Result card

  • ETH8: What are the consequences of implementing / not implementing Abdominal Aorta Aneurysm Screening on justice in the health care system? Are principles of fairness, justness and solidarity respected? Is there a clear rule for prioriticing screening procedures?
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What are the consequences of implementing / not implementing Abdominal Aorta Aneurysm Screening on justice in the health care system? Are principles of fairness, justness and solidarity respected? Is there a clear rule for prioriticing screening procedures?

Authors: Gottfried Endel

Internal reviewers: Wilhelm Donner, Scott Goulden, Grace Jennings, Paolo Giorgi Rossi, Ingrid Wilbacher, Claudia Wild

In this question the dimension of justice is highlighted. So a summary of the previous findings is necessary.

Justice:

  • ETH1: Looking at the healthcare system as an SSGI the dimension of justice is given a low value in the standard mode of care. Organised screening dramatically increases the value of the justice domain.
  • ETH2: Excluding women from screening needs a strong argument.
  • ETH3: In this question the domain of justice not only addresses the people eligible for AAA screening but also the service providers. Allocating the service provision to general practice, hospitals or specialised units for ultrasound examinations involves decisions about quality, workload and income.
  • ETH4: In this question the domain of justice not only addresses the test procedure but also organisational aspects especially in evaluation
  • ETH5: In this question the domain of justice addresses political interest of the healthcare providers. The impact on different groups of providers depends on the type of organisational decision.
  • ETH6: In this question the domain of justice addresses the political interests of the healthcare providers. The impact on different groups of providers depends on the type of organisational decision. Organised programmes are able to reduce the gaps in access to care caused by lack of education and information.
  • ETH7: In this question the domain of justice requires objective information to compare different possibilities of investing public money.

Justice addresses restriction to access for citizens by gender or other characteristics, the healthcare system as an SSGI, organisational aspects for providers, evaluation for citizens (data protection), and objective information needed both for informed consent (clinical level) and for system decisions (political level). At the moment a clear rule for prioritising screening procedures is not available, so decisions will follow national or local priorities and values.

Critical
Partially
Endel G Result Card ETH8 In: Endel G Ethical analysis In: Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy; 2013. [cited 30 June 2022]. Available from: http://corehta.info/ViewCover.aspx?id=106