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EDITOR'S CHOICE: Fiona Godlee The ground or the goal posts? BMJ 2006; 332: 0-f [Full text]

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The next debate?

Graeme M Mackenzie   (21 March 2006)

The next debate? 21 March 2006
Graeme M Mackenzie, GP Whitehaven CA28 7RG Send response to journal: Re: The next debate?	If you screen for and treat low risk you have to know very well what the iatrogenic sequelae are from that strategy. Thus you may have very good evidence that screening for and treating low risk individuals is worthwhile in terms of the disease end points but what is the cost? By looking for and treating high risk you protect many more people for the anxiety and complex attitudinal change that can accrue from screening and treating low risk. Life is probably only worth living with some element of denial that we are mortal, perhaps even more so with the demise of religious belief. Screening by its nature takes that denial away and perhaps reduces us to neurotic, fearful individuals adding our risks to a score card for most of our life and reacting negatively to anything other than a very low score. Competing interests: None declared