Art of Medicine
Aug 2023

Horror PSA

Kelly Wang
AMA J Ethics. 2023;25(8):E643-645. doi: 10.1001/amajethics.2023.643.


Public health messaging commonly happens with public service announcements (PSAs). Health screenings are often marketed using various incentives, such as odds presentation. This comic invites readers to consider aesthetic and ethical intersections of how odds might be presented—even exaggerated—to cultivate fear. When accompanied by implicit or explicit attribution of individual responsibility for one’s health risks or outcomes, PSAs or other health communications are not ethically neutral.

Figure. Fright Escalation






Drawing on cover art from many so-called pulp magazine covers, the comic traces an evolution in the woman’s expression and invites readers to consider whether growth in her fear experience is due to her cancer risk or to how her cancer risk is represented to her by health care. Recent concern about gaslighting1 in health care suggests the importance of how risk is represented in health messaging, whether coming from a clinician or from a public service announcement. Ethically, we might wonder about the appropriateness of fear-based screening incentives. Whether and to what extent anyone should ever be regarded as clinically or ethically culpable for an illness is also worth interrogating.


  1. Caron C. How to spot “medical gaslighting” and what to do about it. New York Times. July 29, 2022. Accessed June 21, 2023.


AMA J Ethics. 2023;25(8):E643-645.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose. 

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.