Local deliberative approach to the bioethical controversies an opportunity for the proper implementation of neonatal screening

Introduction: Controversial characteristics of neonatal screening influenced by bioethical considerations make complex its implementation.Colombia is no stranger to this situation and local circumstances complicate the panorama. Objective: To know how the bioethical controversies of neonatal screening are approached at a local level as a basis for deliberating on the must-be of this activity in Colombia. Materials and methods: A survey immersed in an Interpretative Investigation with two components of analysis was applied: descriptive and deliberative of values exposed by officials of the National Institute of Health. Results: The compulsory offer of screening by the nation independent of the opportunity cost and the consent for the use in research of results and residual samples were not controversial. In contrast, the type of information and the consent to authorize screening were controversial. Officials with more experience preferred mandatory screening (17.7 vs. 11.79 years on average, p=0.007). Surprisingly, despite the risk of discrimination, having the neonate as purpose, there was agreement to give all information to parents and medical records. Another controversial aspect was the follow-up of cases without hiding their identification, officials with more experience in bioethical aspects preferred the use of codes (4.5 vs. 1.26 years average, p=0.009). In this context, strategies such as informed dissent, specialized advice or public health programs that appreciate diversity allowed to rescue even seemingly opposite values. Conclusion: A local approach regarding the must-be of the neonatal screening obtained through a deliberative bioethical perspective allowed to present a proposal to implement this activity.