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No person left behind: Mapping the health policy landscape for genomics research in the Caribbean. LANCET REGIONAL HEALTH. AMERICAS 2022; 15:100367. [PMID: 36778076 PMCID: PMC9904062 DOI: 10.1016/j.lana.2022.100367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Caribbean has long been an under-represented geographical region in the field of genomics research. Such under-representation may result in Caribbean people being underserved by precision medicine and other public health benefits of genomics. A collaboration among regional and international researchers aims to address this issue through the H3ECaribbean project (Human Heredity, Environment, and Health in the Caribbean), which builds on the lessons and success of H3Africa. The Caribbean project aims to target issues of social justice by encouraging the inclusion of diverse Caribbean communities in genomics research. This paper explores a framework for the ethical and socially acceptable conduct of genomics research in the Caribbean, taking account of the cultural peculiarities of the region. This is done in part by exploring research ethics issues identified in indigenous communities in North America, Small Island Developing States, and similar endeavours from the African continent. The framework provides guidance for interacting with local community leaders, as well as detailing steps for obtaining informed consent of all participants. Specifically, the authors outline the methods to ensure effective interaction and enforce full transparency with study participants to combat historical neglect when working with under-represented communities in the Caribbean.
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Mosavel M, Barker KL, Gardiner HM, Siminoff LA. Responsiveness and adaptability in community engaged biobanking research: experiences from a Hispanic community. J Community Genet 2019; 10:395-406. [PMID: 30610570 PMCID: PMC6591347 DOI: 10.1007/s12687-018-0397-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022] Open
Abstract
The success of biobanking research relies on the willingness of the public to provide biological and sociological information, donate tissue samples, and complete psychosocial questionnaires. Medical advances made through biobanking research have limited reach if tissues are not obtained from a diverse sample of individuals. Within, we describe the process of transitioning a small group of Hispanic community members who met regularly into a more formal Hispanic Community Advisory Board (HCAB) for the Genotype-Tissue Expression (GTEx) project. The sole purpose of the HCAB was to provide input and feedback on GTEx and, specifically, how researchers can best address the concerns of the Hispanic community related to tissue donation. This initial purpose was adapted to be responsive to the HCAB's request to include educating others in the Hispanic community who were not a part of the advisory board about genomic biobanking. While HCAB members' knowledge of biobanking was limited, a strong need for culturally tailored information about the impact of biobanking medical discoveries and their potential benefit to the Hispanic community was expressed. The HCAB's feedback guided revisions to GTEx study documents to specifically address concerns about language use, clarity, and context including the need for consent forms to address cultural concerns and fears. HCAB members also collaborated on the development of a walk-through exhibition which provided a visual, narrative-based explanation of GTEx and the process of tissue donation for research and biobanking purposes. The HCAB demonstrated the value of including community participation in scientific research projects, for both scientists and lay communities, and underscored the importance of developing community engagement approaches that are adaptable and responsive to community needs. Our experience with the HCAB serves as exemplar for a unique paradigm of community inclusiveness and education in research.
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Affiliation(s)
- Maghboeba Mosavel
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 East Main Street, One Capitol Square, 4th floor, Richmond, VA 23219 USA
| | - K. Laura Barker
- College of Public Health, Temple University, 1700 N. Broad Street, Suite 417, Philadelphia, PA 19121 USA
| | - Heather M. Gardiner
- Department of Public Health, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA 19122 USA
| | - Laura A. Siminoff
- College of Public Health (286-00), Bell Building (TECH CENTER), 1101 Montgomery Ave., Philadelphia, PA 19122 USA
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Tupasela A, Snell K, Cañada JA. Constructing populations in biobanking. LIFE SCIENCES, SOCIETY AND POLICY 2015; 11:5. [PMID: 26194269 PMCID: PMC4508277 DOI: 10.1186/s40504-015-0024-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 06/29/2015] [Indexed: 05/18/2023]
Abstract
This article poses the question of whether biobanking practices and standards are giving rise to the construction of populations from which various biobanking initiatives increasingly draw on for legitimacy? We argue that although recent biobanking policies encourage various forms of engagement with publics to ensure legitimacy, different biobanks conceptualize their engagement strategies very differently. We suggest that biobanks undertake a broad range of different strategies with regard to engagement. We argue that these different approaches to engagement strategies are contributing to the construction of populations, whereby specific nationalities, communities, societies, patient groups and political systems become imbued or bio-objectified with particular characteristics, such as compliant, distant, positive, commercialized or authoritarian. This bio-objectification process is problematic in relation to policy aspirations ascribed to biobanking engagement since it gives rise to reified notions of different populations.
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Affiliation(s)
- Aaro Tupasela
- Department of Public Health, Centre for Medical Science and Technology Studies, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen, Denmark,
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McWhirter RE, Critchley CR, Nicol D, Chalmers D, Whitton T, Otlowski M, Burgess MM, Dickinson JL. Community engagement for big epidemiology: deliberative democracy as a tool. J Pers Med 2014; 4:459-74. [PMID: 25563457 PMCID: PMC4282883 DOI: 10.3390/jpm4040459] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/08/2014] [Accepted: 11/12/2014] [Indexed: 12/24/2022] Open
Abstract
Public trust is critical in any project requiring significant public support, both in monetary terms and to encourage participation. The research community has widely recognized the centrality of public trust, garnered through community consultation, to the success of large-scale epidemiology. This paper examines the potential utility of the deliberative democracy methodology within the public health research setting. A deliberative democracy event was undertaken in Tasmania, Australia, as part of a wider program of community consultation regarding the potential development of a Tasmanian Biobank. Twenty-five Tasmanians of diverse backgrounds participated in two weekends of deliberation; involving elements of information gathering; discussion; identification of issues and formation of group resolutions. Participants demonstrated strong support for a Tasmanian Biobank and their deliberations resulted in specific proposals in relation to consent; privacy; return of results; governance; funding; and, commercialization and benefit sharing. They exhibited a high degree of satisfaction with the event, and confidence in the outcomes. Deliberative democracy methodology is a useful tool for community engagement that addresses some of the limitations of traditional consultation methods.
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Affiliation(s)
- Rebekah E McWhirter
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
| | - Christine R Critchley
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart TAS 7001, Australia.
| | - Dianne Nicol
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
| | - Don Chalmers
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
| | - Tess Whitton
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
| | - Margaret Otlowski
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart TAS 7001, Australia.
| | - Michael M Burgess
- Maurice Young Centre for Applied Ethics, University of British Columbia, Vancouver, BC V6T 1Z2, Canada.
| | - Joanne L Dickinson
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
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Abstract
The most common way for people to consent to research with their banked biological material is through signing a blanket consent, which allows any future use, giving the donor no information or control. This does not respect the donor or the philosophy if donation.
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Terry SF, Christensen KD, Metosky S, Rudofsky G, Deignan KP, Martinez H, Johnson-Moore P, Citrin T. Community engagement about genetic variation research. Popul Health Manag 2012; 15:78-89. [PMID: 21815821 PMCID: PMC3363293 DOI: 10.1089/pop.2011.0013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this article is to describe the methods and effectiveness of the Public Engagement in Genetic Variation and Haplotype Mapping Issues (PEGV) Project, which engaged a community in policy discussion about genetic variation research. The project implemented a 6-stage community engagement model in New Rochelle, New York. First, researchers recruited community partners. Second, the project team created community oversight. Third, focus groups discussed concerns generated by genetic variation research. Fourth, community dialogue sessions addressed focus group findings and developed policy recommendations. Fifth, a conference was held to present these policy recommendations and to provide a forum for HapMap (haplotype mapping) researchers to dialogue directly with residents. Finally, findings were disseminated via presentations and papers to the participants and to the wider community beyond. The project generated a list of proposed guidelines for genetic variation research that addressed the concerns of New Rochelle residents. Project team members expressed satisfaction with the engagement model overall but expressed concerns about how well community groups were utilized and what segment of the community actually engaged in the project. The PEGV Project represents a model for researchers to engage the general public in policy development about genetic research. There are benefits of such a process beyond the desired genetic research.
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Affiliation(s)
- Sharon F Terry
- Genetic Alliance, 4301 Connecticut Avenue, NW Suite 404, Washington, DC 20008, USA.
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Lakes KD, Vaughan E, Jones M, Burke W, Baker D, Swanson JM. Diverse perceptions of the informed consent process: implications for the recruitment and participation of diverse communities in the National Children's Study. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2012; 49:215-232. [PMID: 21671109 PMCID: PMC3575189 DOI: 10.1007/s10464-011-9450-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We examined the experiences, perceptions, and values that are brought to bear when individuals from different ethnic and cultural backgrounds consider participating in health research. Fifty-three women from Latino, Asian American, Middle Eastern, or Non-Latino, White backgrounds participated in seven English or Spanish focus groups facilitated by trained investigators using a standard protocol. Investigators described the National Children's Study (NCS) and then asked questions to elicit potential concerns, expectations, and informational needs. Group sessions were audio-recorded, transcribed verbatim, and analyzed using qualitative thematic methods. A major theme that emerged during focus groups was participant self-identification as a member of a cultural group or community when raising issues that would influence their decision to participate in research. A related theme was the belief by some that communities may differ in the ease of participation in the NCS. Identified themes related to the informed consent process included perceived risks, anticipated burden, perceived benefits, informational needs, and decision-making strategies. Although themes were shared across groups, there were cultural differences within themes. Findings indicated that individuals from diverse backgrounds may have different perspectives on and expectations for the research process. To effectively recruit representative samples, it will be important to address a range of issues relevant for informed consent and to consider the impact of participation on both individuals and communities.
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Affiliation(s)
- Kimberley D Lakes
- Department of Pediatrics, University of California, Irvine, 101 Academy Way, Suite 150, Irvine, CA 92617, USA.
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Lemke AA, Wu JT, Waudby C, Pulley J, Somkin CP, Trinidad SB. Community engagement in biobanking: Experiences from the eMERGE Network. Genom Soc Policy 2010; 6:50. [PMID: 22962560 PMCID: PMC3434453 DOI: 10.1186/1746-5354-6-3-50] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Advances in genomic technologies and the promise of "personalised medicine" have spurred the interest of researchers, healthcare systems, and the general public. However, the success of population-based genetic studies depends on the willingness of large numbers of individuals and diverse communities to grant researchers access to detailed medical and genetic information. Certain features of this kind of research - such as the establishment of biobanks and prospective data collection from participants' electronic medical records - make the potential risks and benefits to participants difficult to specify in advance. Therefore, community input into biobank processes is essential. In this report, we describe community engagement efforts undertaken by six United States biobanks, various outcomes from these engagements, and lessons learned. Our aim is to provide useful insights and potential strategies for the various disciplines that work with communities involved in biobank-based genomic research.
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Affiliation(s)
- Amy A Lemke
- Genomics and Social Science Research, Madison, WI; Institute of Medicine, Washington DC; Center for Human Genetics, Marshfield Clinic; Medical Education and Administration, Vanderbilt University; Kaiser Permanente Division of Research, Oakland CA; Department of Bioethics and Humanities, University of Washington
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Goldenberg AJ, Hull SC, Wilfond BS, Sharp RR. Patient perspectives on group benefits and harms in genetic research. Public Health Genomics 2010; 14:135-42. [PMID: 20938159 DOI: 10.1159/000317497] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 06/21/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is unclear how the possible effects of genetic research on socially identifiable groups may impact patient willingness to donate biological samples for future genetic studies. METHODS Telephone interviews with patients at 5 academic medical centers in the U.S. examined how patients' beliefs about benefits and harms to ones racial or ethnic group shape decisions to participate in genetic research. RESULTS Of the 1,113 patients who responded to questions about group harms and benefits, 61% of respondents indicated that potential benefits to their own racial or ethnic group would be a big or moderate part of their decision to donate a sample for genetic research. 63% of black respondents and 57% of white respondents indicated that they were 'very' or 'moderately concerned' about genetic research findings being used to discriminate against people by race or ethnicity. 64% of black and 34% of white respondents reported that their willingness to donate a blood sample would be substantially reduced due to these concerns. CONCLUSION Our findings suggest that a key factor in many patients' decisions to donate samples for genetic research is how those studies may impact identifiable racial and ethnic groups. Given the importance of these considerations to many patients, our study highlights a need to address patients' concerns about potential group benefits and harms in the design of future research studies and DNA biobanks.
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Affiliation(s)
- A J Goldenberg
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio, USA
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Bouffard C, Godin JK, Bévière B. State Intervention in Couples’ Reproductive Decisions: Socioethical Reflections Based on the Practice of Preimplantation Genetic Diagnosis in France. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/21507716.2010.505897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lemke AA, Wolf WA, Hebert-Beirne J, Smith ME. Public and biobank participant attitudes toward genetic research participation and data sharing. Public Health Genomics 2010; 13:368-77. [PMID: 20805700 DOI: 10.1159/000276767] [Citation(s) in RCA: 193] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2009] [Indexed: 11/19/2022] Open
Abstract
Research assessing attitudes toward consent processes for high-throughput genomic-wide technologies and widespread sharing of data is limited. In order to develop a better understanding of stakeholder views toward these issues, this cross-sectional study assessed public and biorepository participant attitudes toward research participation and sharing of genetic research data. Forty-nine individuals participated in 6 focus groups; 28 in 3 public focus groups and 21 in 3 NUgene biorepository participant focus groups. In the public focus groups, 75% of participants were women, 75% had some college education or more, 46% were African-American and 29% were Hispanic. In the NUgene focus groups, 67% of participants were women, 95% had some college education or more, and the majority (76%) of participants was Caucasian. Five major themes were identified in the focus group data: (a) a wide spectrum of understanding of genetic research; (b) pros and cons of participation in genetic research; (c) influence of credibility and trust of the research institution; (d) concerns about sharing genetic research data and need for transparency in the Policy for Sharing of Data in National Institutes of Health-Supported or Conducted Genome-Wide Association Studies; (e) a need for more information and education about genetic research. In order to increase public understanding and address potential concerns about genetic research, future efforts should be aimed at involving the public in genetic research policy development and in identifying or developing appropriate educational strategies to meet the public's needs.
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Affiliation(s)
- A A Lemke
- Center for Genetic Medicine, Northwestern University, Chicago, Ill. 60611, USA.
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Goddard KAB, Smith KS, Chen C, McMullen C, Johnson C. Biobank Recruitment: Motivations for Nonparticipation. Biopreserv Biobank 2009; 7:119-121. [PMID: 22087353 DOI: 10.1089/bio.2009.0006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 10/07/2009] [Indexed: 11/12/2022] Open
Abstract
Molecular data, essential for genomics research, can be captured more efficiently in large-scale, population-based biobanks of genetic material rather than by individual studies. Biobanks also offer improved quality and reliability of genetic samples and access through automated sample retrieval. However, it is challenging to adequately inform participants of the broad nature of the research and participation risks and benefits. In addition, recent studies suggest concerns about data sharing and return of research results, or future research topics (eg, stereotypical or potentially stigmatizing traits). We evaluated the interest in participating in a biobank and reasons for nonparticipation.
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Affiliation(s)
- Katrina A B Goddard
- The Center for Health Research , Kaiser Permanente Northwest, Portland, Oregon
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Artizzu F. The informed consent aftermath of the genetic revolution. An Italian example of implementation. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2008; 11:181-90. [PMID: 17638119 DOI: 10.1007/s11019-007-9086-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 06/20/2007] [Indexed: 05/16/2023]
Abstract
A great part of human genetics research is carried out collecting data and building large databases of biological samples that are in a non-anonymous format. These constitute a valuable resource for future research. The construction of such databases and tissue banks facilitates important scientific progress. However, biobanks have been recognized as ethically problematic because they contain thousands of data that could expose individuals and populations to discrimination, stigmatization and psychological stress if misused. Informed consent is regarded as a cornerstone in the protection of personal autonomy in research involving human subjects. Yet in recent years this fundamental concept has been overwhelmed by the genomic revolution. From a general overview of international literature, it seems evident that informed consent issues have come into sharp focus, in particular in relation to the twin issues of time extension (blanket versus specific/repeated consent) and personal extension (group consent). After an introduction on obtaining informed consent in the context of genetic research, this paper addresses the apparent lack of a single, universal model of obtaining informed consent among populations involved in genetic research and it argues for the need to develop an ethical framework tailored to the specific features of each project. In order to support this theory of contextualizing, the case of a private biotechnology company, SharDNA is presented. The present paper explores the management of its biobank, developed from a genetic research project carried out on isolated populations living on the Italian island of Sardinia. In particular, the paper highlights how the company is tackling the problem of informed consent and other ethical requirements for genetic research, such as the respect of individual privacy, the population approach and the existing Italian legal regulatory framework.
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Affiliation(s)
- Federica Artizzu
- SHARDNA Life Sciences SpA, Edificio n. 3 - loc. Piscinamanna, Pula, CA, Italy.
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Ragin DF, Ricci E, Rhodes R, Holohan J, Smirnoff M, Richardson LD. Defining the “community” in community consultation for emergency research: Findings from the community VOICES study. Soc Sci Med 2008; 66:1379-92. [DOI: 10.1016/j.socscimed.2007.10.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2007] [Indexed: 10/22/2022]
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Abstract
Nutrigenomics is a new application context for genomics technologies that focuses on the bidirectional study of genetic factors influencing host (individuals' or populations') response to diet and the effects of bioactive constituents in food on host genome and gene expression. Nutrigenomics is considered the next wave after pharmacogenomics for individualization of health interventions. However, relatively little attention has been given to the specific ethical-legal-social issues (ELSIs) and sociotechnical expectations raised by nutrigenomics research. Some of the ELSIs, such as ensuring privacy of genetic information and implications of genetic testing for health insurance and employment, may be shared across the continuum of genomic technology applications in human disease genetics, pharmacogenomics and nutrigenomics. However, there are certain aspects of nutrigenomics research that may result in unique or unprecedented ELSIs. For example, nutrigenomics has a strong focus on public health and the prevention/modification of 'predisease phenotypes' in apparently healthy individuals. Thus, in contrast to previous applications of genomics technologies, where the goal is to distinguish existing disease from absence of disease, the aim of nutrigenomics is the discernment of nuanced differences in predisease states. Moreover, there is evidence to suggest that ELSIs may be different in biomarker discovery, translational research and clinical testing stages of nutrigenomics. Ideally, ELSI research and nutrigenomics bioscience should progress in parallel and in a commensurate manner. We suggest that qualitative research methods, using a hypothesis-free approach, can be employed to gain deeper insights on complex bioethics issues that do not ordinarily lend themselves to formal hypothesis testing with the quantitative methods used in biomedical sciences.
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Affiliation(s)
- Vural Ozdemir
- Department of Preventive and Social Medicine, Bioethics Programs, Faculty of Medicine, University of Montreal C.P. 6128, Succ. Centre-Ville, Montreal, Québec, H3C 3J7, Canada
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Pulley JM, Brace MM, Bernard GR, Masys DR. Attitudes and perceptions of patients towards methods of establishing a DNA biobank. Cell Tissue Bank 2007; 9:55-65. [PMID: 17960495 DOI: 10.1007/s10561-007-9051-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Accepted: 07/03/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study aimed to assess patient attitudes as part of the planning process for a large-scale effort to collect genetic samples for research from excess clinical blood specimens ('DNA Databank' project). METHOD A pre-tested, 38-item questionnaire was mailed to a random sample of 5,000 inpatients, outpatients, and emergency department patients. RESULTS Approximately 20% of patients responded (n = 1003). Most were comfortable with anonymized genetic information being used for research (89.3%) and supported the potential benefits (98.7%). A binary logistic regression on the level of comfort with the DNA program shows that the variability in respondents' feelings about the program can best be explained by beliefs, age, and health status. Respondents were attitudinally segmented into 5 distinct categories. CONCLUSIONS These data indicate general acceptance among respondents, but a subset of the population would be opposed to the program. This reinforces the need to broadly and continuously communicate with patients about the program and the ability to exclude a given sample. The effects of prior beliefs would benefit from further exploration.
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Affiliation(s)
- Jill M Pulley
- Vanderbilt University Medical Center, Vanderbilt Office of Research, 2525 West End Avenue, 6th Floor, Nashville, TN 37203-8820, USA.
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Smith K, Wueste D, Frugoli J. Using "ethics labs" to set a framework for ethical discussion in an undergraduate science course. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2007; 35:332-6. [PMID: 21591119 DOI: 10.1002/bmb.94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Teaching ethics across the curriculum is a strategy adopted by many universities. One of the fundamental aims of teaching ethics across the curriculum is to get students to see ethics as truly relevant to the subjects they are studying. Ideally, students will come to see that ethics is a thread woven deeply in the fabric of all knowledge and practice. The standard approach, in which students are required to take a separate ethics course, is not especially well suited to this task, but incorporating ethics into science courses presents significant challenges and is likely to meet with resistance, if only because professors in the sciences are often untrained in the teaching of ethics. In an effort to raise the standard of science education as well as comply with a university-wide curricular mandate, we as a team developed the concept of an "ethics lab." We discuss the design of the exercises done during laboratory sections, the training of the graduate students who run the exercises, and the iterations of the exercises over time. We report unanticipated rapid positive outcomes of an attempt to integrate ethics education into a sophomore/junior level science course, Introduction to Genetics.
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Affiliation(s)
- Kelly Smith
- From the Department of Philosophy and Religion and Lemon Fellow, Rutland Institute for Ethics, Clemson University
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Godard B, Marshall J, Laberge C. Community engagement in genetic research: results of the first public consultation for the Quebec CARTaGENE project. Public Health Genomics 2007; 10:147-58. [PMID: 17575459 DOI: 10.1159/000101756] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This paper presents the results of the first public consultation for the creation of a large-scale genetic database, the Quebec CARTaGENE project. A consultation has been undertaken in order to gauge whether the general public is receptive to the project. An integral part of the approach of the researchers is to establish a dialogue with the public. METHODS Two independent expert groups have carried out qualitative and quantitative studies measuring knowledge of and interest in genetics, incentives and obstacles to CARTaGENE participation and comprehension and evaluation of the communication tools. RESULTS CARTaGENE is seen to hold promise for the greater population. However, reported across qualitative and quantitative studies is the concern for confidentiality and respect for the individual, transparency, the donor's right to feedback and governance. Participation would be conditional on a response to those concerns and a greater dissemination of information. CONCLUSION Community engagement in genetic research requires targeted communications, with an appropriate proportioning of information and communication, and a consideration of the 'values and personal interests' of individuals according to different societal segments.
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Affiliation(s)
- Béatrice Godard
- Bioethics Programs, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
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Rebulla P, Lecchi L, Giovanelli S, Butti B, Salvaterra E. Biobanking in the Year 2007. Transfus Med Hemother 2007. [DOI: 10.1159/000103922] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Clinical practice guidelines derived from genetic research using population-based biobanks could dramatically change the nature of personal and public health medicine. Centralized population-based biobanks have been established or proposed in at least nine countries to date, and many lessons have been learned from these landmark developments. Scientific and governmental leaders in the United States are currently contemplating pending federal legislation regarding the establishment of centralized and networked biobanks. Public health practitioners and clinical care providers may be called on to serve pronounced planning roles at the state level. Possible responsibilities include: formulating legislation, gathering public comment, reviewing research proposals, and developing procedures for informed consent, participant withdrawal, and confidentiality protection. State health agencies may also need to create and/or administer banking facilities. Proper planning may ensure that individual rights are protected while research benefits are maximized.
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Affiliation(s)
- Helen Swede
- Connecticut Tumor Registry, Department of Community Medicine & Health Care, University of Connecticut School of Medicine, Farmington, Connecticut 06030-6325, USA.
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Mc Fleming J. The governance of human genetic research databases in mental health research. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2007; 30:182-90. [PMID: 17449098 DOI: 10.1016/j.ijlp.2007.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The field of mental health offers a valuable context in which to examine new challenges presented by human genetic research databases to the legal, ethical and regulatory frameworks for human genetic research. Longitudinal prospective genetic research of psychiatric disorders often involves access to human genetic research databases and to stored tissue for future uses that cannot be specified at the time the patient consents to their collection. The potential of such research to contribute to an improved understanding and treatment of complex genetic diseases such as schizophrenia presupposes sound ethical, legal and regulatory frameworks to ensure public trust and preparedness to participate in such research. This article provides a brief overview of some of the ethical and legal challenges posed by human genetic research databases and their implications for how genetic research should be conducted in the field of mental health.
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Affiliation(s)
- Jennifer Mc Fleming
- Institute for Molecular Biosciences, University of Queensland, St Lucia 4072, Brisbane, Queensland, Australia.
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Ozdemir V, Williams-Jones B, Cooper DM, Someya T, Godard B. Mapping translational research in personalized therapeutics: from molecular markers to health policy. Pharmacogenomics 2007; 8:177-85. [PMID: 17286540 DOI: 10.2217/14622416.8.2.177] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Translational research is frequently used in the bioscience literature to refer to the translation of basic science into practical applications at the point of patient care. With the introduction of theragnostics, a new medical subspecialty that fuses therapeutics and diagnostic medicine with the goal of providing individualized pharmacotherapy, we suggest that the focus of translational research is shifting. We identify two bottlenecks or gaps in translational research for theragnostics: GAP1 translation from basic science to first-in-human proof-of-concept; and GAP2 translation from clinical proof-of-concept to development of evidence-based personalized treatment guidelines. GAP1 translational research in theragnostics is usually performed in traditional craft-based studies with small sample sizes and led by independent academic or industry researchers. In contrast, GAP2 translational investigations typically rely on large research consortiums and population-based biobanks that couple biomarker information with longitudinal ‘real-life’ observational data on a broad range of pharmacological phenotypes. Despite an abundance of research on the use of biobanks in disease gene discovery, there has been little conceptual work on whether and to what extent population biobanks can be utilized for translating genomics discoveries to practical treatment guidelines for theragnostic tests.
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Affiliation(s)
- Vural Ozdemir
- General Clinical Research Center, School of Medicine, University of California, Irvine, CA, USA.
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McGregor JL. Population genomics and research ethics with socially identifable groups. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2007; 35:356-70. [PMID: 17714247 DOI: 10.1111/j.1748-720x.2007.00160.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
In this paper, the author questions whether the research ethics guidelines and procedures are robust enough to protect groups when conducting genetics research with socially identifiable populations, particularly with Native American groups. The author argues for a change in the federal guidelines in substance and procedures of conducting genetic research with socially identifiable groups.
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Affiliation(s)
- Joan L McGregor
- Bioethics, Policy, and Law Program at the School of Life Sciences and Philosophy, Arizona State University, USA
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Ozdemir V, Gunes A, Dahl ML, Scordo MG, Williams-Jones B, Someya T. Could endogenous substrates of drug-metabolizing enzymes influence constitutive physiology and drug target responsiveness? Pharmacogenomics 2006; 7:1199-210. [PMID: 17184207 DOI: 10.2217/14622416.7.8.1199] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Integration of genomic data from pharmacokinetic pathways and drug targets is an emerging trend in bioinformatics, but is there a clear separation of pharmacokinetic pathways and drug targets? Should we also consider the potential interactions of endogenous substrates of drug-metabolizing enzymes with receptors and other molecular drug targets as we combine pharmacogenomic datasets? We discuss these overarching questions through a specific pharmacogenomic case study of the cytochrome P450 (CYP)2D6, serotonin and dopamine triad. Importantly, CYP2D6 may contribute to the regeneration of serotonin from 5-methoxytryptamine by virtue of its catalytic function as a 5-methoxyindolethylamine O-demethylase. Furthermore, serotonergic neurons provide a regulatory feedback on dopaminergic neurotransmission. Hence, we hypothesize that independent of its role as a pharmacokinetic gene, CYP2D6 may nuance the regulation of serotonergic and dopaminergic neurophysiology. Additionally, we reflect upon the contribution of hyperspecialization in biomedicine to the present disconnect between research on pharmacokinetics and drug targets, and the potential for remedying this important gap through informed dialogue among clinical pharmacologists, human geneticists, bioethicists and applied social scientists.
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Affiliation(s)
- Vural Ozdemir
- Biomarker and Clinical Pharmacology Unit, University of California, Irvine, USA.
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25
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Abstract
Many achievements in the genome sciences have been facilitated by policies that have prioritized genome research, secured funding and raised public and health-professional awareness. Such policies should address ethical, legal and social concerns, and are as important to the scientific and commercial development of the field as the science itself. On occasion, policy issues take precedence over science, particularly when impasses are encountered or when public health or money is at stake. Here we discuss the spectrum of current issues and debates in genome policy, and how to actively engage all affected stakeholders to promote effective policy making.
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Affiliation(s)
- Susanne B Haga
- Institute for Genome Sciences & Policy, Duke University, 101 Science Drive, Box 3382, Durham, North Carolina 27708, USA.
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26
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Grady C, Hampson LA, Wallen GR, Rivera-Goba MV, Carrington KL, Mittleman BB. Exploring the ethics of clinical research in an urban community. Am J Public Health 2006; 96:1996-2001. [PMID: 17018826 PMCID: PMC1751807 DOI: 10.2105/ajph.2005.071233] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We consulted with representatives of an urban community in Washington, DC, about the ethics of clinical research involving residents of the community with limited access to health care. METHODS A semistructured community consultation was conducted with core members of the Health Partnership Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Three research case examples were discussed; questions and probes (a predetermined question or series of questions used to further investigate or follow-up a response) guided the discussion. RESULTS The community representatives who took part in the consultation were supportive of research and appreciated the opportunity to be heard. They noted the importance of respecting the circumstances, values, needs, and welfare of research participants; supported widely representative recruitment strategies; and cited the positive benefits of providing care or treatment to participants. Monitoring participants' welfare and ensuring care at a study's end were emphasized. Trust was a central theme; participants suggested several trust-enhancing strategies, including full disclosure of information and the involvement of advocates, physicians, and trusted church members. CONCLUSIONS Several important strategies emerged for conducting ethical research in urban communities whose residents have limited access to health care.
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Affiliation(s)
- Christine Grady
- Department of Clinical Bioethics, National Institutes of Health, Bethesda, Md 20892-1156, USA.
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27
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Wallace HM. The development of UK Biobank: Excluding scientific controversy from ethical debate. CRITICAL PUBLIC HEALTH 2005. [DOI: 10.1080/09581590500523202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Affiliation(s)
- Karen J Maschke
- Ethics and Science Policy, Hastings Center, 21 Malcolm Gordon Road, Garrison, New York 10524-5555, USA.
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29
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Geller LN. The role of databank managers as guardians of public interests. Commentary on "Strategies for consulting with the community: the cases of four large-scale databanks" (Godard et al.). SCIENCE AND ENGINEERING ETHICS 2004; 10:479-480. [PMID: 15362703 DOI: 10.1007/s11948-004-0004-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Lisa N Geller
- Wilmer Cutler Pickering Hale and Dorr LLP, 60 State Street, Boston, MA 02109, USA.
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30
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Bird SJ. Consulting the community: limits and expectations. Commentary on "Strategies for consulting with the community: the cases of four large-scale databanks" (Godard et al.). SCIENCE AND ENGINEERING ETHICS 2004; 10:481-482. [PMID: 15362704 DOI: 10.1007/s11948-004-0005-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Stephanie J Bird
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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