Privacy enhancing techniques - the key to secure communication and management of clinical and genomic data

OBJECTIVES

To introduce some of the privacy protection problems related to genomics based medicine and to highlight the relevance of Trusted Third Parties (TTPs) and of Privacy Enhancing Techniques (PETs) in the restricted context of clinical research and statistics.

METHODS

Practical approaches based on two different pseudonymisation models, both for batch and interactive data collection and exchange, are described and analysed.

RESULTS AND CONCLUSIONS

The growing need of managing both clinical and genetic data raises important legal and ethical challenges. Protecting human rights in the realm of privacy, while optimising research potential and other statistical activities is a challenge that can easily be overcome with the assistance of a trust service provider offering advanced privacy enabling/enhancing solutions. As such, the use of pseudonymisation and other innovative Privacy Enhancing Techniques can unlock valuable data sources.

From human genes to stem cells: new challenges for patent law?

The social controversies that have surrounded human cloning and the use of embryos for research purposes might create unique patent issues for stem cell researchers. Policy makers should learn from the legal and ethical concerns associated with human gene patents and develop coherent patent policies that recognize and clearly address emerging social controversies.

Key roles of government in genomics and proteomics: a public health perspective

This paper is based on the presentation of Dr. Allan Noonan at the third biennial Asan-Harvard Medical International Symposium on "Genomics and Proteomics: Impact on Medicine and Health" that took place in Seoul, Korea, July 3-4, 2001. Dr. Noonan is a senior advisor to the Surgeon General of the United States and was representing the then Surgeon General, Dr. David Satcher. In this final presentation of the symposium, Dr. Noonan reviews the key roles of government in US health care and discusses several areas where genomic- and proteomic-based information will necessitate changes in the functions of public health. In particular, Dr. Noonan discusses the need for appropriate training to meet the challenges of the genomic future; for sensitivity in the development of policies to address the ethical, legal, and social implications of genomic information; and for dissemination of genomic information to both the professionals and the public. Dr. Noonan concludes with a vision of the genomic future of the next 30 years and a reiteration of the need for partnership among health professionals, educators, and social services professionals.

Social genomics: genomic inventions in society. The nature of what's to come

This paper identifies several kinds of intellectual mistakes that proponents of genetic engineering make, in defending their views and characterizing the views of their opponents. Results from research in the social sciences and humanities illuminate the nature of these mistakes. The mistakes themselves play a role in allowing proponents to gather support from other protagonists in the social controversies involving science and technology. Understanding the controversies requires understanding that innovations are components of complex and ill-structured social problems; the "right answer" does not follow from scientific or technological breakthroughs. If the problems are identified correctly, issues of non-economic or non-market values and political and individual rights will need to be addressed.

The genetic revolution: new ethical issues for obstetrics and gynaecology

The genomic revolution inherently changes the paradigms that have informed the interactions between patient and physician. These changes obligate physicians both to continually learn about the advances occurring in genetic testing and to review their interactions in light of the changing ethical issues these advances uncover. Particular areas for concern are the use of genetic testing for predisposition genes. The issues differ between uses for adults, for children and for pre-implantation genetics. Furthermore, there are issues of justice raised by limited access to these technologies, research confidentiality, potential discrimination and the meaning of individuality in an era of potential genetic cloning. These changes require obstetrician/gynaecologists to advocate for the best interests of both their patients and those who may not be able to voice their interests, for example children-to-be and research subjects in developing countries.

On the edge of tomorrow: fitting genomics into public health policy

The project to map the human genome and the field of genetics in general offer unique opportunities for not only clinical medicine, but also for public health to address and prevent disease. At the same time, genomics is fraught with ethical challenges, not the least of which is how to prevent misuse and abuse of genetic information by virtue of the legal powers conferred on public health organizations. This article examines the role that public health can perform in the 21st Century in using the knowledge gained from the human genome project, including how to address the barriers to widespread application. The article also examines the challenges facing public health in dealing with the legal and ethical issues arising from genomics and in avoiding misapplication. While the opportunities that genomics offers public health agencies are unprecedented, so too are the challenges, which include the fact that genomics exists within a legal and policy paradigm that is the opposite of the one in which public health has traditionally existed. The danger of abuse and misuse, therefore, is very real.

Privacy issues in second stage genomics

Research that identifies genes useful in the prevention and treatment of disease will require access to biologic samples and medical records protected by traditional notions of privacy and confidentiality. Resolving conflicts between privacy and genomic research will require articulating the ethical rules that should govern such practices and then implementing those rules in the national, regional, or local health systems in which the data of interest exists. As consensus develops about the ethical rules that should govern such research, attention will shift to the practical and political problems of installing and implementing those rules in the agencies and institutions where such research will occur.