1
|
Oikawa M, Takimoto Y. Public Perspectives on Consent for and Governance of Biobanking in Japan. J Empir Res Hum Res Ethics 2024:15562646241286143. [PMID: 39328053 DOI: 10.1177/15562646241286143] [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: 09/28/2024]
Abstract
Through strengthened biobank governance, broad consent has been widely accepted as a means to replace donors' discretion based on the information of individual research protocols. Trust and other ethical and social notions, such as reciprocity and solidarity, are key concepts that support biobank governance. The types of allowed broad consent are several; however, they remain unclear, and whether these ethical and social notions are associated with public attitudes toward the consent model is not fully understood. This quantitative study examined two hypotheses: narrower and limited broad consent are more accepted by the public, and acceptance rates for broad consent increase with established measures related to biobank governance. This analysis supported both hypotheses, implying that the limited type of broad consent should be considered an important option, and that a specific type of governance is critical in promoting trust, reciprocity, and solidarity between biobanks and the public.
Collapse
Affiliation(s)
- Masanori Oikawa
- Department of Medical Ethics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Takimoto
- Department of Biomedical Ethics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| |
Collapse
|
2
|
Lutomski JE, Manders P. From opt-out to opt-in consent for secondary use of medical data and residual biomaterial: An evaluation using the RE-AIM framework. PLoS One 2024; 19:e0299430. [PMID: 38547214 PMCID: PMC10977758 DOI: 10.1371/journal.pone.0299430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/11/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Patient records, imaging, and residual biomaterial from clinical procedures are crucial resources for medical research. In the Netherlands, consent for secondary research has historically relied on opt-out consent. For ethical-legal experts who purport passive consent undermines patient autonomy, opt-in consent (wherein affirmative action is required) is seen as the preferred standard. To date, there is little empirical research exploring patient feasibility, organizational consequences, and the potential risks for research based on secondary data. Thus, we applied the RE-AIM framework to evaluate the impact of migrating from an opt-out to an opt-in consent process. METHODS This evaluation was carried out in Radboud University Medical Center, a large tertiary hospital located in the southeast of the Netherlands. All non-acute, mentally competent patients ≥16 years of age registered between January 13, 2020 and June 30, 2023 were targeted (N = 101,437). In line with the RE-AIM framework, individual and organizational consequences were evaluated across five domains: reach, efficacy, adoption, implementation, and maintenance. RESULTS 101,437 eligible patients were approached of whom 66,214 (65.3%) consented, 8,059 (7.9%) refused consent and 27,164 (26.8%) had no response. Of the 74,273 patients with a response, 89.1% consented to secondary use. The migration to an opt-in consent system was modestly successful; yet notably, differential response patterns by key sociodemographic characteristics were observed. Adaptions to the process flow improved its effectiveness and resulted in a reasonable response over time. Implementation was most affected by budgetary restraints, thus impeding the iterative approach which could have further improved domain outcomes. CONCLUSION This evaluation provides an overview of logistical and pragmatic issues encountered when migrating from opt-out to opt-in consent. Response bias remains a major concern. Though not always directly transferable, these lessons can be broadly used to inform other health care organizations of the potential advantages and pitfalls of an opt-in consent system.
Collapse
Affiliation(s)
- Jennifer E. Lutomski
- Radboud Biobank, Radboud University Medical Center, Nijmegen, The Netherlands
- School of Allied Health Professionals, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Peggy Manders
- Radboud Biobank, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Sulaieva ON, Artamonova O, Dudin O, Semikov R, Urakov D, Zakharash Y, Kacharian A, Strilka V, Mykhalchuk I, Haidamak O, Serdyukova O, Kobyliak N. Ethical navigation of biobanking establishment in Ukraine: learning from the experience of developing countries. JOURNAL OF MEDICAL ETHICS 2023:jme-2023-109129. [PMID: 37945338 DOI: 10.1136/jme-2023-109129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Building a biobank network in developing countries is essential to foster genomic research and precision medicine for patients' benefit. However, there are serious barriers to establishing biobanks in low-income and middle-income countries (LMICs), including Ukraine. Here, we outline key barriers and essential milestones for the successful expansion of biobanks, genomic research and personalised medicine in Ukraine, drawing from the experience of other LMICs. A lack of legal and ethical governance in conjunction with limited awareness about biobanking and community distrust are the principal threats to establishing biobanks. The experiences of LMICs suggest that Ukraine urgently needs national guidelines covering ethical and legal aspects of biospecimen-related research. National guidelines must be consistent with international ethical recommendations for safeguarding participants' rights, welfare and privacy. Additionally, efforts to educate and engage physicians and patient communities are essential for achieving biobanking goals and benefits for precision medicine and future patients.
Collapse
Affiliation(s)
- Oksana N Sulaieva
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Doctorate in Bioethics, Neiswanger Institute for Bioethics, Loyola University Chicago, Chicago, Illinois, USA
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | - Oleksandr Dudin
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
| | - Rostyslav Semikov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Dmytro Urakov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | | | | | - Ivan Mykhalchuk
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | | | - Olena Serdyukova
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Nazarii Kobyliak
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, Ukraine
| |
Collapse
|
4
|
Caroline D, Marie-France M. Get this thing out of my body! Factors determining consent for translational oncology research: a qualitative research. J Transl Med 2023; 21:336. [PMID: 37211597 DOI: 10.1186/s12967-023-04039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/05/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Depending on the needs of scientific research at a given time, biobanks make biological samples and data available to researchers. In this article, we aim to describe the reasons and underlying logic that determine the decision to grant or deny consent to the conservation of tumour samples in a biological resource platform for research purposes. We make use of the CARPEM biological resource platform model, where broad consent is required. METHODS The results are based on semi-structured interviews, conducted between 2019 and 2021, with 25 individuals having various profiles. RESULTS All the people interviewed readily accepted the principle of conserving a tumour sample for research purposes. They explained their decision by citing the desire to participate in research dedicated to improving therapeutic medicine. Their trust in research institutions or in doctors was an important factor in their consent. The tumorous nature of the samples also played an important role, as did the absence of constraints. Finally, the high level of consent was also based on the difficulty they had in conceiving what the future risks might be once the sample had been taken, whereas the fact that they did not know the nature or purpose of the research to be carried out when they signed the consent form posed some problems. These results stem from a lack of a culture of ethics among the people interviewed. CONCLUSION The information provided in the context of consent at the CARPEM tumour bank seems inadequate for consent to be considered 'informed', given the low level of knowledge that people have of the risks and issues. Information is missing even though we feel it would not change consent or only marginally. This raises questions, since part of the act of granting consent is based on the implicit trust French people have in the hospital that collects the data and in research practices in general. In the minds of those who participate, transparency is the ground on which trust rests. Lack of transparency could be deleterious for future research practices. However, it is not by striving to improve information leaflets that the consent-related information will improve but, rather, by more effectively helping future patients to assimilate that information.
Collapse
Affiliation(s)
- Desprès Caroline
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France.
| | - Mamzer Marie-France
- Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Inserm, Laboratoire Êtres, Unité Fonctionnelle d'Éthique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France
| |
Collapse
|
5
|
Safarlou CW, Jongsma KR, Vermeulen R, Bredenoord AL. The ethical aspects of exposome research: a systematic review. EXPOSOME 2023; 3:osad004. [PMID: 37745046 PMCID: PMC7615114 DOI: 10.1093/exposome/osad004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
In recent years, exposome research has been put forward as the next frontier for the study of human health and disease. Exposome research entails the analysis of the totality of environmental exposures and their corresponding biological responses within the human body. Increasingly, this is operationalized by big-data approaches to map the effects of internal as well as external exposures using smart sensors and multiomics technologies. However, the ethical implications of exposome research are still only rarely discussed in the literature. Therefore, we conducted a systematic review of the academic literature regarding both the exposome and underlying research fields and approaches, to map the ethical aspects that are relevant to exposome research. We identify five ethical themes that are prominent in ethics discussions: the goals of exposome research, its standards, its tools, how it relates to study participants, and the consequences of its products. Furthermore, we provide a number of general principles for how future ethics research can best make use of our comprehensive overview of the ethical aspects of exposome research. Lastly, we highlight three aspects of exposome research that are most in need of ethical reflection: the actionability of its findings, the epidemiological or clinical norms applicable to exposome research, and the meaning and action-implications of bias.
Collapse
Affiliation(s)
- Caspar W. Safarlou
- Department of Global Public Health and Bioethics, Julius Center for
Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The
Netherlands
| | - Karin R. Jongsma
- Department of Global Public Health and Bioethics, Julius Center for
Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The
Netherlands
| | - Roel Vermeulen
- Department of Global Public Health and Bioethics, Julius Center for
Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The
Netherlands
- Department of Population Health Sciences, Utrecht University,
Utrecht, The Netherlands
| | - Annelien L. Bredenoord
- Department of Global Public Health and Bioethics, Julius Center for
Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The
Netherlands
- Erasmus School of Philosophy, Erasmus University Rotterdam,
Rotterdam, The Netherlands
| |
Collapse
|
6
|
D’Abramo F, Bont A, Nüßlein L. Biomolecular Prospecting, Informative Gaps, and the Cancer Clinic: A Qualitative Fieldwork and an Epistemological, Historical and Ethical Analysis of Informed Consent for Clinical Trials for Monoclonal Antibodies and Biobank Research. Front Genet 2022; 13:872211. [PMID: 35774510 PMCID: PMC9238291 DOI: 10.3389/fgene.2022.872211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
What happens to patients with cancer engaged in biomedical research when intellectual property regimes and ethical regimes intersect? This qualitative historical study addresses this question by situating the experiences, hopes, and reasons of patients to enter clinical trials within the historical trajectory of informed consent and monoclonal antibodies, the biotechnology underpinning many targeted drugs used in oncological clinical trials and biobank research. Based on fieldwork we undertook in a German university hospital where we interviewed patients and the medical personnel, a historical review, and an ethical analysis we inquire into the effects that financial, legal, and technological changes connected to the relevant pharmaceutical research and commerce have on cancer patients engaged in clinical trials and biobank research. We find that the controversial aspects of monoclonal antibodies, especially those related to the commercial interests at stake, enter the informed consent process mainly in the form of informative gaps. We highlight how a qualitative analysis of the clinic, especially when it is situated against the backdrop of the history of related technological advancements and patent regime, it can serve the purpose of giving voice to subjects who are silenced by regimes of an ethical, epistemic, and commercial kind while pointing to informed consent as an unhelpful device for addressing risks arising from the commercial purposes of biomedical products and infrastructure.
Collapse
Affiliation(s)
- Flavio D’Abramo
- Charité Comprehensive Cancer Center, Berlin, Germany
- Division of Health Psychology, Free University of Berlin, Berlin, Germany
- Max Planck Institute for the History of Science, Berlin, Germany
| | | | - Lisa Nüßlein
- Institute of Social and Cultural Anthropology, Department of Political and Social Sciences, Free University of Berlin, Berlin, Germany
| |
Collapse
|
7
|
McKeown A, Mourby M, Harrison P, Walker S, Sheehan M, Singh I. Ethical Issues in Consent for the Reuse of Data in Health Data Platforms. SCIENCE AND ENGINEERING ETHICS 2021; 27:9. [PMID: 33538942 PMCID: PMC7862505 DOI: 10.1007/s11948-021-00282-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 12/21/2020] [Indexed: 05/08/2023]
Abstract
Data platforms represent a new paradigm for carrying out health research. In the platform model, datasets are pooled for remote access and analysis, so novel insights for developing better stratified and/or personalised medicine approaches can be derived from their integration. If the integration of diverse datasets enables development of more accurate risk indicators, prognostic factors, or better treatments and interventions, this obviates the need for the sharing and reuse of data; and a platform-based approach is an appropriate model for facilitating this. Platform-based approaches thus require new thinking about consent. Here we defend an approach to meeting this challenge within the data platform model, grounded in: the notion of 'reasonable expectations' for the reuse of data; Waldron's account of 'integrity' as a heuristic for managing disagreement about the ethical permissibility of the approach; and the element of the social contract that emphasises the importance of public engagement in embedding new norms of research consistent with changing technological realities. While a social contract approach may sound appealing, however, it is incoherent in the context at hand. We defend a way forward guided by that part of the social contract which requires public approval for the proposal and argue that we have moral reasons to endorse a wider presumption of data reuse. However, we show that the relationship in question is not recognisably contractual and that the social contract approach is therefore misleading in this context. We conclude stating four requirements on which the legitimacy of our proposal rests.
Collapse
Affiliation(s)
- Alex McKeown
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.
| | - Miranda Mourby
- Centre for Health, Law and Emerging Technologies (HeLEX), University of Oxford, Oxford, UK
| | - Paul Harrison
- Department of Psyhiatry, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Sophie Walker
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mark Sheehan
- Ethox, Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Ilina Singh
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| |
Collapse
|
8
|
Zalaf BR, Bringel M, Jorge PK, de Oliveira B, Tanabe K, Santos CF, Oliveira RC, Rios D, Cruvinel T, Lourenço Neto N, Oliveira TM, Machado MAAM. A Biobank of Stem Cells of Human Exfoliated Deciduous Teeth: Overview of Applications and Developments in Brazil. Cells Tissues Organs 2020; 209:37-42. [PMID: 32541141 DOI: 10.1159/000506677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/17/2020] [Indexed: 11/19/2022] Open
Abstract
A biobank is an organized collection of biological human material and its associated information stored for research according to regulations under institutional responsibility, without commercial purposes, being a mandatory and strategical activity for research, regenerative medicine, and innovation. Stem cells have largely been employed in research and frequently stored in biobanks, which have been used as an essential source of biological materials. Stem cells of human exfoliated deciduous teeth (SHED) are stem cells which have a high multipotency and can be easily obtained. Besides, this extremely accessible tissue has advantages with respect to storage, as the SHED obtained in childhood can be used in later life, which implies the necessity for the creation and regulation of biobanks. The proper planning for the creation of a biobank includes knowledge of the material types to be stored, requirements regarding handling and storage conditions, storage time, and room for the number of samples. Thus, this study aimed to establish an overview of the development of a SHED biobank. Ethical and legal standardization, current applications, specific orientations, and challenges for the implementation of a SHED biobank were discussed. Through this overview, we hope to encourage further studies to use SHED biobanks.
Collapse
Affiliation(s)
- Bianca Rapini Zalaf
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil,
| | - Mayara Bringel
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Paula Karine Jorge
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Bárbara de Oliveira
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Kim Tanabe
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Carlos Ferreira Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rodrigo Cardoso Oliveira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Natalino Lourenço Neto
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | |
Collapse
|
9
|
Orzechowski M, Schochow M, Kühl M, Steger F. Donor information in research and drug evaluation with induced pluripotent stem cells (iPSCs). Stem Cell Res Ther 2020; 11:126. [PMID: 32192531 PMCID: PMC7083011 DOI: 10.1186/s13287-020-01644-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/07/2020] [Accepted: 03/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background The discovery of induced pluripotent stem cells (iPSCs) opened the possibilities for reprogramming cells back to a pluripotent state. Because of no apparent ethical issues connected with donation and derivation of biomaterial, iPSCs are considered as a research alternative to ethically highly disputed human embryonic stem cells (hESCs). However, the unique character of iPSCs leads to numerous ethical considerations, which mainly concern the issue of donor information and consent for the use of biospecimen in research and drug evaluation. Methods For the purpose of this analysis, we conducted a review of the literature in the PubMed/MEDLINE and Web of Science databases. The search algorithm led to the identification of 1461 results. After removing duplicates and screening of title and abstract, 90 articles were found to be relevant to the study’s objective. Full texts of these articles were apprised and 62 articles were excluded at this step for not properly addressing the study’s objective. In the final step, 28 articles were included in the analysis. Analyzed were both research and non-research manuscripts published in peer-reviewed journals. Results In the case of iPSC research, the information process should be guided by general frameworks established for research on human subjects but also by specific characteristics of iPSCs. We determined four main domains and 12 thematic subdomains that should be included in donor information. Our results show that majority of authors agree to the content of information with regard to the areas of general information, storage of cells, and protection of privacy. Two main issues that are discussed in the literature are donor’s consent for use in future studies and the process of donor information. Conclusions Given the unique character of iPSCs and the possibility of their various uses in the future, the content of donor information should contain specific information central to iPSC research. Effective methods of communicating information to donors should combine written and oral information with the possible use of multimedia.
Collapse
Affiliation(s)
- Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany.
| | - Maximilian Schochow
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany
| | - Michael Kühl
- Institute of Biochemistry and Molecular Biology, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany
| |
Collapse
|
10
|
Broekstra R, Aris-Meijer J, Maeckelberghe E, Stolk R, Otten S. Trust in Centralized Large-Scale Data Repository: A Qualitative Analysis. J Empir Res Hum Res Ethics 2019; 15:365-378. [PMID: 31738093 PMCID: PMC7488827 DOI: 10.1177/1556264619888365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Exponential increases in digital data and calls for participation in human research raise questions about when and why individuals voluntarily provide personal data. We conducted 36 in-depth interviews with ex-participants, participants, and nonparticipants in a biobank to identify key factors influencing trust in centralized large-scale data repository for human research. Our findings indicated that trust depends strongly on whether such data repository benefits the public, the interests of data collectors, the characteristics of the collected data, and application of informed consent for retaining control over personal data. Concerns about the aims and range of data repository appeared to influence withdrawal of participation. Our findings underscore ethical and practical issues relating to data collection and consent procedures in human research.
Collapse
Affiliation(s)
| | | | | | - Ronald Stolk
- University Medical Center Groningen, the Netherlands
| | | |
Collapse
|
11
|
Church TD, Richmond FJ. Biobank Continuity Management: A Survey of Biobank Professionals. Biopreserv Biobank 2019; 17:410-417. [PMID: 31017454 DOI: 10.1089/bio.2018.0142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Academic biobanks face challenges that call for continuity and disaster planning. However, current regulations do not require such planning, so it is unclear if and how biobanks have prepared themselves to deal with future crises. This exploratory study used mixed methods to understand the state of continuity planning in U.S. biobanks. It first reviewed the current state of regulatory and implementation requirements that drive and challenge continuity planning. A survey instrument was then developed and critiqued by a focus group of experienced practitioners in biobanking. The refined survey was disseminated to a targeted group of respondents employed at biobanks across the United States. Most respondents were associated with relatively mature biobanks in operation for more than 6 years and these typically had some form of continuity plan in place. More commonly, continuity planning was reported to be focused on countering natural disasters rather than organization- or personnel-related crises. Respondents identified their most common limitation to be financial resources affecting all phases of implementation. Although many respondents appeared to be aware of some guidance documents and standards for continuity planning, many reported that they did not use or reference them when constructing their biobank continuity plans. Furthermore, nearly 25% of surveyed biobanks did not have a continuity plan and 61% indicated concern in having a mandated continuity plan. Results suggested academic organizations would benefit from a continuity plan template and best practice guidelines for plan development and implementation.
Collapse
Affiliation(s)
- Terry David Church
- Regulatory and Quality Sciences, University of Southern California (USC), USC School of Pharmacy, Los Angeles, California
| | - Frances J Richmond
- Regulatory and Quality Sciences, University of Southern California (USC), USC School of Pharmacy, Los Angeles, California
| |
Collapse
|
12
|
Health, wealth and behavioural change: an exploration of role responsibilities in the wake of epigenetics. J Community Genet 2017; 9:153-167. [PMID: 28726230 PMCID: PMC5849698 DOI: 10.1007/s12687-017-0315-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/18/2017] [Indexed: 01/04/2023] Open
Abstract
The field of epigenetics is leading to new conceptualizations of the role of environmental factors in health and genetic disease. Although more evidence is required, epigenetic mechanisms are being implicated in the link between low socioeconomic status and poor health status. Epigenetic phenomena work in a number of ways: they can be established early in development, transmitted from previous generations and/or responsive to environmental factors. Knowledge about these types of epigenetic traits might therefore allow us to move away from a genetic deterministic perspective, and provide individuals with the opportunity to change their health status. Although this could be equated with patient empowerment, it could also lead to stigmatization and discrimination where individuals are deemed responsible for their health, even if they are not in social situations where they are able to enact change that would alter their health status. In this paper, we will explore the responsibilities of different actors in the healthcare sphere in relation to epigenetics across four different contexts: (1) genetic research, (2) clinical practice, (3) prenatal care and (4) the workplace. Within this exploration of role responsibilities, we will also discuss the potential constraints that might prevent the patient, mother-to-be, research participant or employee, from enacting any necessary steps in order to increase their health status in response to epigenetic information.
Collapse
|
13
|
Budin-Ljøsne I, Teare HJA, Kaye J, Beck S, Bentzen HB, Caenazzo L, Collett C, D'Abramo F, Felzmann H, Finlay T, Javaid MK, Jones E, Katić V, Simpson A, Mascalzoni D. Dynamic Consent: a potential solution to some of the challenges of modern biomedical research. BMC Med Ethics 2017; 18:4. [PMID: 28122615 PMCID: PMC5264333 DOI: 10.1186/s12910-016-0162-9] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/26/2016] [Indexed: 01/04/2023] Open
Abstract
Background Innovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment. Methods An interdisciplinary workshop jointly organised by the University of Oxford and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach. Results Dynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies. Conclusions Dynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures.
Collapse
Affiliation(s)
- Isabelle Budin-Ljøsne
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1130, NO-0318, Oslo, Norway. .,Norwegian Cancer Genomics Consortium, cancergenomics.no, Oslo, Norway.
| | - Harriet J A Teare
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jane Kaye
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Stephan Beck
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Heidi Beate Bentzen
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1130, NO-0318, Oslo, Norway.,Norwegian Cancer Genomics Consortium, cancergenomics.no, Oslo, Norway.,Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
| | | | | | | | - Heike Felzmann
- Centre of Bioethical Research & Analysis, NUI Galway, Galway, Ireland
| | - Teresa Finlay
- Centre for Health, Law and Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Muhammad Kassim Javaid
- NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Erica Jones
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Višnja Katić
- School of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Deborah Mascalzoni
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.,Centre for Biomedicine, EURAC, Bolzano, Italy
| |
Collapse
|
14
|
Brothers KB, Goldenberg AJ. Ethical and legal considerations for pediatric biobank consent: current and future perspectives. Per Med 2016; 13:597-607. [PMID: 29754545 DOI: 10.2217/pme-2016-0028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Innovations in laboratory and information technologies continue to drive the expansion of pediatric biorepository research, with collections of biosamples and data continuing to grow in scale and scope. In this review, we examine the trajectory of recent developments in ethical and legal scholarship on consent to pediatric biorepository research. We focus, in particular, on issues that are likely to grow in importance in coming years, either because significant controversies remain or because they represent trends that are likely to continue into the future. Of particular interest is the evolving conception of consent as a process, the trend toward increased participant engagement and other challenges likely to raise thorny new issues in this field in the decade ahead.
Collapse
Affiliation(s)
- Kyle B Brothers
- Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA
| | - Aaron J Goldenberg
- Department of Bioethics, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
15
|
Capocasa M, Anagnostou P, D’Abramo F, Matteucci G, Dominici V, Destro Bisol G, Rufo F. Samples and data accessibility in research biobanks: an explorative survey. PeerJ 2016; 4:e1613. [PMID: 26966643 PMCID: PMC4782685 DOI: 10.7717/peerj.1613] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/30/2015] [Indexed: 12/23/2022] Open
Abstract
Biobanks, which contain human biological samples and/or data, provide a crucial contribution to the progress of biomedical research. However, the effective and efficient use of biobank resources depends on their accessibility. In fact, making bio-resources promptly accessible to everybody may increase the benefits for society. Furthermore, optimizing their use and ensuring their quality will promote scientific creativity and, in general, contribute to the progress of bio-medical research. Although this has become a rather common belief, several laboratories are still secretive and continue to withhold samples and data. In this study, we conducted a questionnaire-based survey in order to investigate sample and data accessibility in research biobanks operating all over the world. The survey involved a total of 46 biobanks. Most of them gave permission to access their samples (95.7%) and data (85.4%), but free and unconditioned accessibility seemed not to be common practice. The analysis of the guidelines regarding the accessibility to resources of the biobanks that responded to the survey highlights three issues: (i) the request for applicants to explain what they would like to do with the resources requested; (ii) the role of funding, public or private, in the establishment of fruitful collaborations between biobanks and research labs; (iii) the request of co-authorship in order to give access to their data. These results suggest that economic and academic aspects are involved in determining the extent of sample and data sharing stored in biobanks. As a second step of this study, we investigated the reasons behind the high diversity of requirements to access biobank resources. The analysis of informative answers suggested that the different modalities of resource accessibility seem to be largely influenced by both social context and legislation of the countries where the biobanks operate.
Collapse
Affiliation(s)
| | - Paolo Anagnostou
- Istituto Italiano di Antropologia, Rome, Italy
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | | | | | - Valentina Dominici
- Istituto Italiano di Antropologia, Rome, Italy
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Giovanni Destro Bisol
- Istituto Italiano di Antropologia, Rome, Italy
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Rufo
- Istituto Italiano di Antropologia, Rome, Italy
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
16
|
Christen M, Domingo-Ferrer J, Draganski B, Spranger T, Walter H. On the Compatibility of Big Data Driven Research and Informed Consent: The Example of the Human Brain Project. LAW, GOVERNANCE AND TECHNOLOGY SERIES 2016. [DOI: 10.1007/978-3-319-33525-4_9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
17
|
D'Abramo F, Schildmann J, Vollmann J. Research participants' perceptions and views on consent for biobank research: a review of empirical data and ethical analysis. BMC Med Ethics 2015; 16:60. [PMID: 26354520 PMCID: PMC4563851 DOI: 10.1186/s12910-015-0053-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 08/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Appropriate information and consent has been one of the most intensely discussed topics within the context of biobank research. In parallel to the normative debate, many socio-empirical studies have been conducted to gather experiences, preferences and views of patients, healthy research participants and further stakeholders. However, there is scarcity of literature which connects the normative debate about justifications for different consent models with findings gained in empirical research. In this paper we discuss findings of a limited review of socio-empirical research on patients' and healthy research participants' experiences and views regarding consent to biobank research in light of ethical principles for appropriate information and consent. METHODS Review question: Which empirical data are available on research participants' perceptions and views regarding information and elicitation of consent for biobank research? Search of articles published till March 1st 2014 in Pubmed. Review of abstracts and potentially relevant full text articles by two authors independently. As categories for content analysis we defined (i) understanding or recall of information, (ii) preferences regarding information or consent, and (iii) research participants' concerns. RESULTS The search in Pubmed yielded 337 abstracts of which 10 articles were included in this study. Approaches to information and consent varied considerably across the selected studies. The majority of research participants opted for some version of limited consent when being informed about such possibility. Among the factors influencing the type of preferred consent were information about sponsoring of biobank research by pharmaceutical industry and participants' trade-off between privacy and perceived utility. Studies investigating research participants' understanding and recall regarding the consent procedure indicated considerable lack of both aspects. Research participants' perceptions of benefits and harms differ across those studies. CONCLUSION The knowledge, perceptions and views of research participants who have undergone a consent procedure within the context of biobank research raise several questions on the issue of how to inform and elicit consent in an ethically acceptable way. In our empirical-ethical analysis we develop suggestions on how the practice of eliciting consent in the biobank context should be improved.
Collapse
Affiliation(s)
- Flavio D'Abramo
- Institute for Medical Ethics and History of Medicine, Ruhr-Universität Bochum, Markstraße 258a, D-44799, Bochum, Germany. .,Charité Comprehensive Cancer Center, Charité - Universitätsmedizin, Charitéplatz 1, Berlin, D-10117, Germany.
| | - Jan Schildmann
- Institute for Medical Ethics and History of Medicine, Ruhr-Universität Bochum, Markstraße 258a, D-44799, Bochum, Germany.
| | - Jochen Vollmann
- Institute for Medical Ethics and History of Medicine, Ruhr-Universität Bochum, Markstraße 258a, D-44799, Bochum, Germany.
| |
Collapse
|