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September 8, 2015

The Ethics of Incentivizing Mammography Screening

Author Affiliations
  • 1Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 2Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2015;314(10):995-996. doi:10.1001/jama.2015.8852

Patient health incentives are an increasingly common policy tool and have been used widely in areas including smoking cessation and weight loss. In such cases, achieving the incentivized targets produces health and financial benefits without any risks. But other incentivized health behaviors differ. Breast cancer screening is a case in point: incentives for completion of mammograms are an ethically disconcerting distraction in a complex decision-making process. However, incentives for making an evidence-based active choice about breast screening can be ethical—even if this policy may avert fewer breast cancer deaths overall.