The main challenge of (most) political decisions in healthcare is the conflicting goals and values not only in different policy areas but also on different levels within the system. In a pluralistic society such conflicts are normal. Usually the level of clinical medicine “belongs”  to the patient and the clinician. The level of the health system is the domain of “organisations” – the stakeholders (providers, payers, patient groups, industry and so on). The last level deals with the balance of interests between political fields such as education, the labour market, others... and health. It may be attributable to the fact that the issue of AAA screening is a multi-level, multi-stakeholder and diverse interest dilemma. The international dimension should also be taken into account – particularly the previously mentioned open method of coordination of the EU.

So the balancing of the benefits and harms can be done only at the local level because local current use has to be taken into account. The open method of coordination aims to harmonise  healthcare and public health priorities on the EU level.