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The medical industry should NOT be paternalistic towards patients. People have a right to decide for themselves and be treated as adults capable of informed consent. Thankfully that model is starting to change, although there is much inertia.

Any test that is approved for use would have a better-than-random outcome distribution. Preconditioned on that, a test result is still useful no matter how uncertain. It is never the case that more information leaves you in a worse position.

I have personal experience here:

Every year I have elected to have ultrasounds done of my major internal organs. In the past two visits, the technicians spotted multiple developing growths in my liver and now kidneys. These are very likely to be benign cysts, but one piece of blood work that could be a marker for cancer is inconclusive. The odds are still high that this is totally benign and will either clear up on its own, or at least stop growing and cause no further issue. Still:

1. I'm getting my blood work done now far more frequently (twice per year instead of every other year), with specialized/not typically ordered screening tests;

2. I am redoing the ultrasound every year to track progress; and

3. I am actually taking advice about losing weight and exercise far more seriously than I otherwise would, as these issues often resolve with weight loss.

I am actually healthier now than I was two years ago, and feel better about my physical and mental well-being. All while staying on top of what could have be a life threatening issue if left untreated and ignored.

I look forward to the day when I can go get a monthly MRI-like scan. That would be wonderful.

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Well now we’re going down a different path. Telling people to go burn through mountains of cash to get tests they don’t need is not ethical.
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Costs me less than $1000 so far…
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Almost half of the US population doesn’t even have $1000 saved away nor do they have insurance that covers these tests. It’ll be far more expensive unless insurance deems it necessary, which none of what you’re suggesting would be by definition.
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> I don't really get what this means. A false positive causes issues inherently - you don't know if it's right or wrong. It's noise which is bad for care, and it's anxiety-inducing for patients which is also bad.

No its not. This is extremely paternalistic. Humans know how to understand noise and statistics. You don't get to decide that for me. I want more lives saved with more information.

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It’s not paternalistic. It’s reality. Most people are not equipped to vet all the medical information that comes their way. That’s why we should talk to our doctors about results.

I don’t think my mechanic is being paternalistic when he talks through my car and what is/isn’t important. I like that helps me prioritize things. Why is this any different? In the end a person can tell a doctor “I don’t care run the test” or whatever so what’s the big deal? You can still do what you want. Get that biopsy if you need the peace of mind.

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I agree but do you want your mechanic to hide information from you for any reason? For instance, that information can have false positives.

Like, your mechanic hides the fact that your engine may be broken but he's just 70% sure of it. Since he's not 99% sure, he hides it from you. Do you think its a good thing to do?

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