Intended for healthcare professionals

Letters Breast cancer screening

Publicity of NHS breast cancer screening programme is unfair

BMJ 2011; 342 doi: (Published 08 February 2011) Cite this as: BMJ 2011;342:d791

Half truth is no truth

Modern NHS healthcare is supposedly 'open' and 'patient-centred'.
Phrases such as 'Patient Empowerment', 'Patient Partnership', 'Patient
Autonomy' and 'Patient Choice' are well-worn. But are they meaningful? You
can only fool some of the people some of the time.

The public deserves openness. Withholding information is lying by
default and invalidates the consent process. Cherry-picking information
offered to women about the considerable downside of screening mammography
shows lack of respect for a person's autonomy, erodes the doctor/patient
relationship and destroys trust.

Last week Cancer Research UK reported that breast cancer rates in the
UK have increased by 3.5 per cent over the last decade'. Apparently,
'experts have blamed lifestyle factors...' So women are bringing it on
themselves? Or is this nothing more than a rise in cellular 'differences'
picked up by today's more effective mammographic machinery? Are too many
healthy women becoming 'cancer patients' - unnecessarily?

If the public is to take more responsibility for its health, is it
not time for Daddy to let go of the reins?1

1 Coulter A. Editorial: Paternalism or partnership? Patients have
grown up - and there's no going back. BMJ. 1999; 319: 719-20

Competing interests: Author, Nothing Personal, disturbing undercurrents in cancer care, Radcliffe Publishing

11 February 2011
Mitzi A Blennerhassett
medical writer
Compass consumer research panel