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Benedetti DJ, Marron JM, Thomas SM, Brown AEC, Pyke-Grimm KA, Johnson LM, Unguru Y, Kodish E. The role of ethicists in pediatric hematology/oncology: Current status and future needs. Pediatr Blood Cancer 2023; 70:e30132. [PMID: 36495529 DOI: 10.1002/pbc.30132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022]
Abstract
As pediatric hematology/oncology (PHO) becomes more complex and sub-subspecialized, dedicated PHO ethicists have emerged as sub-subspecialists focused on addressing ethical issues encountered in clinical and research practices. PHO physicians and other clinicians with advanced training in bioethics contribute to the field through ethics research, education, and ethics consultation services. Furthermore, there exists a newer generation of PHO trainees interested in bioethics. This review details the experiences of current PHO ethicists, providing a blueprint for future educational, research and service activities to strengthen the trajectory of the burgeoning sub-subspecialty of PHO ethics. Creating an American Society of Pediatric Hematology/Oncology (ASPHO) ethics Special Interest Group, enhancing clinical ethics education for pediatric hematologists/oncologists (PHOs), developing multi-institutional research collaborations, and increasing attention to ethical issues germane to nonmalignant hematology will serve the interests of the entire field of PHO, enhancing the care of PHO patients and careers of PHOs.
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Affiliation(s)
- Daniel J Benedetti
- Division of Pediatric Hematology/Oncology, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan M Marron
- Division of Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, and Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stefanie M Thomas
- Department of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Amy E Caruso Brown
- Division of Pediatric Hematology/Oncology, and Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Kimberly A Pyke-Grimm
- Department of Nursing Research and Evidence-Based Practice, Stanford Children's Health and Division of Pediatric Hematology/Oncology, Stanford University School of Medicine, Stanford, California, USA
| | - Liza-Marie Johnson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Yoram Unguru
- Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, Baltimore, Maryland, USA.,Johns Hopkins University Berman Institute of Bioethics, Baltimore, Maryland, USA
| | - Eric Kodish
- Departments of Pediatrics, Oncology, and Bioethics, Cleveland Clinic Children's and Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA
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Current landscape of research ethics consultation services: National survey results. J Clin Transl Sci 2023; 6:e148. [PMID: 36756077 PMCID: PMC9879897 DOI: 10.1017/cts.2022.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/23/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction The goal of a research ethics consultation service (RECS) is to assist relevant parties in navigating the ethical issues they encounter in conduct of research. The goal of this survey was to describe the current landscape of research ethics consultation and document if and how it has changed over the last decade. Methods The survey instrument was based on the survey previously circulated. We included a number of survey domains from the previous survey with the goal of direct comparison of outcomes. The survey was sent to 57 RECS in the USA and Canada. Results Forty-nine surveys were completed for an overall response rate of 86%. With the passing of 10 years, the volume of consults received by RECS surveyed has increased. The number of consults received by a subset of RECS remains low. RECS continues to receive requests for consults from a wide range of stakeholders. About a quarter of RECS surveyed actively evaluate their services, primarily through satisfaction surveys routinely shared with requestors. The number of RECS evaluating their services has increased. We identified a group of eight key competencies respondents find as key to providing RECS. Conclusions The findings from our survey demonstrate that there have been growth and development of RECS since 2010. Further developing evaluation and competency guidelines will help existing RECS continue to grow and facilitate newly established RECS maturation. Both will allow RECS personnel to better serve their institutions and add value to the research conducted.
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Taylor HA, Porter KM, Paquette ET, McCormick JB, Tumilty E, Arnold JF, Spector-Bagdady K, Danis M, Brandt D, Shah J, Wilfond BS, Lee LM. Creating a Research Ethics Consultation Service: Issues to Consider. Ethics Hum Res 2021; 43:18-25. [PMID: 34496156 DOI: 10.1002/eahr.500101] [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: 11/09/2022]
Abstract
This article provides pragmatic advice for organizations interested in creating a research ethics consultation service (RECS). A robust RECS has the potential to build capacity among investigators to identify and consider the ethical issues they encounter while conducting their research. Determining whether to establish an RECS should begin with an institutional-needs assessment that includes three key questions: What are the current resources available to research teams to navigate ethical concerns that arise from their research? Is there a demand or perceived need for more resources? Is there institutional support (financial and otherwise) to establish and maintain an RECS? If this results in the decision to establish the consultation service, relevant institutional stakeholders must be identified and consulted, and personnel with the requisite skills recruited. The next step is to establish an RECS and build the infrastructure to process and respond to requests. The RECS's long-term sustainability will depend on a stable source of funding and a mechanism to receive constructive feedback to ensure that the service is meeting the institutional needs it set out to address.
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Affiliation(s)
- Holly A Taylor
- Research bioethicist in the Department of Bioethics at the Clinical Center at the National Institutes of Health
| | - Kathryn M Porter
- Research scientist at the Seattle Children's Hospital and Research Institute
| | - Erin Talati Paquette
- Assistant professor of pediatrics (critical care) at the Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago and an assistant professor of law (by courtesy) at the Northwestern University Pritzker School of Law
| | - Jennifer B McCormick
- Associate professor in the Department of Humanities in the College of Medicine at the Pennsylvania State University
| | - Emma Tumilty
- Bioethicist and lecturer at the School of Medicine in the Faculty of Health at Deakin University Waurn Ponds, Geelong, Australia
| | - Jason F Arnold
- Senior fellow of bioethics and health policy and the assistant director of the CTR fellowship program at the Institute of Human Values in Health Care at the Medical University of South Carolina
| | - Kayte Spector-Bagdady
- Associate director of the Center for Bioethics & Social Sciences in Medicine and an assistant professor of obstetrics and gynecology at the University of Michigan Medical School
| | - Marion Danis
- Head of the section on ethics and health policy in the Department of Bioethics at the Clinical Center of the National Institutes of Health
| | - Debra Brandt
- Research assistant professor in the Department of Obstetrics and Gynecology at the University of Iowa
| | - Jina Shah
- Senior director of patient safety and pharmacovigilance at Kite, a Gilead Sciences company, in Santa Monica, CA
| | - Benjamin S Wilfond
- Professor in the divisions of bioethics and palliative care and pulmonary and sleep medicine in the Department of Pediatrics at the Seattle Children's Hospital and Research Institute at the University of Washington School of Medicine
| | - Lisa M Lee
- Associate vice president for research and innovation, the director of scholarly integrity and research compliance, and a professor of population health sciences at Virginia Tech
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Suárez Obando F. Investigación clínica y buenas prácticas clínicas. Más historias por contar. PERSONA Y BIOÉTICA 2020. [DOI: 10.5294/pebi.2020.24.2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Con el objetivo de garantizar la conducción ética de la investigación científica en seres humanos y que en su ejecución prevalezcan el interés por la salud y el bienestar de los sujetos participantes, se han desarrollado diversas pautas, normas y parámetros dirigidos a la comunidad científica que implementa la investigación en estos sujetos. Uno de esos parámetros normativos es el de las buenas prácticas clínicas, el cual, luego de su implementación a través de la Resolución 2378 de 2008, se ha convertido en un documento orientador de gran relevancia para la investigación clínica en Colombia. El presente artículo relata sus orígenes y versiones, y reflexiona sobre sus limitaciones frente al debate ético que gira alrededor de la evaluación de protocolos de investigación por parte de los comités de ética.
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Suárez Obando F, Reynales H, Urina M, Camacho J, Viteri M. Caracterización de un grupo de comités de ética en investigación en Colombia. PERSONA Y BIOÉTICA 2018. [DOI: 10.5294/pebi.2018.22.2.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
En las últimas décadas, los ensayos clínicos controlados patrocinados por la industria farmacéutica han aumentado de manera considerable, lo cual ha llevado a que sea necesario un mayor control y acompañamiento por parte de las entidades reguladoras, y de los comités de ética, para garantizar el adecuado cumplimiento de las normas éticas establecidas y de las buenas prácticas clínicas en general. En Colombia, el Instituto Nacional de Vigilancia de Medicamentos y Alimentos (Invima), la entidad reguladora en el país, reglamenta y vigila el funcionamiento de la investigación clínica con medicamentos. En el 2008, esta entidad emitió la Resolución 2378, normatividad bajo la cual se establecen y regulan los diferentes actores de la investigación en Colombia, incluidos los comités de ética. Después de varios años de vigencia de esta norma, es necesario conocer si los comités de ética en investigación en Colombia funcionan de acuerdo con esta normativa, y determinar el estado de la implementación de lo solicitado en la regulación. Con este objetivo se diseñó una encuesta para ser respondida en forma voluntaria y se obtuvo respuesta de 25 de los 69 comités certificados en Colombia. El análisis fue posible en 22 de ellos cuya información estaba completa. En comparación con estudios anteriores, se observaron cambios favorables en el desarrollo y la organización de acuerdo con la norma actual propuesta.
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Tozzo P, Mazzi A, Aprile A, Rodriguez D, Caenazzo L. Certification ISO 9001 in clinical ethics consultation for improving quality and safety in healthcare. Int J Qual Health Care 2018; 30:486-491. [PMID: 29590373 DOI: 10.1093/intqhc/mzy047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/08/2018] [Indexed: 12/27/2022] Open
Abstract
This paper refers to the quality management process of the Laboratory of Clinical Bioethics (LCB) of the University of Padua (Italy), which has obtained the quality certification to ISO 9001:2008, as a Clinical Ethics Support Service. Its activities consist mainly in clinical ethics consultations and training services, addressed to those who are called to decisions with ethical implications in the clinical setting, proposing a structured approach to identify and analyze the ethical issues that may loom in the relationships between health professionals and patients, and participating in their solution. The expected benefits of the application of ISO 9001 were mainly the following: to formalize the procedure adopted for clinical ethics consultation and training, to obtain a controlled management of documents, information and data, to ensure and demonstrate the quality of the provided activities and to make methods and organization publicly available. The main results which have been achieved with the 'quality management project' are summarized as follows: the enunciation of LCB Mission and Quality Policy; the drafting of the procedure by which clinical ethics consultation is provided; the formalization of members' skills and the adoption of relevant process and outcome indicators. Our experience may be useful in promoting accountability for the quality of ethics consultation services. We consider the certification process as a tool for transparent and reliable management of one of the most critical tasks in the current context of healthcare, motivating similar facilities to undertake similar pathways, with the aim to provide quality control on their activities.
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Affiliation(s)
- Pamela Tozzo
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Anna Mazzi
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Anna Aprile
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Daniele Rodriguez
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Luciana Caenazzo
- Department of Molecular Medicine, University of Padova, Padova, Italy
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Cumyn A, Ouellet K, Côté AM, Francoeur C, St-Onge C. Role of Researchers in the Ethical Conduct of Research: A Discourse Analysis From Different Stakeholder Perspectives. ETHICS & BEHAVIOR 2018. [DOI: 10.1080/10508422.2018.1539671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Annabelle Cumyn
- Department of Medecine, Faculty of Medicine and Health Sciences, Université de Sherbrooke
| | - Kathleen Ouellet
- Centre for Health Sciences Education, Faculty of Medicine and Health Sciences, Université de Sherbrooke
| | - Anne-Marie Côté
- Department of Medicine, Division of Nephrology, Faculty of Medicine and Health Sciences, Université de Sherbrooke
| | - Caroline Francoeur
- Direction de la coordination de la mission universitaire du CIUSSS de l'Estrie-CHUS, Centre intégré universitaire de santé et des services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke
| | - Christina St-Onge
- Centre for Health Sciences Education, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke
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Yanagawa H, Katashima R, Sato C, Takechi K, Nokihara H, Kane C, Chuma M, Aoe Y. Research ethics consultation: an attempt and 5-year experience in a Japanese University Hospital. BMC Res Notes 2018; 11:665. [PMID: 30208946 PMCID: PMC6134693 DOI: 10.1186/s13104-018-3772-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/07/2018] [Indexed: 11/21/2022] Open
Abstract
Objective Research ethics consultation is an advisory activity that differs from ethics committees, and its role is not yet widely known in Japan. Research ethics consultations were started in 2012 by members of the Clinical Trial Center of Tokushima University Hospital, a support section for clinical trials. We analyzed the research ethics consultation records from Tokushima University Hospital during the 5-year period of 2012–2016 to examine the Japanese context of research ethics consultation. Results During the study period, 125 research ethics consultations were carried out, 115 (91%) before starting studies. All but one request were from investigators at Tokushima University. The main issue was compatibility with guidance and regulations (n = 74, 67.2%), such as ethical handling of human biological specimens and information utilized in research; only 6 (4.8%) requests involved research ethics issues that investigators face in their research. Therefore, it is necessary to expand the consultation function, with a nationwide system of consultant education and data sharing. Moreover, standardization of consultation should be considered.
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Affiliation(s)
- Hiroaki Yanagawa
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan.
| | - Rumi Katashima
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Chiho Sato
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Kenshi Takechi
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Hiroshi Nokihara
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Chikako Kane
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Masayuki Chuma
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
| | - Yuki Aoe
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Kuramoto-cho 2, Tokushima, 770-8503, Japan
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Abstract
Research is an intrinsic part of both academia and clinical best practice. Within an academic environment, this can include access to advice and guidance from trained professionals. Similarly, while sometimes overly risk-averse, within the NHS there is a structured and systematic approach to healthcare research. However, in the UK, a large number of specialist dental procedures take place within the private healthcare system, which does not have access to such support and guidance. How, then, can we generate our own dental research from private dental primary care settings? With a number of phrases becoming part of everyday vocabulary in dental primary care, such as practice-based research, patient-centred outcomes, evidence-based dentistry, it is time to consider this. From research ethics to writing papers, via GCP, IRAS, HEIs and MOOCs, this article summarises the experiences of one non-affiliated (non-academic, non-NHS) private dental practice attempting to enter the world of research. The authors discuss their experiences, share the multiple sources of support encountered along the way, and demonstrate the benefits to everyday practice gained by initiating research studies.
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Porter KM, Danis M, Taylor HA, Cho MK, Wilfond BS. Defining the Scope and Improving the Quality of Clinical Research Ethics Consultation: Response to Open Peer Commentaries About the National Collaborative. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:W13-W15. [PMID: 29393779 PMCID: PMC6188676 DOI: 10.1080/15265161.2017.1413438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Open Peer Commentaries on “The Emergence of Clinical Research Ethics Consultation: Insights from a National Collaborative201D highlight the many ways in which the practice of ethics consultation for clinical research can be further advanced. We respond here to a number of key considerations highlighted by commentators, including the role and scope of research ethics consultation (REC), relationships with other institutional services and programs, efforts to ensure the quality of consultations provided, and the feasibility of widespread REC services.
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Arnold JF, Boan AD, Lackland DT, Sade RM. Clinical and Translational Research Ethics: Training Consultants and Biomedical Research Personnel. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:57-61. [PMID: 29313773 DOI: 10.1080/15265161.2017.1401172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Paquette ET, Ross L. The Challenges of Incorporating Research Ethics Consultation Into Institutional Human Subjects Protections Programs. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:49-51. [PMID: 29313769 PMCID: PMC6214683 DOI: 10.1080/15265161.2017.1401179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Lainie Ross
- b University of Chicago and MacLean Center for Clinical Medical Ethics
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Greenbaum D. Hotline Bling: Late-Night Ethics Calls as an Alternative to Research Ethics Consultations. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:61-62. [PMID: 29313783 DOI: 10.1080/15265161.2017.1401165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Porter KM, Danis M, Taylor HA, Cho MK, Wilfond BS. The Emergence of Clinical Research Ethics Consultation: Insights From a National Collaborative. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:39-45. [PMID: 29313771 PMCID: PMC6188703 DOI: 10.1080/15265161.2017.1401156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards (IRBs), to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation (REC) services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research.
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Cole AM, Baldwin LM, Keppel GA, Kuwana E, Mollis BL, Wilfond BS. Conflicts of Interest and Distribution of Resources to Community Partners: An Organizational Ethics Dilemma. Prog Community Health Partnersh 2017; 11:99-106. [PMID: 28603156 DOI: 10.1353/cpr.2017.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Conflicts of interest can arise when faculty and staff administer programs that distribute research funds, training opportunities, and other resources across academic and community partners. We describe the ethical concerns encountered by a Clinical Translational Science Award (CTSA) program in administering its community-focused pilot grant program and how its Research Bioethics Consultation service helped to address them.Ethical Concerns: CTSA program faculty and staff identified ethical concerns in several areas, including appropriateness of including Regional Research Collaborations (RRC) faculty as principal or co-investigators on applications, determining how much help RRC faculty and staff should provide to prospective applicants, and creating a fair and effective application review process. DISCUSSION The CTSA program identified common goals and values for its community-focused pilot grant program, and resolved the conflicts of interest with the new pilot grant policies. This approach could generalize to conflicts of interest that arise in other academic-community partnerships.
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Mamzer MF, Duchange N, Darquy S, Marvanne P, Rambaud C, Marsico G, Cerisey C, Scotté F, Burgun A, Badoual C, Laurent-Puig P, Hervé C. Partnering with patients in translational oncology research: ethical approach. J Transl Med 2017; 15:74. [PMID: 28390420 PMCID: PMC5385033 DOI: 10.1186/s12967-017-1177-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/01/2017] [Indexed: 11/10/2022] Open
Abstract
Background The research program CARPEM (cancer research and personalized medicine) brings together the expertise of researchers and hospital-based oncologists to develop translational research in the context of personalized or “precision” medicine for cancer. There is recognition that patient involvement can help to take into account their needs and priorities in the development of this emerging practice but there is currently no consensus about how this can be achieved. In this study, we developed an empirical ethical research action aiming to improve patient representatives’ involvement in the development of the translational research program together with health professionals. The aim is to promote common understanding and sharing of knowledge between all parties and to establish a long-term partnership integrating patient’s expectations. Methods Two distinct committees were settled in CARPEM: an “Expert Committee”, gathering healthcare and research professionals, and a “Patient Committee”, gathering patients and patient representatives. A multidisciplinary team trained in medical ethics research ensured communication between the two committees as well as analysis of discussions, minutes and outputs from all stakeholders. Results The results highlight the efficiency of the transfer of knowledge between interested parties. Patient representatives and professionals were able to identify new ethical challenges and co-elaborate new procedures to gather information and consent forms for adapting to practices and recommendations developed during the process. Moreover, included patient representatives became full partners and participated in the transfer of knowledge to the public via conferences and publications. Conclusions Empirical ethical research based on a patient-centered approach could help in establishing a fair model for coordination and support actions during cancer research, striking a balance between the regulatory framework, researcher needs and patient expectations. Our approach addresses the concept of translational ethics as a way to handle the main remaining gap between combining care and research activities in the medical pathway and the existing framework.
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Affiliation(s)
- Marie-France Mamzer
- Laboratoire d'Ethique Médicale et Médecine Légale EA4569, Faculté de Médecine, Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France. .,Unité fonctionnelle d'éthique et médecine légale, Hôpital Necker-Enfants malades, Assistance publique-Hôpitaux de Paris, 75015, Paris, France.
| | - Nathalie Duchange
- Laboratoire d'Ethique Médicale et Médecine Légale EA4569, Faculté de Médecine, Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Sylviane Darquy
- Laboratoire d'Ethique Médicale et Médecine Légale EA4569, Faculté de Médecine, Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | | | - Claude Rambaud
- Collectif Interassociatif Sur la Santé (CISS), 75007, Paris, France
| | | | | | - Florian Scotté
- Laboratoire d'Ethique Médicale et Médecine Légale EA4569, Faculté de Médecine, Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France.,Soins de support, Service de cancérologie, Hôpital Européen Georges Pompidou, Assistance publique-Hôpitaux de Paris, 75015, Paris, France
| | - Anita Burgun
- Département d'informatique médicale, de biostatistique et de santé publique, Hôpital Européen Georges Pompidou, Assistance publique-Hôpitaux de Paris, 75015, Paris, France.,UMR-S 1138, Centre de recherche des Cordeliers, 75006, Paris, France.,Faculté de médecine Paris Descartes, Sorbonne universités, Paris, France
| | - Cécile Badoual
- Centre de Ressources biologiques, Service d'anatomo-pathologie, Hôpital Européen Georges Pompidou, Assistance publique-Hôpitaux de Paris, 75015, Paris, France
| | - Pierre Laurent-Puig
- Inserm UMR-S 1147, Université Paris Descartes, 75006, Paris, France.,Service de Biochimie Pharmacogénétique et Oncologie Moléculaire, Hôpital Européen Georges Pompidou, Assistance publique-Hôpitaux de Paris, 75015, Paris, France
| | - Christian Hervé
- Laboratoire d'Ethique Médicale et Médecine Légale EA4569, Faculté de Médecine, Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
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Mamzer MF. [Regulation of French research: How to use it?]. Rev Med Interne 2017; 38:427-429. [PMID: 28215924 DOI: 10.1016/j.revmed.2017.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/16/2017] [Indexed: 11/18/2022]
Affiliation(s)
- M-F Mamzer
- Unité fonctionnelle d'éthique médicale, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France; AP-HP, laboratoire d'éthique médicale et de médecine légale, EA 4569, université Paris-Descartes-Sorbonne-Paris-Cité, 45, rue des Saints-Pères, 75006 Paris, France.
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