ABSTRACT
Two aspects of screening, namely ethics and audit or quality control, form the substance of this chapter and are of the utmost importance. Ethical considerations, such as the harm-to-benefit ratio, must be paramount whenever a screening programme is considered for implementation. In the same way, audit, evaluation and quality control are essential elements without which screening is at best useless and at worst immoral. Screening differs significantly from normal medical practice. In traditional medical practice individuals seek help from a doctor because they have symptoms and want to be reassured or diagnosed and treated appropriately. The public perception of screening – often encouraged by the media – tends to be positive despite these complex ethical considerations. Many believe that early diagnosis, particularly of cancer and heart disease, will lead to the possibility of treatment and improvement in prognosis. Through advances in technology, the potential for testing – particularly in the field of genetics – is immense.
