RT Journal Article SR Electronic T1 Informed choice requires information about both benefits and harms JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 268 OP 269 DO 10.1136/jme.2008.027961 VO 35 IS 4 A1 K J Jørgensen A1 J Brodersen A1 O J Hartling A1 M Nielsen A1 P C Gøtzsche YR 2009 UL http://jme.bmj.com/content/35/4/268.abstract AB A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and the legislation on informed consent, and violates the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material.