Cervical screening legislation is unethical and has the potential to be counter-productive

Abstract

Part 4A of the Health Act 1956--'National Cervical Screening Programme' (NCSP)--provides programme evaluators with unprecedented powers of access to personal health information, overriding both a woman's right to health information privacy and a doctor's duty of confidentiality. Such overriding of important ethical concepts is not justified, at least in the primary care setting where much of the information that may be accessed is irrelevant to a programme evaluation and that which is not irrelevant is not essential. In addition to being unethical, Part 4A is unnecessarily offensive to practitioners: it imposes increased compliance costs onto practitioners who take cervical smears, it threatens them with hefty fines for non-compliance, and also introduces liability into previously protected quality assurance activities. By offending both women and practitioners, and by undermining the trust that necessarily exists between them, Part 4A risks the support of those on whom the NCSP relies for its ongoing success--women and practitioners.