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Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context

Participation in medical screening programs is presented as a voluntary decision that should be based on an informed choice. An informed choice is often emphasized to rely on three assumptions: (1) the decision-maker has available information about the benefits and harms, (2) the decision-maker can...

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Autores principales: Gram, Emma Grundtvig, Jønsson, Alexandra Brandt Ryborg, Brodersen, John Brandt, Damhus, Christina Sadolin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178002/
https://www.ncbi.nlm.nih.gov/pubmed/37174772
http://dx.doi.org/10.3390/healthcare11091230
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author Gram, Emma Grundtvig
Jønsson, Alexandra Brandt Ryborg
Brodersen, John Brandt
Damhus, Christina Sadolin
author_facet Gram, Emma Grundtvig
Jønsson, Alexandra Brandt Ryborg
Brodersen, John Brandt
Damhus, Christina Sadolin
author_sort Gram, Emma Grundtvig
collection PubMed
description Participation in medical screening programs is presented as a voluntary decision that should be based on an informed choice. An informed choice is often emphasized to rely on three assumptions: (1) the decision-maker has available information about the benefits and harms, (2) the decision-maker can understand and interpret this information, and (3) the decision-maker can relate this information to personal values and preferences. In this article, we empirically challenge the concept of informed choice in the context of medical screening. We use document analysis to analyze and build upon findings and interpretations from previously published articles on participation in screening. We find that citizens do not receive neutral or balanced information about benefits and harms, yet are exposed to manipulative framing effects. The citizens have high expectations about the benefits of screening, and therefore experience cognitive strains when informed about the harm. We demonstrate that decisions about screening participation are informed by neoliberal arguments of personal responsibility and cultural healthism, and thus cannot be regarded as decisions based on individual values and preferences independently of context. We argue that the concept of informed choice serves as a power technology for people to govern themselves and can be considered an implicit verification of biopower.
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spelling pubmed-101780022023-05-13 Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context Gram, Emma Grundtvig Jønsson, Alexandra Brandt Ryborg Brodersen, John Brandt Damhus, Christina Sadolin Healthcare (Basel) Article Participation in medical screening programs is presented as a voluntary decision that should be based on an informed choice. An informed choice is often emphasized to rely on three assumptions: (1) the decision-maker has available information about the benefits and harms, (2) the decision-maker can understand and interpret this information, and (3) the decision-maker can relate this information to personal values and preferences. In this article, we empirically challenge the concept of informed choice in the context of medical screening. We use document analysis to analyze and build upon findings and interpretations from previously published articles on participation in screening. We find that citizens do not receive neutral or balanced information about benefits and harms, yet are exposed to manipulative framing effects. The citizens have high expectations about the benefits of screening, and therefore experience cognitive strains when informed about the harm. We demonstrate that decisions about screening participation are informed by neoliberal arguments of personal responsibility and cultural healthism, and thus cannot be regarded as decisions based on individual values and preferences independently of context. We argue that the concept of informed choice serves as a power technology for people to govern themselves and can be considered an implicit verification of biopower. MDPI 2023-04-26 /pmc/articles/PMC10178002/ /pubmed/37174772 http://dx.doi.org/10.3390/healthcare11091230 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gram, Emma Grundtvig
Jønsson, Alexandra Brandt Ryborg
Brodersen, John Brandt
Damhus, Christina Sadolin
Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title_full Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title_fullStr Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title_full_unstemmed Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title_short Questioning ‘Informed Choice’ in Medical Screening: The Role of Neoliberal Rhetoric, Culture, and Social Context
title_sort questioning ‘informed choice’ in medical screening: the role of neoliberal rhetoric, culture, and social context
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178002/
https://www.ncbi.nlm.nih.gov/pubmed/37174772
http://dx.doi.org/10.3390/healthcare11091230
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