1
|
Martschenko DO, Granucci A, Cho MK. "Ethical Responsibility Very Often Gets Drowned Out": A Qualitative Interview Study of Genome Scientists' and ELSI Scholars' Perspectives on the Role and Relevance of ELSI Expertise. AJOB Empir Bioeth 2024:1-12. [PMID: 38916600 DOI: 10.1080/23294515.2024.2370769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Genome scientists and Ethical, Legal, and Social Implications of genetics (ELSI) scholars commonly inhabit distinct research cultures - utilizing different research methods, asking different research questions, and valuing different types of knowledge. Collaborations between these two communities are frequently called for to enhance the ethical conduct of genomics research. Yet, little has been done to qualitatively compare genome scientists' and ELSI scholars' perspectives on collaborations with each other and the factors that may affect these collaborations. METHODS 20 semi-structured interviews with US-based genome scientists and ELSI scholars were conducted between June-September 2021. Interviews were analyzed using inductive thematic analysis. RESULTS Genome scientists and ELSI scholars provided different understandings of the value and goals of their collaborations with each other. Genome scientists largely perceived ELSI expertise to be relevant for human subjects research; they described ELSI scholars as communicators who help the public and/or study participants better understand genomics research. In comparison, ELSI scholars viewed themselves as developing and implementing policies; they expressed frustration at how scientists can misunderstand their research methods or negatively perceive them. A combination of factors - both structural (e.g., criteria for promotion) and cultural (e.g., perceptions of what colleagues value and respect) - seemed to shape these diverging perspectives. CONCLUSION Academic institutions, funders, and researchers commonly call for collaborations between genome scientists and ELSI scholars, but under-consider how their different conceptual frameworks, research methods, goals, norms, and values, conjoin to affect such partnerships. Acknowledging, exploring, and addressing the complex interplay between these factors could help to more effectively facilitate collaborations between genome scientists and ELSI scholars.
Collapse
Affiliation(s)
- Daphne O Martschenko
- Stanford Center for Biomedical Ethics and Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Anna Granucci
- Stanford Center for Biomedical Ethics and Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Mildred K Cho
- Stanford Center for Biomedical Ethics and Department of Pediatrics, Stanford University, Stanford, CA, USA
- Stanford Center for Biomedical Ethics and Department of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
2
|
Attal-Juncqua A, Getz J, Morhard R, Gronvall GK. Integrating safety, security, sustainability, and social responsibility principles into the U.S. bioeconomy. mSphere 2024; 9:e0008424. [PMID: 38687115 PMCID: PMC11237757 DOI: 10.1128/msphere.00084-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/27/2024] [Indexed: 05/02/2024] Open
Abstract
Bioindustrial manufacturing is undergoing rapid expansion and investment and is seen as integral to nations' economic progress. Ensuring that bioindustrial manufacturing benefits society as the field expands is of critical, urgent importance. To better understand the industry's ethical trajectory and to shape policy, we explored the views of biotechnology leaders on four aspects of ethical and social responsibility-safety, security, social responsibility, and sustainability-what we have termed "4S principles." We identified policy actions governments and other stakeholders may take to maximize societal benefits in industrial biotechnology. IMPORTANCE We analyzed biotech leaders' views on safety, security, social responsibility, and sustainability to recommend policies to maximize benefits and economic growth.
Collapse
Affiliation(s)
| | - John Getz
- Ginkgo Bioworks, Boston, Massachusetts, USA
| | | | - Gigi Kwik Gronvall
- Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
3
|
Rajagopalan RM, Cakici J, Bloss CS. A Vision for Empirical ELSI along the R&D Pipeline. AJOB Empir Bioeth 2024; 15:81-86. [PMID: 38214924 DOI: 10.1080/23294515.2023.2297931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Affiliation(s)
- Ramya M Rajagopalan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, USA
- Center for Empathy and Technology, T. Denny Sanford Institute for Empathy and Compassion, UC San Diego, La Jolla, USA
| | - Julie Cakici
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, USA
- School of Public Health, San Diego State University, La Jolla, USA
| | - Cinnamon S Bloss
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, USA
- Center for Empathy and Technology, T. Denny Sanford Institute for Empathy and Compassion, UC San Diego, La Jolla, USA
| |
Collapse
|
4
|
Dolan DD, Lee RH, Cho MK, Soo-Jin Lee S. Understanding the Gap: A Cross-Sectional Survey of ELSI Scholars' Dissemination Practices and Translation Goals. AJOB Empir Bioeth 2024; 15:147-153. [PMID: 38805390 PMCID: PMC11180497 DOI: 10.1080/23294515.2024.2355898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Researchers engaged in the study of the ethical, legal, and social implications (ELSI) of genetics and genomics are often publicly funded and intend their work to be in the public interest. These features of U.S. ELSI research create an imperative for these scholars to demonstrate the public utility of their work and the expectation that they engage in research that has potential to inform policy or practice outcomes. In support of the fulfillment of this "translational mandate," the Center for ELSI Resources and Analysis (CERA), funded by the National Human Genome Research Institute (NHGRI), aims to facilitate community-informed, ELSI research results synthesis and dissemination. However, little is known about how ELSI research scholars define the goals of translation and imagine the intended users of their research findings. METHODOLOGY We distributed a Qualtrics survey to ELSI scholars that aimed to determine: (1) researchers' expectations for their research findings in relation to policy or practice outcomes, (2) the stakeholder groups researchers believe could benefit from their research findings, and (3) the methods researchers use to foster the uptake of their findings by those stakeholders. RESULTS Most ELSI researchers surveyed thought there were stakeholders that could benefit from their research findings, including health care professionals, at-risk individuals, patients, and their family members, policy-makers, and researchers/scientists, and expected their research findings to inform the creation or revision of laws, policies, or practice guidelines. Most researchers planned to disseminate findings directly to relevant stakeholders, with fewer expecting dissemination support from research funders, universities, or other entities. CONCLUSION The broad range of research topics, disciplines, and set of potential end users represented in ELSI reseach complicate the work of a knowledge broker. Nonetheless, the CERA can play an important role in disseminating ELSI results to relevant stakeholders. Further research should explore outreach mechanisms.
Collapse
Affiliation(s)
- Deanne Dunbar Dolan
- Center for ELSI Resources and Analysis (CERA), Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel H. Lee
- Center for ELSI Resources and Analysis (CERA), Stanford University School of Medicine, Stanford, CA, USA
| | - Mildred K. Cho
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
| | - Sandra Soo-Jin Lee
- Division of Ethics, Department of Medical Humanities & Ethics, Columbia University, New York, NY, USA
| |
Collapse
|
5
|
Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
Collapse
Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| |
Collapse
|
6
|
Capps B, Chadwick R, Lederman Z, Lysaght T, Mills C, Mulvihill JJ, Oetting WS, Winship I. The Human Genome Organisation (HUGO) and a vision for Ecogenomics: the Ecological Genome Project. Hum Genomics 2023; 17:115. [PMID: 38111041 PMCID: PMC10726505 DOI: 10.1186/s40246-023-00560-x] [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: 05/04/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The following outlines ethical reasons for widening the Human Genome Organisation's (HUGO) mandate to include ecological genomics. MAIN: The environment influences an organism's genome through ambient factors in the biosphere (e.g. climate and UV radiation), as well as the agents it comes into contact with, i.e. the epigenetic and mutagenic effects of inanimate chemicals and pollution, and pathogenic organisms. Emerging scientific consensus is that social determinants of health, environmental conditions and genetic factors work together to influence the risk of many complex illnesses. That paradigm can also explain the environmental and ecological determinants of health as factors that underlie the (un)healthy ecosystems on which communities rely. We suggest that The Ecological Genome Project is an aspirational opportunity to explore connections between the human genome and nature. We propose consolidating a view of Ecogenomics to provide a blueprint to respond to the environmental challenges that societies face. This can only be achieved by interdisciplinary engagement between genomics and the broad field of ecology and related practice of conservation. In this respect, the One Health approach is a model for environmental orientated work. The idea of Ecogenomics-a term that has been used to relate to a scientific field of ecological genomics-becomes the conceptual study of genomes within the social and natural environment. CONCLUSION The HUGO Committee on Ethics, Law and Society (CELS) recommends that an interdisciplinary One Health approach should be adopted in genomic sciences to promote ethical environmentalism. This perspective has been reviewed and endorsed by the HUGO CELS and the HUGO Executive Board.
Collapse
Affiliation(s)
- Benjamin Capps
- Department of Bioethics, Dalhousie University, 5849 University Avenue, CRC Building, Room C-312, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | | | | | - Tamra Lysaght
- National University of Singapore, Singapore, Singapore
| | | | - John J Mulvihill
- University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | | | | |
Collapse
|
7
|
Ormond KE, Blasimme A, Vayena E. Ethical Aspects of Pediatric Genetic Care: Testing and Treatment. Pediatr Clin North Am 2023; 70:1029-1046. [PMID: 37704345 DOI: 10.1016/j.pcl.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Pediatric health care providers caring for patients and families with genetic disease will encounter a range of ethical issues. These include traditional pediatric health care issues, such as surrogate decision making and end-of-life care. Genetic testing raises the importance of informed consent for potential risks that move beyond the oft discussed physical risks and into longer term concepts such as psychological impact, privacy and potential discrimination. Predictive testing in childhood also raises questions of whether the child has an autonomy interest in delaying testing until they have decision making capacity to do so on their own. And finally, treatments including gene therapies and gene editing, may raise issues of identity for families dealing with genetic disease.
Collapse
Affiliation(s)
- Kelly E Ormond
- Department of Health Sciences and Technology, Health Ethics & Policy Lab, ETH Zurich. Hottingerstrasse 10, Zurich 8092, Switzerland; Department of Genetics and Stanford Center for Biomedical Ethics, Stanford University School of Medicine.
| | - Alessandro Blasimme
- Department of Health Sciences and Technology, Health Ethics & Policy Lab, ETH Zurich. Hottingerstrasse 10, Zurich 8092, Switzerland
| | - Effy Vayena
- Department of Health Sciences and Technology, Health Ethics & Policy Lab, ETH Zurich. Hottingerstrasse 10, Zurich 8092, Switzerland
| |
Collapse
|
8
|
Jabloner A, Walker A. The Pitfalls of Genomic Data Diversity. Hastings Cent Rep 2023; 53:10-13. [PMID: 37963133 PMCID: PMC10655895 DOI: 10.1002/hast.1511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Biomedical research recruitment today focuses on including participants representative of global genetic variation-rightfully so. But ethnographic attention to practices of inclusion highlights how this agenda often transforms into "predatory inclusion," simplistic pushes to get Black and brown people into genomic databases. As anthropologists of medicine, we argue that the question of how to get from diverse data to concrete benefit for people who are marginalized cannot be presumed to work itself out as a byproduct of diverse datasets. To actualize the equitable translation of genomics, practitioners need to place the impacts of ancestral genetic difference in the scope of much more impactful social determinants. For this to happen, multidisciplinary expertise needs to be leveraged, and current, structurally unequal health care systems ultimately need to transform. As modest steps toward this goal, new models for benefit-sharing must be developed and implemented to mitigate existing inequality between data donors and the entities profiting from that data.
Collapse
|
9
|
Mueller R. The Impact of Transmissible Microbes: How the Cystic Fibrosis Community Mobilized Against Cepacia. PERSPECTIVES IN BIOLOGY AND MEDICINE 2023; 66:89-106. [PMID: 38662010 PMCID: PMC11104521 DOI: 10.1353/pbm.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Long before COVID-19 made social distancing familiar, people with cystic fibrosis (CF) already practiced such behaviors. CF is held up as a classic example of genetic disease, yet people with CF are also susceptible to bacteria from the environment and from other CF patients. Starting in the 1980s, a bacterial epidemic in the CF population highlighted clashing priorities of connection, physical safety, and environmental protection. Policymakers ultimately called for the physical separation of people with CF from one another via recommendations that reconfigured the CF community. Simultaneously, medical researchers recognized that one highly transmissible CF pathogen called cepacia was being developed for environmental applications and got the EPA to limit cepacia's environmental deployment. Environmental regulations speak to the challenge of useful microbes that harm a minority, but CF cross-infection also involves legal implications for microbial and genetic discrimination, social consequences for CF communities, and ethical questions about balancing autonomy, harms, and benefits. As scientists increasingly study connections between host genetics, microbial genetics, and infectious risks, CF is a vital referent.
Collapse
|