There are so many confusions, distortions, evasions, and deceptions in this New York Times story that I don't know where to begin.
First, the debate isn't between science and nonscience or between "evidence-based" medicine and some other type of medicine. This is manipulative rhetoric, designed to get mileage out of the favorable connotations of the words "science" and "evidence." It's between having a choice made for one and making the choice oneself. It's about who decides whether the "risks" are worth the benefits. It's about paternalism and condescension. It's about treating adults as though they were children.
Second, if the recommendation is merely advisory, as various people quoted in the story proclaim it to be, why is there so much defensiveness? The fact is, it was going to start out as advisory and then, when the uproar subsided, become enforced by law. The hope was that people wouldn't notice the change, or that, if they did, they would view it as inevitable. Doctors would simply not recommend screenings for their female patients until the patients were 50. When government controls health care, panels of "experts" whose only concern is containing costs will decide which treatments are available and which are not. This is not the American way. It is the totalitarian way.
Third, this isn't a matter of educating people. This isn't about ignorance. It's about differences in values. Most Americans disagree that the costs of screening for breast cancer outweigh the benefits. Whether costs outweigh benefits isn't a factual question; it's an evaluative question. To me, the costs of owning a cellphone outweigh the benefits. To you, the benefits may outweigh the costs. Neither of us is mistaken about the facts. We simply have different values. I don't want some bean counter to decide that the costs of a prostate screening, to me, outweigh the benefits, to me. I decide that!
I hope young people in particular are paying attention to this debate. Their lives and health are on the line. Do you want health-care decisions to be made by you and your doctor, or by distant bureaucrats who don't give a damn about you as a person?
Keith Burgess-Jackson, J.D., Ph.D. 