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Roberts KJ, Chaves E, Ariza AJ, Thaker VV, Cho CC, Binns HJ. Exploring Genetic Testing for Rare Disorders of Obesity: Experience and Perspectives of Pediatric Weight Management Providers. Child Obes 2024. [PMID: 38227789 DOI: 10.1089/chi.2023.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: This study describes experiences and perspectives of pediatric weight management (PWM) providers on the implementation of genetic testing for rare causes of obesity. Methods: Purposive and snowball sampling recruited PWM providers via email to complete a 23-question survey with multiple choice and open-ended questions. Analyses include descriptive statistics, Fisher's exact test, one-way ANOVA with Tukey's post hoc test, and qualitative analysis. Results: Of the 55 respondents, 80% reported ordering genetic testing. Respondents were primarily physicians (82.8%) in practice for 11-20 years (42%), identified as female (80%), White (76.4%), and non-Hispanic (92.7%) and provided PWM care 1-4 half day sessions per week. Frequently reported patient characteristics that prompted testing did not vary by provider years of experience (YOE). These included obesity onset before age 6, hyperphagia, dysmorphic facies, and developmental delays. The number of patient characteristics that prompted testing varied by YOE (p = 0.03); respondents with 6-10 YOE indicated more patient characteristics than respondents with >20 YOE (mean 10.3 vs. mean 6.2). The reported primary benefit of testing was health information for patients/families; the primary drawback was the high number of indeterminate tests. Ethical concerns expressed were fear of increasing weight stigma, discrimination, and impact on insurance coverage. Respondents (42%) desired training and guidance on interpreting results and counseling patients and families. Conclusions: Most PWM providers reported genetic testing as an option for patient management. Provider training in genetics/genomics and research into provider and family attitudes on the genetics of obesity and the value of genetic testing are next steps to consider.
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Affiliation(s)
- Karyn J Roberts
- School of Nursing, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eileen Chaves
- Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Adolfo J Ariza
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Vidhu V Thaker
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Chi C Cho
- School of Nursing, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Helen J Binns
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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2
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Salerno J, Coughlin SS, Goodman KW, Hlaing WM. Current ethical and social issues in epidemiology. Ann Epidemiol 2023; 80:37-42. [PMID: 36758845 DOI: 10.1016/j.annepidem.2023.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE The American College of Epidemiology held its 2021 Annual Meeting virtually, September 8-10, with a conference theme of 'From Womb to Tomb: Insights from Health Emergencies'. The American College of Epidemiology Ethics Committee hosted a symposium session in recognition of the ethical and social challenges brought to light by the coronavirus disease 2019 pandemic and on the occasion of the publication of the third edition of the classic text, Ethics and Epidemiology. The American College of Epidemiology Ethics Committee invited the book editor and contributing authors to present at the symposium session titled 'Current Ethical and Social Issues in Epidemiology.' The purpose of this paper is to further highlight the ethical challenges and presentations. METHODS Three speakers with expertise in ethics, health law, health policy, global health, health information technology, and translational research in epidemiology and public health were selected to present on the social and ethical issues in the current landscape. Dr. S Coughlin presented on the 'Ethical and Social Issues in Epidemiology', Dr. L Beskow presented on 'Ethical Challenges in Genetic Epidemiology', and Dr. K Goodman presented on the 'Ethics of Health Informatics'. RESULTS New digital sources of data and technologies are driving the ethical challenges and opportunities in epidemiology and public health as it relates to the three emerging topic areas identified: (1) digital epidemiology, (2) genetic epidemiology, and (3) health informatics. New complexities such as the reliance on social media to control infectious disease outbreaks and the introduction of computing advancements are requiring re-evaluation of traditional bioethical frameworks for epidemiology research and public health practice. We identified several cross-cutting ethical and social issues related to informed consent, benefits, risks and harms, and privacy and confidentiality and summarized these alongside more nuanced ethical considerations such as algorithmic bias, group harms related to data (mis)representation, risks of misinformation, return of genomic research results, maintaining data security, and data sharing. We offered an integrated synthesis of the stages of epidemiology research planning and conduct with the ethical issues that are most relevant in these emerging topic areas. CONCLUSIONS New realities exist for epidemiology and public health as professional groups who are faced with addressing population health, and especially given the recent pandemic and the widespread use of digital tools and technologies. Many ethical issues can be understood in the context of existing ethical frameworks; however, they have yet to be clearly identified or connected with the new technical and methodological applications of digital tools and technologies currently in use for epidemiology research and public health practice. To address current ethical challenges, we offered a synthesis of traditional ethical principles in public health science alongside more nuanced ethical considerations for emerging technologies and aligned these with lifecycle stages of epidemiology research. By critically reflecting on the impact of new digital sources of data and technologies on epidemiology research and public health practice, specifically in the control of infectious outbreaks, we offered insights on cultivating these new areas of professional growth while striving to improve population health.
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Affiliation(s)
- Jennifer Salerno
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Steven S Coughlin
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA; Institute of Public and Preventive Health, Augusta University, Augusta, GA
| | - Kenneth W Goodman
- Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL
| | - WayWay M Hlaing
- Division of Epidemiology and Population Sciences, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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3
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Beskow LM, Wolf LE. "Choice of law" in precision medicine research. Am J Hum Genet 2022; 109:1347-1352. [PMID: 35931047 PMCID: PMC9388386 DOI: 10.1016/j.ajhg.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/15/2022] [Indexed: 02/06/2023] Open
Abstract
Large-scale precision medicine research requires massive amounts of data representing people from all walks of life; thus, in the US, it is often multistate research. Significant legal and ethical quandaries arise as a result of the patchwork of laws states have enacted that may apply to research, are not preempted by federal law, and may impose requirements or provide participant rights and protections that differ from other states. Determining which state's laws apply, and under what circumstances, is not solved by the transition to a single-IRB model and researchers cannot simply choose one state's laws to apply uniformly. At a minimum, the current process of meeting each state's requirements could be made more reliable and efficient. To fundamentally change this status quo, however, requires action at multiple levels. Federally, well-known gaps in the Genetic Information Nondiscrimination Act should be closed, and a coherent system of compensation for research injury-including non-physical injuries-should be developed. States should clarify which of their laws are intended to apply to research and work collaboratively to harmonize them. At the level of individual research projects, numerous policies and procedures could be standardized through authoritative guidelines. Examples include clarifying the scope of broad consent, understanding and upholding Certificates of Confidentiality, offering individual research results responsibly, and consistently disseminating aggregate results to participants and the public. Overall, development of a choice of law framework specific to the research context could significantly promote clarity and consistency.
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Affiliation(s)
- Laura M. Beskow
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN 37203, USA,Corresponding author
| | - Leslie E. Wolf
- Center for Law, Health and Society, Georgia State University College of Law, Atlanta, GA 30303, USA
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Erdmann A, Rehmann-Sutter C, Bozzaro C. Patients' and professionals' views related to ethical issues in precision medicine: a mixed research synthesis. BMC Med Ethics 2021; 22:116. [PMID: 34465328 PMCID: PMC8406914 DOI: 10.1186/s12910-021-00682-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Precision medicine development is driven by the possibilities of next generation sequencing, information technology and artificial intelligence and thus, raises a number of ethical questions. Empirical studies have investigated such issues from the perspectives of health care professionals, researchers and patients. We synthesize the results from these studies in this review. METHODS We used a systematic strategy to search, screen and assess the literature for eligibility related to our research question. The initial search for empirical studies in five data bases provided 665 different records and we selected 92 of these publications for inclusion in this review. Data were extracted in a spreadsheet and categorized into different topics representing the views on ethical issues in precision medicine. RESULTS Many patients and professionals expect high benefits from precision medicine and have a positive attitude towards it. However, patients and professionals also perceive some risks. Commonly perceived risks include: lack of evidence for accuracy of tests and efficacy of treatments; limited knowledge of patients, which makes informed consent more difficult; possible unavailability of access to precision medicine for underprivileged people and ethnic minorities; misuse of data by insurance companies and employers, potential of racial stigmatization due to genetic information; unwanted communication of incidental findings; changes in doctor-patient-relationship through focusing on data; and the problem that patients could feel under pressure to optimize their health. CONCLUSIONS National legislation and guidelines already minimize many risks associated with precision medicine. However, from our perspective some problems require more attention. Should hopes for precision medicine's benefits be fulfilled, then the ethical principle of justice would require an unlimited access to precision medicine for all people. The potential for autonomous patients' decisions must be greatly enhanced by improvements in patient education. Harm from test results must be avoided in any case by the highest possible data security level and communication guidelines. Changes in the doctor-patient relationship and the impact of precision medicine on the quality of life should be further investigated. Additionally, the cost-effectiveness of precision medicine should be further examined, in order to avoid malinvestment.
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Affiliation(s)
- Anke Erdmann
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University (CAU), Kiel, Germany.
| | | | - Claudia Bozzaro
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University (CAU), Kiel, Germany
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5
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Vernaz N, Simona A, Samer CF. The Swiss Cheese Prescribing Model for Precision Medicine. Am J Med 2020; 133:1249-1251. [PMID: 32603792 DOI: 10.1016/j.amjmed.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Nathalie Vernaz
- Medical Directorate, Finance Directorate Geneva University Hospitals, University of Geneva, Switzerland.
| | - Aurélien Simona
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, University of Geneva, Switzerland
| | - Caroline Flora Samer
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, University of Geneva, Switzerland
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6
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Abstract
Biomedical research is increasingly capitalizing on an array of data to illuminate the interplay between "omics," lifestyle, and health. Leveraging this information presents opportunities to advance knowledge but also poses risks to research participants. In interviews with thought leaders, we asked which data type associated with a hypothetical precision medicine research endeavor was riskiest: 42% chose ongoing access to electronic health records, 17% chose genomic analyses of biospecimens, and 15% chose streaming data from mobile devices. Other responses included "It depends" (15%), the three types are equally risky (8%), and the combination of data types together is riskiest (3%). When asked to consider the hypothetical study overall, 60% rated the likelihood of the risks materializing as low, but 20% rated the potential consequences as severe. These results have implications for study design and informed consent, including placing appropriate emphasis on the risks and protections for the full range of data.
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Affiliation(s)
- Laura M Beskow
- Ann Geddes Stahlman Chair in Medical Ethics and a professor of health policy at the Center for Biomedical Ethics and Society at the Vanderbilt University Medical Center
| | - Catherine M Hammack-Aviran
- Associate in health policy at the Center for Biomedical Ethics and Society at the Vanderbilt University Medical Center
| | - Kathleen M Brelsford
- Research assistant professor at the Center for Biomedical Ethics and Society at the Vanderbilt University Medical Center at the time of this work
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Woodbury RB, Beans JA, Wark KA, Spicer P, Hiratsuka VY. Community Perspectives on Communicating About Precision Medicine in an Alaska Native Tribal Health Care System. Front Commun (Lausanne) 2020; 5:70. [PMID: 33511166 PMCID: PMC7839995 DOI: 10.3389/fcomm.2020.00070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Precision medicine seeks to better tailor medical care to the needs of individual patients, but there are challenges involved in communicating to patients, health care providers, and health system leaders about this novel and complex approach to research and clinical care. These challenges may be exacerbated for Alaska Native and American Indian (ANAI) people, whose experiences of unethical research practices have left some ANAI communities hesitant to engage in research that involves extensive data-sharing and diminished control over the terms of data management and who may have distinct, culturally-informed communication needs and preferences. There is need for communication research to support Tribal health organizations and ANAI people as they consider implementation of and participation in precision medicine. To address that need, this study characterizes the informational needs and communication preferences of patients, providers, and leaders at an Alaska Native Tribal health organization. METHODS We conducted 46 individual, semi-structured interviews to explore perspectives on precision medicine and related communication needs among patients, providers, and leaders of a Tribal health organization. Analysis involved team-based coding to identify a priori and emergent themes, followed by identification and recoding of content relevant to precision medicine informational needs and communication preferences. RESULTS Patients, providers, and leaders were described as both sources and recipients of information about precision medicine. Information deemed essential for making decisions about whether to participate in or implement a precision medicine program included information about the clinical and research applications of precision medicine, benefits and risks, health system costs and impacts, and data management practices. Preferred communication channels included digital and non-digital informational materials, as well as in-person learning opportunities for individuals and groups. Participants also describe contextual factors and barriers that influenced the acceptability and effectiveness of approaches to health communication. CONCLUSION Results can inform approaches to communicating information about precision medicine to stakeholders within Tribal and other health care systems considering implementation of precision medicine in clinical or research contexts.
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Affiliation(s)
- R. Brian Woodbury
- Southcentral Foundation, Anchorage, AK, United States
- Correspondence: R. Brian Woodbury,
| | | | - Kyle A. Wark
- Southcentral Foundation, Anchorage, AK, United States
| | - Paul Spicer
- University of Oklahoma, Norman, OK, United States
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Beskow LM, Hammack-Aviran CM, Brelsford KM. Developing model biobanking consent language: what matters to prospective participants? BMC Med Res Methodol 2020; 20:119. [PMID: 32414333 PMCID: PMC7227271 DOI: 10.1186/s12874-020-01001-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Efforts to improve informed consent have led to calls for providing information a reasonable person would want to have, in a way that facilitates understanding of the reasons why one might or might not want to participate. At the same time, advances in large-scale genomic research have expanded both the opportunities and the risks for participants, families, and communities. To advance the use of effective consent materials that reflect this landscape, we used empirical data to develop model consent language, as well as brief questions to assist people in thinking about their own values relative to participation. METHODS We conducted in-person interviews to gather preliminary input on these materials from a diverse sample (n = 32) of the general population in Nashville, Tennessee. We asked them to highlight information they found especially reassuring or concerning, their hypothetical willingness to participate, and their opinions about the values questions. RESULTS Consent information most often highlighted as reassuring included the purpose of the biobank, the existence and composition of a multidisciplinary oversight committee, the importance of participants' privacy and efforts to protect it, and controlled access to a scientific database. Information most often highlighted as concerning included the deposition of data in a publicly accessible database, the risk of unintended access to data, the potential for non-research use of data, and use of medical record information in general. Seventy-five percent of participants indicated initial willingness to participate in the hypothetical biobank; this decreased to 66% as participants more closely considered the information over the course of the interview. A large majority rated the values questions as helpful. CONCLUSIONS These results are consistent with other research on public perspectives on biobanking and genomic cohort studies, suggesting that our model language effectively captures commonly expressed reasons for and against participation. Our study enriches this literature by connecting specific consent form disclosures with qualitative data regarding what participants found especially reassuring or concerning and why. Interventions that facilitate individuals' closer engagement with consent information may result in participation decisions more closely aligned with their values.
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Affiliation(s)
- Laura M Beskow
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA.
| | - Catherine M Hammack-Aviran
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA
| | - Kathleen M Brelsford
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 400, Nashville, TN, 37203, USA
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9
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Abstract
Biomedical research using data from participants' mobile devices borrows heavily from the ethos of the "citizen science" movement, by delegating data collection and transmission to its volunteer subjects. This engagement gives volunteers the opportunity to feel like partners in the research and retain a reassuring sense of control over their participation. These virtues, in turn, give both grass-roots citizen science initiatives and institutionally sponsored mHealth studies appealing features to flag in recruiting participants from the public. But while grass-roots citizen science projects are often community-based, mHealth research ultimately depends on the individuals who own and use mobile devices. This inflects the ethos of mHealth research towards a celebration of individual autonomy and empowerment, at the expense of its implications for the communities or groups to which its individual participants belong. But the prospects of group harms - and benefits - from mHealth research are as vivid as they are in other forms of data-intensive "precision health" research, and will be important to consider in the design of any studies using this approach.
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Affiliation(s)
- Joon-Ho Yu
- Joon-Ho Yu, M.P.H., Ph.D., is a Research Assistant Professor in the Division of Genetic Medicine, Division of Bioethics and Palliative Care, Department of Pediatrics; Institute for Public Health Genetics, Department of Biostatistics, at the University of Washington in Seattle, WA; and a member of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital and Research Institute in Seattle, WA. Eric Juengst, Ph.D., is the Director of the Center for Bioethics and Professor of Social Medicine in the School of Medicine of the University of North Carolina at Chapel Hill, NC
| | - Eric Juengst
- Joon-Ho Yu, M.P.H., Ph.D., is a Research Assistant Professor in the Division of Genetic Medicine, Division of Bioethics and Palliative Care, Department of Pediatrics; Institute for Public Health Genetics, Department of Biostatistics, at the University of Washington in Seattle, WA; and a member of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital and Research Institute in Seattle, WA. Eric Juengst, Ph.D., is the Director of the Center for Bioethics and Professor of Social Medicine in the School of Medicine of the University of North Carolina at Chapel Hill, NC
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10
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Wolf LE, Hammack CM, Brown EF, Brelsford KM, Beskow LM. Protecting Participants in Genomic Research: Understanding the "Web of Protections" Afforded by Federal and State Law. J Law Med Ethics 2020; 48:126-141. [PMID: 32342774 PMCID: PMC7307001 DOI: 10.1177/1073110520917000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Researchers now commonly collect biospecimens for genomic analysis together with information from mobile devices and electronic health records. This rich combination of data creates new opportunities for understanding and addressing important health issues, but also intensifies challenges to privacy and confidentiality. Here, we elucidate the "web" of legal protections for precision medicine research by integrating findings from qualitative interviews with structured legal research and applying them to realistic research scenarios involving various privacy threats.
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Affiliation(s)
- Leslie E Wolf
- Leslie E. Wolf, J.D., M.P.H., is a Distinguished University Professor and Professor of Law at Georgia State University College of Law in Atlanta, Georgia and Director of the GSU Center for Law, Health & Society. Catherine M. Hammack, J.D., M.A., is an Associate in Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Erin Fuse Brown, J.D., M.P.H., is an Associate Professor of Law at the Georgia State University College of Law in Atlanta, Georgia. Kathleen M. Brelsford, M.A., Ph.D., M.P.H., is a Research Assistant Professor in the Department of Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Laura M. Beskow, M.P.H., Ph.D. is a Professor of Health Policy and the Anne Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at the Vanderbilt University Medical Center in Nashville, Tennessee
| | - Catherine M Hammack
- Leslie E. Wolf, J.D., M.P.H., is a Distinguished University Professor and Professor of Law at Georgia State University College of Law in Atlanta, Georgia and Director of the GSU Center for Law, Health & Society. Catherine M. Hammack, J.D., M.A., is an Associate in Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Erin Fuse Brown, J.D., M.P.H., is an Associate Professor of Law at the Georgia State University College of Law in Atlanta, Georgia. Kathleen M. Brelsford, M.A., Ph.D., M.P.H., is a Research Assistant Professor in the Department of Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Laura M. Beskow, M.P.H., Ph.D. is a Professor of Health Policy and the Anne Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at the Vanderbilt University Medical Center in Nashville, Tennessee
| | - Erin Fuse Brown
- Leslie E. Wolf, J.D., M.P.H., is a Distinguished University Professor and Professor of Law at Georgia State University College of Law in Atlanta, Georgia and Director of the GSU Center for Law, Health & Society. Catherine M. Hammack, J.D., M.A., is an Associate in Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Erin Fuse Brown, J.D., M.P.H., is an Associate Professor of Law at the Georgia State University College of Law in Atlanta, Georgia. Kathleen M. Brelsford, M.A., Ph.D., M.P.H., is a Research Assistant Professor in the Department of Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Laura M. Beskow, M.P.H., Ph.D. is a Professor of Health Policy and the Anne Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at the Vanderbilt University Medical Center in Nashville, Tennessee
| | - Kathleen M Brelsford
- Leslie E. Wolf, J.D., M.P.H., is a Distinguished University Professor and Professor of Law at Georgia State University College of Law in Atlanta, Georgia and Director of the GSU Center for Law, Health & Society. Catherine M. Hammack, J.D., M.A., is an Associate in Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Erin Fuse Brown, J.D., M.P.H., is an Associate Professor of Law at the Georgia State University College of Law in Atlanta, Georgia. Kathleen M. Brelsford, M.A., Ph.D., M.P.H., is a Research Assistant Professor in the Department of Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Laura M. Beskow, M.P.H., Ph.D. is a Professor of Health Policy and the Anne Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at the Vanderbilt University Medical Center in Nashville, Tennessee
| | - Laura M Beskow
- Leslie E. Wolf, J.D., M.P.H., is a Distinguished University Professor and Professor of Law at Georgia State University College of Law in Atlanta, Georgia and Director of the GSU Center for Law, Health & Society. Catherine M. Hammack, J.D., M.A., is an Associate in Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Erin Fuse Brown, J.D., M.P.H., is an Associate Professor of Law at the Georgia State University College of Law in Atlanta, Georgia. Kathleen M. Brelsford, M.A., Ph.D., M.P.H., is a Research Assistant Professor in the Department of Health Policy and a member of the core faculty of the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center in Nashville, Tennessee. Laura M. Beskow, M.P.H., Ph.D. is a Professor of Health Policy and the Anne Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at the Vanderbilt University Medical Center in Nashville, Tennessee
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11
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12
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Abstract
Precision medicine research is rapidly taking a lead role in the pursuit of new ways to improve health and prevent disease, but also presents new challenges for protecting human subjects. The extent to which the current "web" of legal protections, including technical data security measures, as well as measures to restrict access or prevent misuse of research data, will protect participants in this context remains largely unknown. Understanding the strength, usefulness, and limitations of this constellation of laws, regulations, and procedures is critical to ensuring not only that participants are protected, but also that their participation decisions are accurately informed. To address these gaps, we conducted in-depth interviews with a diverse group of 60 thought-leaders to explore their perspectives on the protections associated with precision medicine research.
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Affiliation(s)
- Catherine M Hammack
- Catherine M. Hammack, M.A., J.D., is an Associate in Health Policy in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Kathleen M. Brelsford, M.P.H., Ph.D., is a Research Assistant Professor in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Laura M. Beskow, M.P.H., Ph.D., is a Professor of Health Policy and Ann Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN)
| | - Kathleen M Brelsford
- Catherine M. Hammack, M.A., J.D., is an Associate in Health Policy in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Kathleen M. Brelsford, M.P.H., Ph.D., is a Research Assistant Professor in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Laura M. Beskow, M.P.H., Ph.D., is a Professor of Health Policy and Ann Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN)
| | - Laura M Beskow
- Catherine M. Hammack, M.A., J.D., is an Associate in Health Policy in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Kathleen M. Brelsford, M.P.H., Ph.D., is a Research Assistant Professor in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN). Laura M. Beskow, M.P.H., Ph.D., is a Professor of Health Policy and Ann Geddes Stahlman Chair in Medical Ethics in the Center for Biomedical Ethics & Society at Vanderbilt University Medical Center (Nashville, TN)
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