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Stoeklé HC, Hulier-Ammar E, Hervé C. Data Medicine: ‘Broad’ or ‘Dynamic’ Consent? Public Health Ethics 2022. [DOI: 10.1093/phe/phac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The General Data Protection Regulation imposes, at European level, a need to seek express or explicit consent for the processing of health data. In the framework of biomedical research, some favor the use of express ‘broad’ consent, whereas other maintain, or wish to maintain the use of presumed or implicit consent, often referred to as ‘non-opposition’ in conditions in which such consent is still authorized. In our view, broad consent and presumed consent are likely to prove to be easy solutions in the short term but much less relevant in the long term, for both hospital and patients, if the bioethical objective remains the improvement of patient quality of life and/or survival, regardless of the disease considered. Dynamic consent could be the best way to achieve this objective because only this type of consent could improve hospital transparency and increase patient confidence by allaying certain fears.
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Affiliation(s)
- Henri-Corto Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital , Suresnes , France
| | | | - Christian Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital , Suresnes , France
- Medical School, Versailles Saint-Quentin-en-Yvelines University , Montigny-le-Bretonneux , France
- Medical School, Paris Cité University , Paris , France
- International Academy of Medical Ethics and Public Health, Paris Cité University , Paris , France
- Veterinary Academy of France , Paris , France
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Goncharov L, Suominen H, Cook M. Dynamic consent and personalised medicine. Med J Aust 2022; 216:547-549. [PMID: 35611469 PMCID: PMC9544476 DOI: 10.5694/mja2.51555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Liza Goncharov
- Institute for Communication in Health Care Australian National University Canberra ACT
| | - Hanna Suominen
- Australian National University Canberra ACT
- University of Turku Turku Finland
| | - Matthew Cook
- Australian National University Canberra ACT
- Canberra Health Services Canberra ACT
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Stoeklé HC, Hervé C. Ownership of Genetic Data: Between Universalism and Contextualism? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:75-77. [PMID: 34806963 DOI: 10.1080/15265161.2021.1991033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Stoeklé HC, Ivasilevitch A, Marignac G, Hervé C. Creation and use of organoids in biomedical research and healthcare: the bioethical and metabioethical issues. Cell Adh Migr 2021; 15:285-294. [PMID: 34706616 PMCID: PMC8555554 DOI: 10.1080/19336918.2021.1996749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In the field of bioethics, scientific articles have already been published, and have highlighted relatively pluralist reflections concerning the creation and use of organoids. This plurality, rather than simply reflecting the complexity of the subject, may also be a consequence of the multiple theoretical and practical frameworks applied. Moreover, the creation and use of organoids in biomedical research and healthcare is probably in its infancy. This phenomenon is likely to increase in amplitude. Bioethics may be able to provide it with an effective and pertinent moral meaning, provided that a veritable metabioethical reflection is developed in parallel, that is, a reflection on bioethics itself, to provide scientists and clinicians with the best possible assistance in their everyday practice.
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Affiliation(s)
- Henri-Corto Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - Achille Ivasilevitch
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France.,Laboratory of Business Law and New Technologies (Dante) (UR4498), Paris-Saclay University (Uvsq), Montigny-Le-Bretonneux, France
| | | | - Christian Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France.,University of Paris, Paris, France.,International Academy of Medical Ethics and Public Health, University of Paris, Paris, France.,Veterinary Academy of France, Paris, France
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Abstract
We present here a new method for bioethics: systemic modelling. In this method, the complex phenomenon being studied (e.g. personalized medicine, genetic testing, gene therapy, genetically modified organisms) is modelled as a whole, to shed light on its organization and functioning, and major (bio)ethical issues and solutions for their resolution are then identified. This systemic modelling method is ideal for use in the identification of solutions, rather than their validation, with other methods then used to test the solutions found. We provide a description and reproducible instructions for the application of systemic modelling in bioethics, together with a brief example of the application of this method to the study of the impact of personalized medicine on French society.
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Affiliation(s)
- Henri-Corto Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - Philippe Charlier
- Laboratoire Anthropologie, Archéologie, Biologie (LAAB), Université Paris-Saclay (UVSQ), 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France; Musée du Quai Branly - Jacques-Chirac, 222, rue de l'Université, 75007 Paris, France
| | - Marie-France Mamzer-Bruneel
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Laboratoire ETRES, F-75006, Paris, France; Cancer Research for Personalized Medicine (CARPEM), Paris Descartes, APHP (HEGP, Cochin, Necker) INSERM, Paris, France; Assistance Publique-Hôpitaux de Paris AP-HP, Necker-Enfants Malades Hospital, Paris, France
| | - Christian Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France; Medical School, University of Paris, Paris, France; International Academy of Medical Ethics and Public Health, Université de Paris, Paris, France
| | - Guillaume Vogt
- Laboratoire Neglected Human Genetics, Inserm, Université Paris Descartes, Paris, France
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Gourraud PA, Simon F. Differences Between Europe and the United States on AI/Digital Policy: Comment Response to Roundtable Discussion on AI. GENDER AND THE GENOME 2020. [DOI: 10.1177/2470289720907103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
For AI policy, there are significant differences between Europe and the United States. The General Data Protection Regulation, which applies not only to European Union companies but also to all American companies with European customers, is more protective than health insurance portability and accountability act for individual health data. Its Article 22 stipulates that citizens cannot be submitted to medical decisions generated by an automated source.
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Affiliation(s)
- Pierre-Antoine Gourraud
- INSERM, Ecole Centrale de Nantes, Centre de Recherche en Transplantation et Immunologie, Nantes University, Nantes, France
- CHU de Nantes, INSERM, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, Nantes, France
| | - Francoise Simon
- School of Public Health, Columbia University, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine, Mount Sinai, New York, NY, USA
- Nantes University, Nantes, France
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Ekong R, Vihinen M. Checklist for gene/disease-specific variation database curators to enable ethical data management. Hum Mutat 2019; 40:1634-1640. [PMID: 31347738 DOI: 10.1002/humu.23881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/16/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022]
Abstract
Databases with variant and phenotype information are essential for advancing research and improving the health and welfare of individuals. These resources require data to be collected, curated, and shared among relevant specialties to maximize impact. The increasing generation of data which must be shared both nationally and globally for maximal effect presents important ethical and privacy concerns. Database curators need to ensure that their work conform to acceptable ethical standards. A Working Group of the Human Variome Project had the task of updating and streamlining ethical guidelines for locus-specific/gene variant database curators. In this article, we present practical and achievable steps which should assist database curators in carrying out their responsibilities within acceptable ethical norms.
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Affiliation(s)
- Rosemary Ekong
- Department of Genetics, Evolution & Environment, University College London, London, UK
| | - Mauno Vihinen
- Department of Experimental Medical Science, BMC B13, Lund University, Lund, Sweden
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