1
|
Lensink MA, Boers SN, Jongsma KR, Carter SE, van der Ent CK, Bredenoord AL. Organoids for personalized treatment of Cystic Fibrosis: Professional perspectives on the ethics and governance of organoid biobanking. J Cyst Fibros 2020; 20:443-451. [PMID: 33303364 DOI: 10.1016/j.jcf.2020.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/07/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Organoid technology is emerging rapidly as a valuable tool for precision medicine, particularly in the field of Cystic Fibrosis (CF). However, biobank storage and use of patient-derived organoids raises specific ethical and practical challenges that demand sound governance. We examined the perspectives of professionals affiliated with CF or organoids on the ethical aspects of organoid biobanking for CF precision medicine. By conducting this study parallel to the process of innovation and development of organoid biobanking, its findings are valuable for the design of responsible governance frameworks. METHODS To identify relevant themes and attitudes we conducted 21 semi-structured qualitative interviews with professionals in the field of organoid technology, biobanking, or CF research and care. RESULTS We identified three key challenges, as well as the suggestions of professionals on how to address them: (1) The challenges associated with commercial involvement, trust, and ownership, (2) Navigating the blurring boundary between research and clinical care, (3) Appropriate approaches to the informed consent procedure. CONCLUSION Sound governance of organoid biobanks aimed at precision medicine requires coming to terms with the fact that its stakeholders no longer belong to separate domains. Responsible governance should be aimed at finding a sound, context-sensitive balance between integration of ongoing co-operation and mutual consideration of interests, and maintaining a feasible and sustainable research climate.
Collapse
Affiliation(s)
- Michael A Lensink
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Sarah N Boers
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Karin R Jongsma
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Sarah E Carter
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Cornelis K van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Internal Post KH.01.419.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
| | - Annelien L Bredenoord
- Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Internal Post Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| |
Collapse
|
2
|
Lensink MA, Jongsma KR, Boers SN, Noordhoek JJ, Beekman JM, Bredenoord AL. Responsible use of organoids in precision medicine: the need for active participant involvement. Development 2020; 147:147/7/dev177972. [DOI: 10.1242/dev.177972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT
Organoids are three-dimensional multicellular structures grown in vitro from stem cells and which recapitulate some organ function. They are derivatives of living tissue that can be stored in biobanks for a multitude of research purposes. Biobank research on organoids derived from patients is highly promising for precision medicine, which aims to target treatment to individual patients. The dominant approach for protecting the interests of biobank participants emphasizes broad consent in combination with privacy protection and ex ante (predictive) ethics review. In this paradigm, participants are positioned as passive donors; however, organoid biobanking for precision medicine purposes raises challenges that we believe cannot be adequately addressed without more ongoing involvement of patient-participants. In this Spotlight, we argue why a shift from passive donation towards more active involvement is particularly crucial for biobank research on organoids aimed at precision medicine, and suggest some approaches appropriate to this context.
Collapse
Affiliation(s)
- Michael A. Lensink
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Karin R. Jongsma
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Sarah N. Boers
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Jacquelien J. Noordhoek
- Dutch Cystic Fibrosis Foundation (NCFS), Dr. A. Schweitzerweg 3A, 3744 MG Baarn, The Netherlands
| | - Jeffrey M. Beekman
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, Regenerative Medicine Center, University Medical Center, Internal post KH.01.419.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands
| | - Annelien L. Bredenoord
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, The Netherlands
| |
Collapse
|
5
|
Mora M, Angelini C, Bignami F, Bodin AM, Crimi M, Di Donato JH, Felice A, Jaeger C, Karcagi V, LeCam Y, Lynn S, Meznaric M, Moggio M, Monaco L, Politano L, de la Paz MP, Saker S, Schneiderat P, Ensini M, Garavaglia B, Gurwitz D, Johnson D, Muntoni F, Puymirat J, Reza M, Voit T, Baldo C, Bricarelli FD, Goldwurm S, Merla G, Pegoraro E, Renieri A, Zatloukal K, Filocamo M, Lochmüller H. The EuroBioBank Network: 10 years of hands-on experience of collaborative, transnational biobanking for rare diseases. Eur J Hum Genet 2015; 23:1116-23. [PMID: 25537360 PMCID: PMC4538193 DOI: 10.1038/ejhg.2014.272] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/15/2014] [Accepted: 11/10/2014] [Indexed: 11/09/2022] Open
Abstract
The EuroBioBank (EBB) network (www.eurobiobank.org) is the first operating network of biobanks in Europe to provide human DNA, cell and tissue samples as a service to the scientific community conducting research on rare diseases (RDs). The EBB was established in 2001 to facilitate access to RD biospecimens and associated data; it obtained funding from the European Commission in 2002 (5th framework programme) and started operation in 2003. The set-up phase, during the EC funding period 2003-2006, established the basis for running the network; the following consolidation phase has seen the growth of the network through the joining of new partners, better network cohesion, improved coordination of activities, and the development of a quality-control system. During this phase the network participated in the EC-funded TREAT-NMD programme and was involved in planning of the European Biobanking and Biomolecular Resources Research Infrastructure. Recently, EBB became a partner of RD-Connect, an FP7 EU programme aimed at linking RD biobanks, registries, and bioinformatics data. Within RD-Connect, EBB contributes expertise, promotes high professional standards, and best practices in RD biobanking, is implementing integration with RD patient registries and 'omics' data, thus challenging the fragmentation of international cooperation on the field.
Collapse
Affiliation(s)
- Marina Mora
- Muscle Cell Biology Lab, Neuromuscular Diseases and Neuroimmunolgy Unit, Fondazione Istituto Neurologico C. Besta, Milano, Italy
| | - Corrado Angelini
- IRCCS Fondazione San Camillo Hospital, Lido Venice, Italy
- Department of Neurosciences, NPSRR University of Padova, Padova, Italy
| | | | - Anne-Mary Bodin
- EURORDIS, European Organisation for Rare Diseases, Paris, France
| | | | | | - Alex Felice
- Laboratory of Molecular Genetics and Malta BioBank, University of Malta, and Thalassaemia Clinic, Mater Dei Hospital, Msida, Malta
| | | | - Veronika Karcagi
- Department of Molecular Genetics and Diagnostics, National Institute of Environmental Health, Budapest, Hungary
| | - Yann LeCam
- EURORDIS, European Organisation for Rare Diseases, Paris, France
| | - Stephen Lynn
- MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
| | - Marija Meznaric
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maurizio Moggio
- Neuromuscular Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, University of Milan, Milan, Italy
| | | | - Luisa Politano
- Division of Cardiomyology and Medical Genetics, Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Manuel Posada de la Paz
- Manuel Posada de la Paz, Institute of Rare Diseases Research, IIER, ISCIII and Spain RDR & CIBERER, Madrid, Spain
| | | | - Peter Schneiderat
- Muscle Tissue Culture Collection, Friedrich-Baur-Institute, Neurological Department, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Monica Ensini
- MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
| | - Barbara Garavaglia
- Molecular Neurogenetics Unit, Fondazione Istituto Neurologico C. Besta, Milano, Italy
| | - David Gurwitz
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Diana Johnson
- Dubowitz Neuromuscular Centre, MRC Neuromuscular Centre at UCL Institute of Child Health, London, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, MRC Neuromuscular Centre at UCL Institute of Child Health, London, UK
| | - Jack Puymirat
- Department of Human Genetics, Centre Hospitalier Universitaire de Quebec, Quebec City, Quebec, Canada
| | - Mojgan Reza
- MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
| | - Thomas Voit
- Inserm U974—Institute of Myology, University Pierre and Marie Curie Paris 6, Paris, France
| | - Chiara Baldo
- Laboratorio di Genetica Umana, E.O. Ospedali Galliera, Genova, Italy
| | | | - Stefano Goldwurm
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy
| | - Giuseppe Merla
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Elena Pegoraro
- Department of Neurosciences, NPSRR University of Padova, Padova, Italy
| | - Alessandra Renieri
- Division of Medical Genetics, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Kurt Zatloukal
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Mirella Filocamo
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Genova, Italy
| | - Hanns Lochmüller
- MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
| |
Collapse
|
6
|
Thorogood A, Zawati MH. International Guidelines for Privacy in Genomic Biobanking (or the Unexpected Virtue of Pluralism). THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2015; 43:690-702. [PMID: 26711410 DOI: 10.1111/jlme.12312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article reviews international privacy norms governing human genomic biobanks and databases, and how they address issues related to consent, secondary use, de- identification, access, security, and governance. A range of international instruments were identified, varying in substance - e.g., human rights, data protection, research ethics, biobanks, and genetics - and legal character. Some norms detail processes for broad consent, namely, that even where potential participants cannot consent to specific users and uses, they should be given clear information on access policies, procedures, and governance structures. Some also give guidance about the conditions under which secondary use of data and samples without consent is appropriate, e.g., where consent is impracticable. International norms exhibit a confusing range of terminology relating to de-identification. They also continue to rely heavily on consent and anonymity as the basis for privacy protection, though governance is becoming more prominent. It may not be fatal that such a plurality of norms apply to biobanking; what is essential is that governance be built on shared values, our common interest in the success of genomic research, and practical tools that incentivize responsible, global sharing.
Collapse
Affiliation(s)
- Adrian Thorogood
- Lawyer and an Academic Associate at the Centre of Genomics and Policy at McGill University. He is a member of the Bar of Ontario and earned his joint common law and civil law degree from McGill University in Quebec, Canada
| | - Ma'n H Zawati
- Lawyer, Academic Coordinator of the Centre of Genomics and Policy, and an Associate Member of the Biomedical Ethics Unit, McGill University. He is a member of the Quebec Bar
| |
Collapse
|
8
|
Abstract
While the disclosure of research findings is relevant to all types of biomedical research, it has garnered particular attention with respect to genetics and genomics research due to some of the unique aspects of the data and the high public profile of the field. In this chapter, we review the attitudes of stakeholders (research participants, policymakers, and researchers) to define areas of consensus regarding the issue of returning research results across and within groups. In addition to stakeholder attitudes about obligations and interest in research results, other major related issues related to returning research results, such as informed consent, communication of research results, and cost, are discussed. Given the consensus between stakeholders to return summary reports of a study's outcomes and individual research results of clinical significance, we conclude that the time has come to encourage, if not require, researchers to consider these issues in the developmental planning stages of a project and to plan and budget accordingly.
Collapse
Affiliation(s)
- Susanne B Haga
- Institute for Genome Sciences & Policy, Duke University, Durham, North Carolina, USA.
| | | |
Collapse
|