ESGE/UEGF Colorectal Cancer - Public Awareness CampaignThe Public/Professional Interface WorkshopOslo, Norway, June 20 - 22, 2003A. T. R. Axon, U. Beilenhoff, T. James, S. D. Ladas, E. Larsen, C. S. Neumann, A. Nowak, R. Schöfl, K. M. Tveit
In the clinical situation patients approach their doctor with a medical problem. The duties of the doctor are clear: he or she has to address the patient’s concerns. The responsibility for establishing the relationship lies with the patient who has approached the doctor. Where screening is concerned, the situation is different. In this case it is a health provider or doctor who approaches normal, fit members of the public, warning them that although they believe themselves to be healthy they may, nevertheless be harboring serious disease but if they are prepared to undergo certain clinical procedures they can abolish or reduce their likelihood of developing it. In this case it is the medical system that has created the interface and it must bear the responsibility for the outcome. Fit, normal people may be seriously disadvantaged or even die as a result of the intervention their medical advisers propose to undertake. The principle ”first do no harm” is in this case subordinated to the concept of providing the greatest benefit for the largest number.
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A. T. R. Axon, MD
United Leeds Teaching Hospitals, Centre for Digestive Diseases, Department of Gastroenterology
Room 190A, Clarendon Wing · The General Infirmary at Leeds · Great George Street · Leeds LS1 3EX · United Kingdom