essay.

  • 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 None declared.

  • Patient consent for publication Not required.

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

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