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Austoker's editorial (1), "Gaining informed consent for
screening" focussed upon disclosure and comprehension of
information. A further important, but neglected, element of
informed consent identified by Beauchamp and Childress (2),
briefly alluded to by Austoker (1), concerns voluntariness.
The NHSBSP aims to, "recognise and respect every woman's
right to make HER OWN informed decisions about breast
screening" (3). Squaring this with the social influence
implicit in the practice of issuing an appointment time and,
in some units, a GPs letter of support is problematic. Once
again, the tension between informed consent and the need for
maximum recruitment appears. Whether these practices require
amendment or elimination in the quest for "truly informed
consent" (1) is a matter requiring further debate.
1. Austoker J. Gaining informed consent for screening. Br
Med J 1999;319:722-723.
2. Beauchamp T, Childress J. Principles of biomedical
ethics. New York: Oxford University Press, 1995.
3. Austoker J, Fagge D, Gray S, Patnick J. Messages about
breast screening. Sheffield: NHSBSP publications,
No competing interests
10 January 2000
Honorary research fellow
School of Nursing and Midwifery, University of Southampton