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Contested guideline development in Australia’s cervical screening program: values drive different views of the purpose and implementation of organized screening

Journal Article


Abstract


  • This article draws on an empirical investigation of how Australia’s cervical screening program came to be the way it is. The study was carried out using grounded theory methodology and primarily uses interviews with experts involved in establishing, updating or administering the program. We found strong differences in experts’ normative evaluations of the program and beliefs about optimal ways of achieving the same basic outcome: a reduction in morbidity and mortality caused by invasive cervical cancer. Our analysis demonstrates how variations in values and preferences associated with key concepts underpinning public health such as benefit, harm and burden led to different perspectives on the purpose of an organized cervical screening program. These variations were largely driven by different bases of professional experience. Differently conceived purposes in turn led to conflict over how the program should be operationalized. Following Frith’s model of empirical bioethics, the results of the study both draw on and inform the existing public health and screening ethics literature.

UOW Authors


Publication Date


  • 2016

Citation


  • Williams, J. & Carter, S. (2016). Contested guideline development in Australia’s cervical screening program: values drive different views of the purpose and implementation of organized screening. Public Health Ethics, 10 (1), 5-18.

Scopus Eid


  • 2-s2.0-85045662832

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/3443

Number Of Pages


  • 13

Start Page


  • 5

End Page


  • 18

Volume


  • 10

Issue


  • 1

Place Of Publication


  • United Kingdom

Abstract


  • This article draws on an empirical investigation of how Australia’s cervical screening program came to be the way it is. The study was carried out using grounded theory methodology and primarily uses interviews with experts involved in establishing, updating or administering the program. We found strong differences in experts’ normative evaluations of the program and beliefs about optimal ways of achieving the same basic outcome: a reduction in morbidity and mortality caused by invasive cervical cancer. Our analysis demonstrates how variations in values and preferences associated with key concepts underpinning public health such as benefit, harm and burden led to different perspectives on the purpose of an organized cervical screening program. These variations were largely driven by different bases of professional experience. Differently conceived purposes in turn led to conflict over how the program should be operationalized. Following Frith’s model of empirical bioethics, the results of the study both draw on and inform the existing public health and screening ethics literature.

UOW Authors


Publication Date


  • 2016

Citation


  • Williams, J. & Carter, S. (2016). Contested guideline development in Australia’s cervical screening program: values drive different views of the purpose and implementation of organized screening. Public Health Ethics, 10 (1), 5-18.

Scopus Eid


  • 2-s2.0-85045662832

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/3443

Number Of Pages


  • 13

Start Page


  • 5

End Page


  • 18

Volume


  • 10

Issue


  • 1

Place Of Publication


  • United Kingdom