Abstract
BackgroundThe French national cancer institute (INCa) conducted a series of studies to assist decision-making in view of the implementation of organised cervical cancer screening that will be launched in 2018. The programme will concern all women aged 25–65 and targeted interventions will be developed for underscreened populations. This is an evolution from an equality-based approach to a step-by-step strategy of equity aiming to tackle health cancer inequalities that are avoidable and represents unfair differences. Here we present the work of the expert-group in ethics drafted by INCa to review the ethical issues prior to the programme implementation.DiscussionWe discuss the value of such a strategy and presents reflections with regard to issues of stigmatization, respect for individual freedom and autonomy. Indeed, the balance has to be found between the search for beneficence and the potential occurrence of perverse effects, which should be considered with particular attention.ConclusionMoving toward an equity-oriented policy under a strategy of proportionate universalism faces a number of challenges, thus an overview of ethics and social sciences must be an integral part of the process.
Highlights
DiscussionWe discuss the value of such a strategy and presents reflections with regard to issues of stigmatization, respect for individual freedom and autonomy
The French national cancer institute (INCa) conducted a series of studies to assist decision-making in view of the implementation of organised cervical cancer screening that will be launched in 2018
Moving toward an equity-oriented policy under a strategy of proportionate universalism faces a number of challenges, an overview of ethics and social sciences must be an integral part of the process
Summary
A public health programme that aims at equity The efficacy of CC screening in reducing incidence and mortality is well recognized. It is essential to achieve the desired health objectives while minimising the degree of intrusion into the private sphere, and the benefit it generates must be justified [38, 39] This may lead to vigilance on how targeted actions may potentially conflict with respect for individual freedom and privacy according to the principle of autonomy. This calls for an evaluation of the degree of paternalism that can be justified and acceptable in the quest for the common good that is health [40,41,42,43]. The target actions aim at reinforcing information and awareness raising on access to screening within the framework of respect for autonomy and freedom to participate
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