Challenges of Informed Consent in Return of Data from Genomic Research

基因组研究数据返还时知情同意的挑战

• 批准号: 8240260
• 负责人: Paul Stuart Appelbaum
• 金额: $ 20万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-23 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8240260
• 关键词: Access to Information; Address; Adverse effects; Alzheimer' s Disease; Area; BRCA1 gene; Bioethics; Caring; Categories; Child; Complex; Consensus; Consent; DNA; Data; Data Set; Diagnostic tests; Disadvantaged; Empirical Research; Ethics; Family member; Feedback; Genetic screening method; Genome; Genomics; Goals; Health; Human Subject Research; Incidental Findings; Individual; Informed Consent; Internet; Interview; Investigation; Laws; Legal; Life Style; Light; Literature; Medical; Paper; Participant; Persons; Policies; Process; Publications; Publishing; Recommendation; Research; Research Personnel; Research Subjects; Sampling; Series; Structure; Suggestion; Surveys; Thinking; Time; Tissues; Uncertainty; adverse outcome; base; biobank; child bearing; common rule; exome; genome wide association study; meetings; preference; prophylactic; repository; reproductive; response

DESCRIPTION (provided by applicant): Genomic data, including findings incidental to the purpose for which a study is undertaken, can contain information of use and importance to research subjects related to their health, lifestyle, and reproductive choices. A growing consensus of expert groups is that at least some information from genomic studies should be available to participants. It seems clear that return of results from genomic studies should and will require the informed consent of research subjects. However, there are a number of challenging issues that must be addressed with regard to obtaining meaningful consent from subjects, including the content of the consent process, minimizing adverse consequences from an expanded consent process, special issues relating to biobanked samples, and considerations regarding children, decisional impaired persons, and deceased subjects. The aims of this study are: 1) To develop a menu of potential approaches for dealing with the key challenges regarding informed consent that must be addressed before widespread efforts to return genomic data are put into place, based on an analytic review of the normative and empirical literatures; 2) To obtain the perspectives of genomic investigators and research subjects on these issues, their suggestions for addressing them, and their thoughts about the menu options, in a series of semi- structured interviews and surveys; 3) To formulate a series of discussion papers that outline the challenges, consider the options for response, offer recommendations for realistic approaches to address these challenges, and suggest a policy-relevant research agenda. To address the complex challenges of informed consent, the research team will use a combination of analytic and empirical strategies. Based on an analysis of the existing literature, we will develop menus of alternative approaches to consent in commonly occurring genomic research situations. The menus of options for these situations will then form the basis for semi-structured interviews and internet-based surveys of genomic researchers and research subjects to identify the probable advantages and disadvantages of the alternative approaches. Integrating these data into the previously developed analysis of alternatives, realistic options will be identified. When neither normative argument nor empirical evidence allows plausible conclusions to be drawn about the most desirable options, suggestions will be offered regarding further normative and empirical investigation. Findings will be embodied in a set of three discussion papers that will be reviewed by experts in genomic research and bioethics. After incorporating their feedback, the papers will be made available on the internet, submitted for publication in the medical and bioethical literatures, and presented at relevant professional meetings. PUBLIC HEALTH RELEVANCE: Genomic data can contain information of use and importance to research subjects related to their health, lifestyle, and reproductive choices. Although there is a growing consensus that at least some information from genomic studies should be available to participants, there are a number of challenges to obtaining informed consent from research subjects for that purpose. This study is aimed at elucidating those challenges, identifying options for dealing with them, obtaining feedback from key stakeholders about those options, and formulating recommendations for the field as to how challenges to meaningful informed consent can be met.

描述（由申请人提供）：基因组数据，包括与研究目的相关的发现，可能包含与研究受试者的健康、生活方式和生殖选择相关的用途和重要性信息。专家组越来越多的共识是，至少应该向参与者提供来自基因组研究的一些信息。似乎很清楚，基因组研究结果的归还应该而且将需要研究对象的知情同意。然而，在获得受试者有意义的同意方面，必须解决一些具有挑战性的问题，包括同意过程的内容，最大限度地减少扩大同意过程的不良后果，与生物库样本有关的特殊问题，以及对儿童、决策障碍者和死亡受试者的考虑。本研究的目的是：1）在对规范性和经验性文献进行分析性综述的基础上，制定一系列潜在方法，以应对在广泛努力归还基因组数据之前必须解决的有关知情同意的关键挑战; 2）了解基因组研究者和研究对象对这些问题的看法，以及他们对解决这些问题的建议，3）编写一系列讨论文件，概述挑战，考虑应对办法，就应对这些挑战的现实办法提出建议，并提出与政策有关的研究议程。为了解决知情同意的复杂挑战，研究团队将使用分析和经验策略相结合。基于对现有文献的分析，我们将开发在常见的基因组研究情况下同意的替代方法菜单。这些情况下的选项菜单将形成半结构化访谈和基于互联网的基因组研究人员和研究对象的调查，以确定替代方法的可能优点和缺点的基础。将这些数据纳入先前制定的替代品分析，将确定现实的备选方案。当规范论证和经验证据都不允许对最可取的选择得出合理的结论时，将提供关于进一步规范和经验调查的建议。研究结果将载入一套三份讨论文件，由基因组研究和生物伦理学专家审查。在纳入他们的反馈后，这些论文将在互联网上发布，提交在医学和生物伦理文献中发表，并在相关专业会议上发表。 公共卫生相关性：基因组数据可以包含与健康、生活方式和生殖选择相关的研究对象的有用信息和重要信息。虽然越来越多的人一致认为，至少应该向参与者提供基因组研究的一些信息，但为此目的获得研究对象的知情同意存在一些挑战。本研究旨在阐明这些挑战，确定应对这些挑战的备选方案，从关键利益攸关方获得关于这些备选方案的反馈意见，并就如何应对有意义的知情同意方面的挑战为实地提出建议。