Result card

  • ETH5: Does the implementation challenge or change professional values, ethics or traditional roles?
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Does the implementation challenge or change professional values, ethics or traditional roles?

Authors: Gottfried Endel

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

As already stated the organisational decisions accompanying the implementation of an AAA screening have an impact on the healthcare professionals at least on their workload and income

  • Respect for autonomy: organised population screening reduces the autonomy of the individual healthcare professional. The performance of the service provision is standardised and monitored.
  • Non-maleficence: standardisation is sometimes seen as destruction of the professional “art”. This was discussed during the scoping. The acceptance of standardisation varies due to cultural differences. Decisions about allocation of services have an impact on income or workload.
  • Beneficence: balancing risks and cost with potential benefits can only be done at the local level (information on cost and organisational issues is local). Organisational aspects are important. Screening may bring additional money to the system.
  • Justice: 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.

As professional autonomy is reduced by standardisation of  organised screening programme, and decisions about the type of organisation have an impact on workload and income, the acceptability of such a programme from the viewpoint of the healthcare providers will depend on the local setting. Early involvement and balancing pros and cons of different organisational settings are important. The interactive, participatory HTA approach (iHTA – see Ethical methodology 100906) should attach considerable weight to the opinions of the experts and the healthcare provider.

Endel G Result Card ETH5 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 (, Italy; 2013. [cited 28 May 2023]. Available from: