Techno-politics of genomic nationalism: tracing genomics and its use in drug regulation in Japan and Taiwan

Turning Ethics into Institutions: The Techno-politics of Human Research Regulation in Taiwan

This article provides a critical assessment of the development of Taiwan’s ethical framework for regulating medical and biopharmaceutical innovations. Advancing science, technology and society scholarship that treats ethics as subject to modification, adjustment and negotiation rather than as an abstract set of principles, this article examines the dominant role of East Asian states in the development of the life sciences. It also looks at the logic these states utilise to legitimise their therapeutic standards and to support the biopharmaceutical infrastructure in order to increase their economic competitiveness. In particular, this article traces the establishment of legal regulations in different social settings where innovations in clinical practice and medicine are introduced. It argues that, instead of a comprehensive, coherent ethical framework based on the adoption of international conventions, Taiwan’s 2011 Human Subjects Research Act is a techno-political assemblage, an inconsistent legal product involving not only policy makers but also physicians, the pharmaceutical industry and the state. This article also takes a critical stance towards institutional review boards (IRBs), which resolve jurisprudential conflicts within this legal framework of human research. It argues that, rather than being passive organisations that protect research from unethical fraud, IRBs in Taiwan have been institutions in which negotiations among investigators, research sponsors and the government are conducted in the name of health governance.

Social and Communicative Functions of Informed Consent Forms in East Asia and Beyond

The recent research and technology development in medical genomics has raised new issues that are profoundly different from those encountered in traditional clinical research for which informed consent was developed. Global initiatives for international collaboration and public participation in genomics research now face an increasing demand for new forms of informed consent which reflect local contexts. This article analyzes informed consent forms (ICFs) for genomic research formulated by four selected research programs and institutes in East Asia – the Medical Genome Science Program in Japan, Universiti Sains Malaysia Human Research Ethics Committee in Malaysia, and the Taiwan Biobank and the Taipei Medical University- Joint Institutional Review Board in Taiwan. The comparative text analysis highlights East Asian contexts as distinct from other regions by identifying communicative and social functions of consent forms. The communicative functions include re-contact options and offering interactive support for research participants, and setting opportunities for family or community engagement in the consent process. This implies that informed consent cannot be validated solely with the completion of a consent form at the initial stage of the research, and informed consent templates can facilitate interactions between researchers and participants through (even before and after) the research process. The social functions consist of informing participants of possible social risks that include genetic discrimination, sample and data sharing, and highlighting the role of ethics committees. Although international ethics harmonization and the subsequent coordination of consent forms may be necessary to maintain the quality and consistency of consent process for data-intensive international research, it is also worth paying more attention to the local values and different settings that exist where research participants are situated for research in medical genomics. More than simply tools to gain consent from research participants, ICFs function rather as a device of social communication between research communities and civic communities in liaison with intermediary agents like ethics committees, genetic counselors, and public biobanks and databases.

Confidentiality and data sharing: vulnerabilities of the Mexican Genomics Sovereignty Act

A law known as "Genomic Sovereignty Act", instituted in 2011, regulates research on the human genome in Mexico. This law establishes Government regulations for the exportation of DNA samples from Mexican nationals for population genetics studies. The Genomic Sovereignty Act protects fundamental human values, as confidentiality and non-discrimination based on personal genetic information. It also supports the development of the genome-based medical biotechnology and the bio-economy. Current laws for the protection of the genomic confidentiality, however, are inexplicit and insufficient, and the legal and technological instruments are primitive and insufficient to safeguard this bioethical principle. In addition, this law may undermine efforts of the national and international scientific communities to cooperate with big-data analysis for the development of the genome-based biomedical sciences. The argument of this article is that deficiencies in the protection of the confidentiality of genomic information and limitations in data sharing severely weaken the objectives and scope of the Genomic Sovereignty Act. In addition, the Act may compromise the national biomedical development and the international cooperation for research and development in the field of human genomics.

ELSI practices in genomic research in East Asia: implications for research collaboration and public participation

Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the 'ELSI 2.0' initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries.