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Isenor C, Weiss MJ, Beed S, Urquhart R, Tennankore K, Lucas A, Tomblin-Murphy G, Krmpotic K, Dhanani S, Sullivan V, West Oc LJ, Gongal P, Hartell D, Simpson C, James L, Landry A, Dirk J. Development of a consortium to examine organ donation legislative and system reforms: A report from the LEADDR consortium. Healthc Manage Forum 2023; 36:357-363. [PMID: 37253083 DOI: 10.1177/08404704231175024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In April 2019, the province of Nova Scotia became the first jurisdiction in North America to pass legislation that incorporated deemed consent for deceased organ donation. The reform included many other important updates, including the hierarchy for consent, enabled donor and recipient contact, and mandatory referral of potential deceased donors. Additionally, system reforms were implemented to improve the deceased donation system in Nova Scotia. A collection of national colleagues identified the magnitude of the opportunity to develop a comprehensive strategy to measure and evaluate the impact of the legislative and system reforms. This article describes the successful development of a consortium from both national and provincial jurisdictions that included experts from a variety of backgrounds and clinical and administrative disciplines. In describing the creation of this group, we hope to offer our case example as a model for the evaluation of other health system reforms from a multidisciplinary perspective.
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Affiliation(s)
- Cynthia Isenor
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Matthew J Weiss
- Transplant Québec, Montréal, Québec, Canada
- CHU de Québec-Université Laval Research Center, Laval, Québec, Canada
- Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada
| | - Stephen Beed
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robin Urquhart
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karthik Tennankore
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Kristina Krmpotic
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Sonny Dhanani
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | | | - Lori J West Oc
- Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada
- University of Alberta, Edmonton, Alberta, Canada
| | - Patricia Gongal
- Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada
- University of Alberta, Edmonton, Alberta, Canada
| | - David Hartell
- Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada
| | - Christy Simpson
- Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Lee James
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Alain Landry
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Jade Dirk
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Amorim M, Silva S, Machado H, Teles EL, Baptista MJ, Maia T, Nwebonyi N, de Freitas C. Benefits and Risks of Sharing Genomic Data for Research: Comparing the Views of Rare Disease Patients, Informal Carers and Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148788. [PMID: 35886636 PMCID: PMC9319916 DOI: 10.3390/ijerph19148788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023]
Abstract
Assessing public and patients’ expectations and concerns about genomic data sharing is essential to promote adequate data governance and engagement in rare diseases genomics research. This cross-sectional study compared the views of 159 rare disease patients, 478 informal carers and 63 healthcare professionals in Northern Portugal about the benefits and risks of sharing genomic data for research, and its associated factors. The three participant groups expressed significantly different views. The majority of patients (84.3%) and informal carers (87.4%) selected the discovery of a cure for untreatable diseases as the most important benefit. In contrast, most healthcare professionals revealed a preference for the development of new drugs and treatments (71.4%), which was the second most selected benefit by carers (48.3%), especially by the more educated (OR (95% CI): 1.58 (1.07–2.34)). Lack of security and control over information access and the extraction of information exceeding research objectives were the two most often selected risks by patients (72.6% and 50.3%, respectively) and carers (60.0% and 60.6%, respectively). Conversely, professionals were concerned with genomic data being used to discriminate citizens (68.3%), followed by the extraction of information exceeding research objectives (54.0%). The latter risk was more frequently expressed by more educated carers (OR (95% CI): 1.60 (1.06–2.41)) and less by those with blue-collar (OR (95% CI): 0.44 (0.25–0.77) and other occupations (OR (95% CI): 0.44 (0.26–0.74)). Developing communication strategies and consent approaches tailored to participants’ expectations and needs can benefit the inclusiveness of genomics research that is key for patient-centred care.
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Affiliation(s)
- Mariana Amorim
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Susana Silva
- Centro em Rede de Investigação em Antropologia, Universidade do Minho, 4710-057 Braga, Portugal;
- Instituto de Ciências Sociais, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Helena Machado
- Instituto de Ciências Sociais, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Elisa Leão Teles
- Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal;
| | - Maria João Baptista
- Centro de Referência de Cardiopatias Congénitas, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal;
- Departamento de Ginecologia, Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Tiago Maia
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Ngozi Nwebonyi
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
| | - Cláudia de Freitas
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal; (M.A.); (T.M.); (N.N.)
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
- Correspondence:
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Morrison M, Mourby M, Gowans H, Coy S, Kaye J. Governance of research consortia: challenges of implementing Responsible Research and Innovation within Europe. LIFE SCIENCES, SOCIETY AND POLICY 2020; 16:13. [PMID: 33190636 PMCID: PMC7667809 DOI: 10.1186/s40504-020-00109-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
Responsible Research and Innovation ('RRI') is a cross-cutting priority for scientific research in the European Union and beyond. This paper considers whether the way such research is organised and delivered lends itself to the aims of RRI. We focus particularly on international consortia, which have emerged as a common model to organise large-scale, multi-disciplinary research in contemporary biomedical science. Typically, these consortia operate through fixed-term contracts, and employ governance frameworks consisting of reasonably standard, modular components such as management committees, advisory boards, and data access committees, to co-ordinate the activities of partner institutions and align them with funding agency priorities. These have advantages for organisation and management of the research, but can actively inhibit researchers seeking to implement RRI activities. Conventional consortia governance structures pose specific problems for meaningful public and participant involvement, data sharing, transparency, and 'legacy' planning to deal with societal commitments that persist beyond the duration of the original project. In particular, the 'upstream' negotiation of contractual terms between funders and the institutions employing researchers can undermine the ability for those researchers to subsequently make decisions about data, or participant remuneration, or indeed what happens to consortia outputs after the project is finished, and can inhibit attempts to make project activities and goals responsive to input from ongoing dialogue with various stakeholders. Having explored these challenges, we make some recommendations for alternative consortia governance structures to better support RRI in future.
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Affiliation(s)
- Michael Morrison
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Miranda Mourby
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Heather Gowans
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Sarah Coy
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
| | - Jane Kaye
- Centre for Health, Law, and Emerging Technologies (HeLEX), Faculty of Law, University of Oxford, Oxford, UK
- Melbourne Law School, University of Melbourne, Melbourne, Australia
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Borry P, Bentzen HB, Budin-Ljøsne I, Cornel MC, Howard HC, Feeney O, Jackson L, Mascalzoni D, Mendes Á, Peterlin B, Riso B, Shabani M, Skirton H, Sterckx S, Vears D, Wjst M, Felzmann H. The challenges of the expanded availability of genomic information: an agenda-setting paper. J Community Genet 2018; 9:103-116. [PMID: 28952070 PMCID: PMC5849701 DOI: 10.1007/s12687-017-0331-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/03/2017] [Indexed: 01/20/2023] Open
Abstract
Rapid advances in microarray and sequencing technologies are making genotyping and genome sequencing more affordable and readily available. There is an expectation that genomic sequencing technologies improve personalized diagnosis and personalized drug therapy. Concurrently, provision of direct-to-consumer genetic testing by commercial providers has enabled individuals' direct access to their genomic data. The expanded availability of genomic data is perceived as influencing the relationship between the various parties involved including healthcare professionals, researchers, patients, individuals, families, industry, and government. This results in a need to revisit their roles and responsibilities. In a 1-day agenda-setting meeting organized by the COST Action IS1303 "Citizen's Health through public-private Initiatives: Public health, Market and Ethical perspectives," participants discussed the main challenges associated with the expanded availability of genomic information, with a specific focus on public-private partnerships, and provided an outline from which to discuss in detail the identified challenges. This paper summarizes the points raised at this meeting in five main parts and highlights the key cross-cutting themes. In light of the increasing availability of genomic information, it is expected that this paper will provide timely direction for future research and policy making in this area.
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Affiliation(s)
- Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
- Leuven Institute for Human Genomics and Society, 3000, Leuven, Belgium.
- Faculty of Medicine, University of Leuven, Leuven, Belgium.
| | - Heidi Beate Bentzen
- Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway
- Norwegian Cancer Genomics Consortium, Oslo, Norway
| | - Isabelle Budin-Ljøsne
- Norwegian Cancer Genomics Consortium, Oslo, Norway
- Centre for Medical Ethics, Institute of Health and Society, University of Oslo, P.O Box 1130, Blindern, 0318, Oslo, Norway
- Cohort Studies, Norwegian Institute of Public Health, Oslo, Norway
| | - Martina C Cornel
- Department of Clinical Genetics, Section of Community Genetics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Heidi Carmen Howard
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Oliver Feeney
- Centre of Bioethical Research and Analysis (COBRA), National University of Ireland (Galway), Galway, Republic of Ireland
| | - Leigh Jackson
- RILD Building, Royal Devon and Exeter Hospital, University of Exeter Medical School, Exeter, UK
| | - Deborah Mascalzoni
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- EURAC Research, Bolzano, Italy
| | - Álvaro Mendes
- i3S, Instituto de Investigação e Inovação em Saúde, IBMC-UnIGENe and Centre for Predictive and Preventive Genetics, Universidade do Porto, Porto, Portugal
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Šlajmerjeva 4, 1000, Ljubljana, Slovenia
| | - Brigida Riso
- Instituto Universitário de Lisboa (ISCTE-IUL), CIES-IUL, Lisbon, Portugal
| | - Mahsa Shabani
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genomics and Society, 3000, Leuven, Belgium
| | - Heather Skirton
- Faculty of Health and Human Sciences, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK
| | - Sigrid Sterckx
- Bioethics Institute Ghent, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
| | - Danya Vears
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Leuven Institute for Human Genomics and Society, 3000, Leuven, Belgium
| | - Matthias Wjst
- Helmholtz Center Munich, National Research Centre for Environmental Health, Institute of Lung Biology and Disease, Munich, Germany
- Institute of Medical Statistics, Epidemiology and Medical Informatics, Technical University Munich, Munich, Germany
| | - Heike Felzmann
- Centre of Bioethical Research and Analysis (COBRA), National University of Ireland (Galway), Galway, Republic of Ireland
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Kaye J, Terry SF, Juengst E, Coy S, Harris JR, Chalmers D, Dove ES, Budin-Ljøsne I, Adebamowo C, Ogbe E, Bezuidenhout L, Morrison M, Minion JT, Murtagh MJ, Minari J, Teare H, Isasi R, Kato K, Rial-Sebbag E, Marshall P, Koenig B, Cambon-Thomsen A. Including all voices in international data-sharing governance. Hum Genomics 2018. [PMID: 29514717 PMCID: PMC5842530 DOI: 10.1186/s40246-018-0143-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Governments, funding bodies, institutions, and publishers have developed a number of strategies to encourage researchers to facilitate access to datasets. The rationale behind this approach is that this will bring a number of benefits and enable advances in healthcare and medicine by allowing the maximum returns from the investment in research, as well as reducing waste and promoting transparency. As this approach gains momentum, these data-sharing practices have implications for many kinds of research as they become standard practice across the world. Main text The governance frameworks that have been developed to support biomedical research are not well equipped to deal with the complexities of international data sharing. This system is nationally based and is dependent upon expert committees for oversight and compliance, which has often led to piece-meal decision-making. This system tends to perpetuate inequalities by obscuring the contributions and the important role of different data providers along the data stream, whether they be low- or middle-income country researchers, patients, research participants, groups, or communities. As research and data-sharing activities are largely publicly funded, there is a strong moral argument for including the people who provide the data in decision-making and to develop governance systems for their continued participation. Conclusions We recommend that governance of science becomes more transparent, representative, and responsive to the voices of many constituencies by conducting public consultations about data-sharing addressing issues of access and use; including all data providers in decision-making about the use and sharing of data along the whole of the data stream; and using digital technologies to encourage accessibility, transparency, and accountability. We anticipate that this approach could enhance the legitimacy of the research process, generate insights that may otherwise be overlooked or ignored, and help to bring valuable perspectives into the decision-making around international data sharing.
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Affiliation(s)
- Jane Kaye
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK. .,Melbourne Law School, University of Melbourne, 185 Pelham Street, Carlton, Victoria, 3053, Australia.
| | - Sharon F Terry
- Genetic Alliance USA, 4301 Connecticut Ave NW, Suite 404, Washington DC, 20008-2369, USA
| | - Eric Juengst
- Center for Bioethics, University of North Carolina at Chapel Hill, 333 McNider Hall, Chapel Hill, NC, 27599-7240, USA
| | - Sarah Coy
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK
| | - Jennifer R Harris
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| | - Don Chalmers
- Faculty of Law, University of Tasmania, Private Bag 89, Hobart, Tasmania, 7001, Australia
| | - Edward S Dove
- School of Law, University of Edinburgh, Old College, South Bridge, Edinburgh, EH8 9YL, UK
| | - Isabelle Budin-Ljøsne
- Cohort Studies, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway
| | - Clement Adebamowo
- Center for Bioethics and Research, Ibadan, Nigeria.,Institute of Human Virology Nigeria, Abuja, Nigeria.,Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, 725 W. Lombard St. Suite 445, Baltimore, MD, 21201, USA
| | - Emilomo Ogbe
- International Centre for Reproductive Health, University of Gent, De Pintepark II, De Pintelaan 185, 9000, Ghent, Belgium
| | - Louise Bezuidenhout
- Institute for Science, Innovation and Society, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, UK
| | - Michael Morrison
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK
| | - Joel T Minion
- Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Madeleine J Murtagh
- Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Jusaku Minari
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Harriet Teare
- Centre for Health Law and Emerging Technologies, NDPH, University of Oxford, Ewert House, Ewert Place, Summertown, Oxford, OX2 7DD, UK.,Melbourne Law School, University of Melbourne, 185 Pelham Street, Carlton, Victoria, 3053, Australia
| | - Rosario Isasi
- Institute for Bioethics and Health Policy, Department of Human Genetics, Leonard M. Miller School of Medicine, University of Miami, 1501 NW 10th Avenue, Biomedical Research Building (BRB) Room 361, Miami, FL, 33136, USA
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Emmanuelle Rial-Sebbag
- National Institute for Research and Health (Inserm), UMR 1027 Inserm, Toulouse University, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Patricia Marshall
- Department of Bioethics, School of Medicine, TA200, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4976, USA
| | - Barbara Koenig
- UCSF School of Nursing, Institute for Health and Aging, University of California, San Francisco, 3333 Calif. St, Laurel Heights, San Francisco, CA, 94118, USA
| | - Anne Cambon-Thomsen
- CNRS, Toulouse, France; Joint research unit on epidemiology and public health, Inserm (National Institute for Health and Medical Research) and University Toulouse III Paul Sabatier, Toulouse, France
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Laurie G. What Does It Mean to Take an Ethics+ Approach to Global Biobank Governance? Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0030-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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