Navigating the Uncertainties of Screening Key note speakers

Screening programmes are social interventions as much as they are medical interventions, and can pose challenging ethical, legal and social dilemmas. The sociological scrutiny of screening can be particularly useful both in informing the development and implementation of screening programmes, but also in developing sociological theory.

Debates and controversies about screening are rarely confined to policy makers and health professionals. Contestations about the science underlying population screening are common, and frequently enter the public sphere, engaging with wider societal themes and normative questions. The difficulty of establishing a screening test with maximum sensitivity and specificity (thereby avoiding as many false negative and false positive results as possible) is often underestimated and underrepresented in the popular press. Instead, pleas for new or extended screening programmes typically draw on discourses of rights or entitlements rather than the need to balance possible harms and benefits.

Recent years have seen a marked shift, at least in policy terms, towards screening based on an individual’s informed consent, having weighed up the possible harms and benefits, rather than on an expectation of attendance. In turn, an increased focus on possible harms is evident within information material sent to those invited, and tools to help people make decisions about attendance are beginning to emerge. This paper will explore some of the challenges involved in trying to achieve this informed consent model in practice.