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Smit AK, Gokoolparsadh A, McWhirter R, Newett L, Milch V, Hermes A, McInerney-Leo A, Newson AJ. Ethical, legal, and social issues related to genetics and genomics in cancer: A scoping review and narrative synthesis. Genet Med 2024; 26:101270. [PMID: 39282688 DOI: 10.1016/j.gim.2024.101270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 09/10/2024] [Accepted: 09/11/2024] [Indexed: 11/05/2024] Open
Abstract
Genomics is increasingly being incorporated into models of care for cancer. Understanding the ethical, legal, and social issues (ELSI) in this domain is important for successful and equitable implementation. We aimed to identify ELSI scholarship specific to cancer control and genomics. To do this, we undertook a scoping literature review and narrative synthesis, identifying 46 articles that met inclusion criteria. Eighteen ELSI themes were developed, including (1) equity of access, which included structural barriers to testing and research, access to preventive and follow-up care, and engagement with health systems; (2) family considerations, such as an ethical obligation to disseminate relevant genomic information to at-risk family members; (3) legal considerations, including privacy and confidentiality, genetic discrimination, and the prospective duty to reclassify variants; and (4) optimizing consent processes in clinical care and research. Gaps in the literature were identified with respect to equity for people living in rural or remote areas, and how to provide ethical care within culturally, linguistically, and ethnically diverse communities, including First Nations peoples. Our findings suggest a need for a multidisciplinary approach to examining ELSI in cancer genomics beyond initial test indication and within the broader context of the mainstreaming of genomics in health care.
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Affiliation(s)
- Amelia K Smit
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia; The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney, NSW, Australia
| | - Akira Gokoolparsadh
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia
| | - Rebekah McWhirter
- ANU College of Law, Australian National University, Canberra, ACT, Australia
| | - Lyndsay Newett
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT Australia
| | - Vivienne Milch
- Cancer Australia, Surry Hills, NSW Australia; Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Azure Hermes
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT Australia
| | - Aideen McInerney-Leo
- Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, QLD Australia
| | - Ainsley J Newson
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, Sydney, NSW, Australia.
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Campbell-Salome G. Communication in genomic and precision medicine: Editorial - PEC Innovation. PEC INNOVATION 2023; 2:100126. [PMID: 37214511 PMCID: PMC10194269 DOI: 10.1016/j.pecinn.2023.100126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Gemme Campbell-Salome
- Department of Genomic Health, Department of Population Health Sciences, Geisinger, 100 N Academy Ave., Danville, PA 17822, United States of America
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