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Giesbertz NAA, Melham K, Kaye J, van Delden JJM, Bredenoord AL. Personalized assent for pediatric biobanks. BMC Med Ethics 2016; 17:59. [PMID: 27733160 PMCID: PMC5062866 DOI: 10.1186/s12910-016-0142-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 09/29/2016] [Indexed: 12/22/2022] Open
Abstract
Pediatric biobanking is considered important for generating biomedical knowledge and improving (pediatric) health care. However, the inclusion of children’s samples in biobanks involves specific ethical issues. One of the main concerns is how to appropriately engage children in the consent procedure. We suggest that children should be involved through a personalized assent procedure, which means that both the content and the process of assent are adjusted to the individual child. In this paper we provide guidance on how to put personalized assent into pediatric biobanking practice and consider both the content and process of personalized assent. In the discussion we argue that the assent procedure itself is formative. Investing in the procedure should be a requirement for pediatric biobank research. Although personalized assent will require certain efforts, the pediatric (biobank) community must be aware of its importance. The investment and trust earned can result in ongoing engagement, important longitudinal information, and stability in/for the research infrastructure, as well as increased knowledge among its participants about research activity. Implementing personalized assent will both respect the child and support biobank research.
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Affiliation(s)
- Noor A A Giesbertz
- Department of Medical Humanities, Division Julius Center, University Medical Center Utrecht, Office Stratenum 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. .,Department of Genetics, Division Biomedical Genetics, University Medical Center Utrecht, KC.04.084.2, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands.
| | - Karen Melham
- Clinical Trials & Research Governance (CTRG) University of Oxford Joint Research Office, Block 60, Churchill Hospital, Headington, Oxford, OX3 7LE, United Kingdom
| | - Jane Kaye
- Nuffield Department of Population Health, HeLEX-Centre for Health, Law and Emerging Technologies at Oxford, University of Oxford, Ewert House, Ewert Place, Banbury Road, Summertown, Oxford, OX2 7DD, UK
| | - Johannes J M van Delden
- Department of Medical Humanities, Division Julius Center, University Medical Center Utrecht, Office Stratenum 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Annelien L Bredenoord
- Department of Medical Humanities, Division Julius Center, University Medical Center Utrecht, Office Stratenum 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
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Waligora M, Różyńska J, Piasecki J. Child's objection to non-beneficial research: capacity and distress based models. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2016; 19:65-70. [PMID: 25916607 PMCID: PMC4805702 DOI: 10.1007/s11019-015-9643-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A child's objection, refusal and dissent regarding participation in non-beneficial biomedical research must be respected, even when the parents or legal representatives have given their permission. There is, however, no consensus on the definition and criteria of a meaningful and valid child's objection. The aim of this article is to clarify this issue. In the first part we describe the problems of a child's assent in research. In the second part we distinguish and analyze two models of a child's objection to research: the capacity-based model and the distress-based model. In the last part we present arguments for a broader and unified understanding of a child's objection within regulations and practices. This will strengthen children's rights and facilitate the entire process of assessment of research protocols.
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Affiliation(s)
- Marcin Waligora
- Department of Philosophy and Bioethics, Faculty of Health Science, Jagiellonian University, Medical College, Michałowskiego 12, 31-126, Krakow, Poland.
| | - Joanna Różyńska
- Department of Ethics, Institute of Philosophy, University of Warsaw, Krakowskie Przedmieście 3, 00-927, Warsaw, Poland
| | - Jan Piasecki
- Department of Philosophy and Bioethics, Faculty of Health Science, Jagiellonian University, Medical College, Michałowskiego 12, 31-126, Krakow, Poland
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Waligora M, Dranseika V, Piasecki J. Child's assent in research: age threshold or personalisation? BMC Med Ethics 2014; 15:44. [PMID: 24923433 PMCID: PMC4073511 DOI: 10.1186/1472-6939-15-44] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 06/10/2014] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Assent is an important ethical and legal requirement of paediatric research. Unfortunately, there are significant differences between the guidelines on the details of assent. DISCUSSION What often remains unclear is the scope of the assent, the procedure for acquiring it, and the way in which children's capacity to assent is determined. There is a general growing tendency that suggests that the process of assent should be personalised, that is, tailored to a particular child. This article supports the idea of personalisation. However, we also propose placing limits on personalisation by introducing a suggested requirement of assent starting at a school-age threshold. In some situations RECs/IRBs and researchers could reduce the suggested threshold. SUMMARY A recommended age threshold is likely to serve the interests of children better than ambiguous and flexible criteria for personalised age determination.
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Affiliation(s)
- Marcin Waligora
- Department of Philosophy and Bioethics, Faculty of Health Sciences, Jagiellonian University, Medical College, Michalowskiego 12, Krakow 31-126, Poland
| | - Vilius Dranseika
- Department of Logic and History of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Jan Piasecki
- Department of Philosophy and Bioethics, Faculty of Health Sciences, Jagiellonian University, Medical College, Michalowskiego 12, Krakow 31-126, Poland
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