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Informed or misinformed choice? Framing effects in a national information pamphlet on colorectal cancer screening
Health, Risk & Society ( IF 1.8 ) Pub Date : 2018-07-23 , DOI: 10.1080/13698575.2018.1499877
Christina Sadolin Damhus 1 , Gabriela Byskov Petersen 1 , Thomas Ploug 2 , John Brodersen 3, 4
Affiliation  

In March 2014 the Danish Health Authority established a national screening programme for colorectal cancer. During a four-year period all Danish citizens aged 50–74 years will receive an invitation along with an information pamphlet about the benefits and harms of participating. There is an international consensus that participation in cancer screening should be based on informed consent, as all screening programmes for cancer have the potential to bring about both benefits and harms. To enhance the possibility of making an informed choice about participation, it is essential to provide individuals with understandable and adequate information. The aim of this article was to examine to what extent a small, non-probability, but nevertheless heterogeneous sample of Danish citizens were able to understand the chances of benefits and risks of harms in the Danish national information pamphlet. We also explored whether the framing of the information had a ‘nudge effect’ on choice concerning participation. In March and April 2015 we conducted 14 individual semi-structured interviews. Through analysis using a ‘meaning condensation’ approach, we found evidence that the participants misunderstood important parts of the pamphlet. Our results further indicate that the information was framed so it nudged citizens to participate in screening. We argue that insufficient information and framing effects are in conflict with the requirements of informed consent and leave the citizen at risk of participating in potentially harmful procedures without understanding the consequences. Our analysis raises important ethical and legal questions regarding the pamphlet and its basis for making an informed choice.



中文翻译:

明智还是不明智的选择?国家信息手册中的构架对大肠癌筛查的影响

2014年3月,丹麦卫生局制定了一项针对大肠癌的国家筛查计划。在四年内,所有年龄在50-74岁之间的丹麦公民都将收到邀请,并获得有关参与的好处和危害的信息手册。国际上已经达成共识,参与癌症筛查应基于知情同意,因为所有癌症筛查计划都可能带来好处和伤害。为了增加就参与进行知情选择的可能性,必须为个人提供可理解的充分信息。本文的目的是研究一个小的非概率问题,但是,尽管如此,丹麦公民的异类样本仍能够了解丹麦国家信息手册中带来的好处的机会和受到伤害的风险。我们还探讨了信息框架是否对参与选择产生了“微调效应”。2015年3月和4月,我们进行了14次半结构化访谈。通过使用“意义缩合”方法进行分析,我们发现了参与者误解了小册子重要部分的证据。我们的结果进一步表明,该信息具有一定的框架,因此会促使公民参与筛查。我们认为,信息不足和框架效应与知情同意的要求相抵触,使公民有参加潜在的有害程序而不了解后果的风险。

更新日期:2018-07-23
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