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Fiona Alice Miller, PhD, Jason Scott Robert, PhD and Robin Z. Hayeems, PhD

Fiona Alice Miller and Robin Z. Hayeems are with the Department of Health Policy, Management, and Evaluation, University of Toronto, Ontario. Jason Scott Robert is with the Center for Biology and Society and the School of Life Sciences, Arizona State University, Tempe, and the Department of Basic Medical Sciences, College of Medicine, University of Arizona, Phoenix.

Correspondence: Requests for reprints should be sent to Fiona Alice Miller, PhD, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, 155 College Street, fourth floor, Toronto, ON, M5T 3M6 (e-mail: fiona.miller{at}utoronto.ca).

An apparent consensus governs the management of carrier status information generated incidentally through newborn screening: results cannot be withheld from parents. This normative stance encodes the focus on autonomy and distaste for paternalism that characterize the principles of clinical bioethics.

However, newborn screening is a classic public health intervention in which paternalism may trump autonomy and through which parents are—in effect—required to receive carrier information. In truth, the disposition of carrier results generates competing moral infringements: to withhold information or require its possession.

Resolving this dilemma demands consideration of a distinctive body of public health ethics to highlight the moral imperatives associated with the exercise of collective authority in the pursuit of public health benefits.

This article has been cited by other articles:

				F A Miller, R Z Hayeems, Y Bombard, J Little, J C Carroll, B Wilson, J Allanson, M Paynter, J P Bytautas, R Christensen, et al. Clinical obligations and public health programmes: healthcare provider reasoning about managing the incidental results of newborn screening J. Med. Ethics, October 1, 2009; 35(10): 626 - 634. [Abstract] [Full Text] [PDF]

				L. F. Ross and E. W. Clayton CLINICAL AND ETHICAL CONSIDERATIONS IN MANAGING CARRIER DETECTION Am J Public Health, August 1, 2009; 99(8): 1348 - 1349. [Full Text] [PDF]

				F. A. Miller, R. Z. Hayeems, and J. S. Robert CARRIER DETECTION AND CLINICAL UNCERTAINTY: THE CASE FOR PUBLIC HEALTH ETHICS Am J Public Health, August 1, 2009; 99(8): 1349 - 1350. [Full Text] [PDF]