Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs.

This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise - both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole?

These questions are addressedby applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to alarge number of ongoing and proposed screening programs whichmakes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public."

Medical or health-oriented screening programs are amongst the most debated aspects of health care and public health practices in health care and public health ethics, as well as health policy discussions. In spite of this, most treatments of screening in the research literature restrict themselves to isolated scientific aspects, sometimes complemented by economic analyses or loose speculations regarding policy aspects. At the same time, recent advances in medical genetics and technology, as well as a rapidly growing societal focus on public health concerns, inspires an increase in suggested or recently started screening programs.

This book involves an in-depth analysis of the ethical, political and philosophical issues related to health-oriented screening programs.It explores the considerations that arise when heath care interacts with other societal institutions on a large scale, as is the case with screening: What values may be promoted or compromised by screening programs? What conflicts of values do typically arise - both internally and in relation to the goals of health care, on the one hand, and the goals of public health and the general society, on the other? What aspects of screening are relevant for determining whether it should be undertaken or not and how it should be organised in order to remain defensible? What implications does the ethics of screening have for health care ethics as a whole?

These questions are addressedby applying philosophical methods of conceptual analysis, as well as models and theories from moral and political philosophy, medical ethics, and public health ethics, to alarge number of ongoing and proposed screening programs whichmakes this book the first comprehensive work on the ethics of screening. Analyses and suggestions are made that are of potential interest to health care staff, medical researchers, policy makers and the general public."

This book discusses the moral concerns due to the increasing possibilities to predict individuals' health on the basis of genetic testing. To what extent should such testing be performed? Which parties should be allowed to gain access to the results of such testing? The scope and limits of patients' right to know and not know are presented. It is also argued that patients' value of presymptomatic genetic testing ultimately rests on autonomy and subjective well-being. Moreover, a conception of autonomy is developed, which is useful to analyse the novel idea in this area that autonomy is a value that should be promoted. Regarding the question of blood relatives' rights to genetic information, it is argued that we should generally leave the decision to inform relatives to the tested person. The idea that genetic information belongs to a new paradigm of medical information that is communal in its nature is criticized. Broader societal questions regarding e.g. insurance companies' right to genetic information are also discussed. It is argued that the development of genetics strengthens the need for and defence of a comprehensive welfare state.

The result of two key social developments in recent years are examined here: the partial dismantling of the welfare state and the progress of genetics. Genetic insights are increasingly valuable for risk assessment, and insurers would like to use these insights to help determine premiums. Combined with the fact that social welfare is being curtailed, this could potentially create an uninsured high-risk population. Along with considerations of autonomy and privacy, this is the basis for an ethical critique of insurer's access to information. The result has often been regulation of such information; but the authors argues that due to adverse selection, regulation will not solve these problems, and this may jeopardize the survival of private personal insurance. Instead, we should look towards the resurrection of social insurance, a key component of the welfare state. This will interest academic researchers as well as professionals involved with genetics and insurance.

The authors of this study emphasize the effectiveness of collectively funded public insurances as opposed to genetic information regulation within the private insurance sector. Genetics has provided tools to determine individuals' risk of future disease, which is of key interest for insurance companies in determining insurance premiums; but persons with high enough risk may remain uninsured. For this reason, genetic information has been regulated. But, regulation may not be the solution, according to the authors, and they call for the resumption of social insurance, a key element of the welfare state.