When science meets philosophy: Understanding the ethical implications of overdiagnosis
Awarded a Future Fellowship in the latest rounds of ARC grants, Professor Rogers' research project will develop an account of disease that can help to distinguish risk factors from disease, provide ethical reasons for screening or not screening, and be useful in addressing the problems of overdiagnosis.
Overdiagnosis refers to a range of healthcare activities or interventions which end up harming rather than helping patients. Overdiagnosis arises in a number of ways, such as when the definitions of disease are widened, when harmless or clinically insignificant lesions are diagnosed or treated,or when screening identifies harmless as well as progressive cancers.
"Apart from causing harm to patients who are diagnosed with conditions that, if left undiagnosed, would cause them no harm, overdiagnosis increases health care costs and diverts healthcare resources away from the treatment of diseases with significant morbidity and mortality. Thus overdiagnosis is a problem, not only for individual patients who may be harmed, but also for healthcare providers and policy makers." says Professor Rogers.
Trained as a general practitioner before undertaking philosophy honours and a PhD in medical ethics,this research project continues to combine Professor Rogers' passion for medicine and ethics.
"One of the drivers for overdiagnosis is the lack of an account of disease that will ground distinctions between normal or healthy, abnormal or increased risk, and presence of disease. Philosophy can help with this kind of definitional work." explains Professor Rogers.
She is currently working on taxonomy of overdiagnosis, examining the different ways in which it arises, and the various ethical issues that these entail. She has already presented the work at the University of Sydney, the Australian Catholic University, and Medical Grand Rounds at St Vincent's hospital. In September she will be leading a booked out workshop at the international Preventing Overdiagnosis conference at Oxford University.