February 21, 2005
Screening for Newborns
Today's New York Times has an article by Gina Kolata discussing a federal panel's recommendation to screen newborns for 29 rare medical conditions. This doesn't sound like a very controversial topic but as Ms. Kolata reveals, scientists and doctors are divided about the benefits of the tests and the potential for harm if false positives occur. She reports,
Proponents say that the diseases are terrible and that an early diagnosis can be lifesaving. When testing is not done, parents often end up in a medical odyssey to find out what is wrong with their child. By the time the answer is in, it may be too late for treatment to do much good.
But opponents say that for all but about five or six of the conditions, it is not known whether the treatments help or how often a baby will test positive but never show signs of serious disease. There is a danger, they say, of children with mild versions of illnesses being treated needlessly and aggressively for more serious forms and suffering dire health consequences.
It is a great read and would make a great article to stimulate class discussion concerning medical science and limits and the influential role of public health spending and recommendations. [bm]
February 21, 2005 | Permalink
I teach a seminar to law students and medical residents in which we explore legal and ethical influences on the practice of medicine. This article raises similar issues that we discuss in the seminar using PSA testing as the vehicle. Having the ability to collect the data, and not knowing exactly what it means, is a big dilemma in medicine, especially with the hindsight bias prevalent in malpractice cases (e.g., see JAMA Jan 4, 2004 "Piece of My Mind" segment). Often, doctors will obtain tests 'just because they can' and the patient expects them to do so.
Posted by: Dan Larriviere, MD, JD | Feb 21, 2005 5:59:33 PM