PEDIATRICS Vol. 91 No. 4 April 1993, pp. 853
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Screening for Treatable Disorders

ELLEN WRIGHT CLAYTON MD, JD1

1 Division of General Pediatrics, Vanderbilt University School of Medicine, Vanderbilt University School of Law, Nashville, Tennessee

In Reply.—

I appreciate the opportunity to respond to Dr Arnold's thoughtful letter because she raises a frequently made argument that failure to consent to newborn screening constitutes actionable neglect.1-3 The problem with this argument, however, is that it tends to combine inappropriately the risks of failing to screen with the risks of failing to treat a child with the disease being sought.4 For example, the actual risk that any particular child who is not screened will develop mental retardation that could have been avoided is very low simply because the incidence of phenylketouria (PKU), congenital hypothyroidism, and the other metabolic disorders sought is very low, even in the aggregate.


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