TY - JOUR T1 - Just caring: screening needs limits JF - Journal of Medical Ethics JO - J Med Ethics SP - 253 LP - 254 DO - 10.1136/medethics-2019-105884 VL - 46 IS - 4 AU - Leonard Michael Fleck Y1 - 2020/04/01 UR - http://jme.bmj.com/content/46/4/253.abstract N2 - 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. ER -