The University of Sydney Medical School, School of Public Health
Abstract
Breast screening is controversial. Despite many supporters and a large evidence base, some experienced breast screening experts disagree with selected policies and practices. I sought to examine the reasoning of people who have influenced breast screening in Australia. I used an empirical ethics approach, combining empirical study with theoretical analysis. I interviewed Australians with expertise and influence in breast screening across a range of professional roles. I found that participants drew on values as well as evidence when talking and reasoning about breast screening. Participants expressed a range of interpretations and prioritisations for each value and experts’ disagreements were based, at least in part, on these differences. Experts did not always acknowledge the role of values in shaping their views or recognise different ways of conceptualising or prioritising values. I recommend including values in decision making for breast screening policy and practice. I provide guidance about formats for values based discussions. I conclude that values play an important but often unrecognised role in shaping breast screening policy and practice, and propose regular review of values to deliver breast screening in the most ethically sound manner
