Evidence map›Paper›PMID 33208479›Full record

ArticleJournal of medical ethics2020

Prevention in the age of personal responsibility: epigenetic risk-predictive screening for female cancers as a case study.

Ineke Bolt, Eline M Bunnik, Krista Tromp, Nora Pashayan, Martin Widschwendter, Inez de Beaufort

Open access · hybridAbstract read
In one paragraph

Article in Journal of medical ethics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Ineke BoltDepartment of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, The Netherlands L.Bolt@erasmusmc.nl.
Eline M BunnikDepartment of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, The Netherlands.
Krista TrompDepartment of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, The Netherlands.
Nora PashayanUCL Department of Applied Health Research, University College London, London, UK.
Martin WidschwendterDepartment of Women's Cancer, University College London, London, UK.
Inez de BeaufortDepartment of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, The Netherlands.
Erasmus MC · NLUniversity College London · GBErasmus University Rotterdam · NLInstitute of Medical Ethics · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Epigenetic markers could potentially be used for risk assessment in risk-stratified population-based cancer screening programmes. Whereas current screening programmes generally aim to detect existing cancer, epigenetic markers could be used to provide risk estimates for not-yet-existing cancers. Epigenetic risk-predictive tests may thus allow for new opportunities for risk assessment for developing cancer in the future. Since epigenetic changes are presumed to be modifiable, preventive measures, such as lifestyle modification, could be used to reduce the risk of cancer. Moreover, epigenetic markers might be used to monitor the response to risk-reducing interventions. In this article, we address ethical concerns related to personal responsibility raised by epigenetic risk-predictive tests in cancer population screening. Will individuals increasingly be held responsible for their health, that is, will they be held accountable for bad health outcomes? Will they be blamed or subject to moral sanctions? We will illustrate these ethical concerns by means of a Europe-wide research programme that develops an epigenetic risk-predictive test for female cancers. Subsequently, we investigate when we can hold someone responsible for her actions. We argue that the standard conception of personal responsibility does not provide an appropriate framework to address these concerns. A different, prospective account of responsibility meets part of our concerns, that is, concerns about inequality of opportunities, but does not meet all our concerns about personal responsibility. We argue that even if someone is responsible on grounds of a negative and/or prospective account of responsibility, there may be moral and practical reasons to abstain from moral sanctions.

Indexed as

genetic screening/testingtechnology/risk assessment

Identifiers

PMID33208479
PMCPMC8639925
OpenAlexW3106110085

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.