Pairing accountability with responsibility – the consequences of screening ‘promotion’

摘要

The chain of accountability, beginning with the inadequate information provision to women being invited for mammographic screening over the last decade, against a background of changing attitudes in women and increased understanding of DCIS, and the consequences and effectiveness of mammographic screening, is explored. In particular, an example is used of family repercussions arising from facile, unjustified extrapolation by insurance brokers of genetic risk by use of the 'breast cancer' label in a case of diagnosis of screen-detected ductal carcinoma in situ (DCIS) to seek to unjustly deny, restrict or withhold. The question posed is: where does the responsibility lie for such a serious, previously unadvised repercussion in a public health programme imposed on `healthy` women, promoted to them in a coercive manner with unbalanced, inadequate information, and still not revised in the light of recent findings and GMC guidelines?