Ethical implications of screening for loneliness in primary care when intervention capacity is limited

Abstract

Abstract Background Loneliness has emerged as a clinically significant health concern, prompting growing interest in systematic screening in care settings. However, the ethical justification for such screening remains uncertain when intervention capacity is limited or inequitably distributed. Main body Drawing on Wilson and Jungner’s classical screening criteria and contemporary social risk screening literature, we argue that screening without response capacity violates core ethical principles including autonomy, beneficence, nonmaleficence, and justice. Potential ethical tensions are not hypothetical but are documented across implementation studies and qualitative research on social needs screening. Conclusion Ethically defensible loneliness screening requires alignment between identification and response capacity, including adequate referral pathways, clinician training, community partnerships, and transparent communication about the limits of available assistance.