Ethical aspects of overdiagnosis: Between the utilitarianism and the ethics of responsibility

Abstract

Overdiagnosis is an emerging and unexpected phenomenon in medicine with multiple causes: social, cognitive and technical. The most prevalent ethical assessment is the utilitarian one: in medicine it is not ethical to carry out any intervention with a negative benefit risk balance. However, there are non-utilitarian moral criteria, based on principles or individual rights, and personal utilities that must also be considered in the decision-making processes. The ethical approach of overdiagnosis has to be carried out from an ethics of responsibility that contemplates principles and consequences assuming that the decisions of managers, clinicians and citizens will introduce different moral perspectives. The solutions go through training and research; have a reliable biomedical knowledge; avoid conflicts of interest, both business and organizational, and improve shared decision-making in the public, clinical and individual spheres.