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Kaiser B, Uberoi D, Raven-Adams MC, Cheung K, Bruns A, Chandrasekharan S, Otlowski M, Prince AER, Tiller J, Ahmed A, Bombard Y, Dupras C, Moreno PG, Ryan R, Valderrama-Aguirre A, Joly Y. A proposal for an inclusive working definition of genetic discrimination to promote a more coherent debate. Nat Genet 2024:10.1038/s41588-024-01786-8. [PMID: 38914718 DOI: 10.1038/s41588-024-01786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 05/03/2024] [Indexed: 06/26/2024]
Abstract
Genetic discrimination is an evolving phenomenon that impacts fundamental human rights such as dignity, justice and equity. Although, in the past, various definitions to better conceptualize genetic discrimination have been proposed, these have been unable to capture several key facets of the phenomenon. In this Perspective, we explore definitions of genetic discrimination across disciplines, consider criticisms of such definitions and show how other forms of discrimination and stigmatization can compound genetic discrimination in a way that affects individuals, groups and systems. We propose a nuanced and inclusive definition of genetic discrimination, which reflects its multifaceted impact that should remain relevant in the face of an evolving social context and advancing science. We argue that our definition should be adopted as a guiding academic framework to facilitate scientific and policy discussions about genetic discrimination and support the development of laws and industry policies seeking to address the phenomenon.
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Affiliation(s)
- Beatrice Kaiser
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Diya Uberoi
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | | | - Katherine Cheung
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Andreas Bruns
- The German Human Genome-Phenome Archive, University Hospital, Heidelberg, Germany
| | | | - Margaret Otlowski
- Centre for Health, Law and Emerging Technologies, University of Oxford, Oxford, UK
| | | | - Jane Tiller
- Monash University, Parkville, Victoria, Australia
| | | | - Yvonne Bombard
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Genomics Health Services Research Program, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | | | | | | | | | - Yann Joly
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada.
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2
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Kolarcik CL, Bledsoe MJ, O'Leary TJ. Returning Individual Research Results to Vulnerable Individuals. THE AMERICAN JOURNAL OF PATHOLOGY 2022; 192:1218-1229. [PMID: 35750259 DOI: 10.1016/j.ajpath.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Although issues associated with returning individual research results to study participants have been well explored, these issues have been less thoroughly investigated in vulnerable individuals and populations. Considerations regarding return of research results to these individuals and populations, including how best to ensure truly informed consent, how to minimize the risks and benefits of the return of research results, and how best to ensure justice may differ from those of the population at large. This article discusses the issues and challenges associated with the return of individual research results (such as genomic, proteomic, or other biomarker data) to potentially vulnerable individuals and populations, including those who may be vulnerable for cognitive, communicative, institutional, social, deferential, medical, economic, or social reasons. It explores factors that should be considered in the design, conduct, and oversight of ethically responsible research involving the return of research results to vulnerable individuals and populations and discuss recommendations for those engaged in this work.
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Affiliation(s)
- Christi L Kolarcik
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Timothy J O'Leary
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
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3
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Should Interventionalists Be Screened for Genetic Mutations That May Impair Their Ability to Repair DNA Damage from Radiation Exposure? J Vasc Interv Radiol 2019; 30:1830-1831. [PMID: 31655766 DOI: 10.1016/j.jvir.2019.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 11/23/2022] Open
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4
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Barrett R, Neben CL, Zimmer AD, Mishne G, McKennon W, Zhou AY, Ginsberg J. A scalable, aggregated genotypic-phenotypic database for human disease variation. Database (Oxford) 2019; 2019:5316668. [PMID: 30759220 PMCID: PMC6372842 DOI: 10.1093/database/baz013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/04/2019] [Accepted: 01/18/2019] [Indexed: 12/19/2022]
Abstract
Next generation sequencing multi-gene panels have greatly improved the diagnostic yield and cost effectiveness of genetic testing and are rapidly being integrated into the clinic for hereditary cancer risk. With this technology comes a dramatic increase in the volume, type and complexity of data. This invaluable data though is too often buried or inaccessible to researchers, especially to those without strong analytical or programming skills. To effectively share comprehensive, integrated genotypic-phenotypic data, we built Color Data, a publicly available, cloud-based database that supports broad access and data literacy. The database is composed of 50 000 individuals who were sequenced for 30 genes associated with hereditary cancer risk and provides useful information on allele frequency and variant classification, as well as associated phenotypic information such as demographics and personal and family history. Our user-friendly interface allows researchers to easily execute their own queries with filtering, and the results of queries can be shared and/or downloaded. The rapid and broad dissemination of these research results will help increase the value of, and reduce the waste in, scientific resources and data. Furthermore, the database is able to quickly scale and support integration of additional genes and human hereditary conditions. We hope that this database will help researchers and scientists explore genotype-phenotype correlations in hereditary cancer, identify novel variants for functional analysis and enable data-driven drug discovery and development.
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Affiliation(s)
- Ryan Barrett
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Cynthia L Neben
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Anjali D Zimmer
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Gilad Mishne
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Wendy McKennon
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Alicia Y Zhou
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
| | - Jeremy Ginsberg
- Color Genomics, 831 Mitten Road, Suite 100, Burlingame, CA, USA
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5
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Genetics in an isolated population like Finland: a different basis for genomic medicine? J Community Genet 2017; 8:319-326. [PMID: 28730583 PMCID: PMC5614886 DOI: 10.1007/s12687-017-0318-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/29/2017] [Indexed: 11/24/2022] Open
Abstract
A unique genetic background in an isolated population like that of Finland offers special opportunities for genetic research as well as for applying the genetic developments to the health care. On the other hand, the different genetic background may require local attempts to develop diagnostics and treatment as the selection of diseases and mutations differs from that in the other populations. In this review, we describe the experiences of research and health care in this genetic isolate starting from the identification of specific monogenic diseases enriched in the Finnish population all the way to implementing the knowledge of the unique genetic background to genomic medicine at population level.
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6
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Tercyak KP, Silber E, Johnson AC, Fleischmann A, Murphy SE, Mays D, O'Neill SC, Sharkey CM, Shoretz R. Survey on Addressing the Information and Support Needs of Jewish Women at Increased Risk for or Diagnosed with Breast Cancer: The Sharsheret Experience. Healthcare (Basel) 2015; 3:324-37. [PMID: 27417765 PMCID: PMC4939535 DOI: 10.3390/healthcare3020324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/13/2015] [Accepted: 05/15/2015] [Indexed: 01/02/2023] Open
Abstract
Approximately 12% of women living in the United States will be diagnosed with breast cancer during their lifetimes. While all women face formidable challenges posed by the threat of living with or at increased risk for breast cancer, those of Ashkenazi Jewish descent face additional challenges owing to higher BRCA1/2 mutation prevalence in this population. Amidst calls for population-based screening for hereditary breast cancer risk, much can be learned from the experiences of Jewish women about their needs. The present study is a secondary analysis of psychoeducational program satisfaction and evaluation data previously collected by a community organization dedicated to serving women of all Jewish backgrounds facing, or at risk for, breast cancer. Among respondents (n = 347), over one-third were referred to the organization by family or friends, most often after a cancer crisis. Of the information and support resources offered, the greatest level of engagement occurred with the one-on-one peer support and health care symposia resources. Respondents endorsed high levels of satisfaction with the programs and services, and a strong desire to give back to the community. These data suggest that culturally-relevant information and support services for Jewish women could be scaled-up for larger dissemination to meet the anticipated needs in this special population.
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Affiliation(s)
- Kenneth P Tercyak
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
| | | | - Andrea C Johnson
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
| | | | - Sarah E Murphy
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
| | - Darren Mays
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
| | - Suzanne C O'Neill
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
| | - Christina M Sharkey
- Division of Population Sciences, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
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Modell SM, King SB, Citrin T, Kardia SLR. Phase changes in the BRCA policy domain. JOURNAL OF RELIGION AND HEALTH 2014; 53:715-724. [PMID: 24599711 DOI: 10.1007/s10943-014-9836-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The recent US Supreme Court ruling against gene patenting has been accompanied by the passage at the federal level of the Patient Protection and Affordable Care Act, both events representing a thawing or phase change in policies that will now make preventive techniques, such as BRCA genetic testing to predict risk for familial breast and ovarian cancer, more affordable and accessible. Authors including Yun-Han Huang in this journal have noted the judicial ruling is one step--a significant one--in the process of patent system reform. This commentary links such changes with policy formation and action taken by members of diverse religious communities in the aftermath of the Human Genome Project and continuing in today's genome sequencing area. Religious engagement has acted as a catalyzing force for change in the creation and dissemination of genetic developments. Religious perspectives are needed to solve the new ethical dilemmas posed by population screening for BRCA mutations and the rise of direct-to-consumer and provider marketing of such genetic tests, which have far-reaching consequences at the individual, family, and societal levels.
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Affiliation(s)
- Stephen M Modell
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA,
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Armstrong K, Putt M, Halbert CH, Grande D, Schwartz JS, Liao K, Marcus N, Demeter MB, Shea J. The influence of health care policies and health care system distrust on willingness to undergo genetic testing. Med Care 2012; 50:381-7. [PMID: 22473221 PMCID: PMC3360826 DOI: 10.1097/mlr.0b013e31824d748b] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE As the potential role of genetic testing in disease prevention and management grows, so does concern about differences in uptake of genetic testing across social and racial groups. Characteristics of how genetic tests are delivered may influence willingness to undergo testing and, if they affect population subgroups differently, alter disparities in testing. METHODS Conjoint analysis study of the effect of 3 characteristics of genetic test delivery (ie, attributes) on willingness to undergo genetic testing for cancer risk. Data were collected using a random digit dialing survey of 128 African American and 209 white individuals living in the United States. Measures included conjoint scenarios, the Revised Health Care System Distrust Scale (including the values and competence subscales), health insurance coverage, and sociodemographic characteristics. The 3 attributes studied were disclosure of test results to the health insurer, provision of the test by a specialist or primary care doctor, and race-specific or race-neutral marketing. RESULTS In adjusted analyses, disclosure of test results to insurers, having to get the test from a specialist, and race-specific marketing were all inversely associated with willingness to undergo the genetic test, with the greatest effect for the disclosure attribute. Racial differences in willingness to undergo testing were not statistically significant (P=0.07) and the effect of the attributes on willingness to undergo testing did not vary by patient race. However, the decrease in willingness to undergo testing with insurance disclosure was greater among individuals with high values distrust (P=0.03), and the decrease in willingness to undergo testing from specialist access was smaller among individuals with high competence distrust (P=0.03). CONCLUSIONS Several potentially modifiable characteristics of how genetic tests are delivered are associated with willingness to undergo testing. The effect of 2 of these characteristics vary according to the level of health care system distrust, suggesting that policy decisions about delivery of genetic testing may influence differences in uptake across patient subgroups defined by levels of distrust rather than by race.
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Affiliation(s)
- Katrina Armstrong
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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9
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Admixture mapping: from paradigms of race and ethnicity to population history. THE HUGO JOURNAL 2010; 4:23-34. [PMID: 21472046 PMCID: PMC3051047 DOI: 10.1007/s11568-010-9145-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 08/26/2010] [Accepted: 08/31/2010] [Indexed: 11/02/2022]
Abstract
Admixture mapping is a whole genome association strategy that takes advantage of population history-or genetic ancestry-to map genes for complex diseases. However, because it uses racial/ethnic groupings to examine differential disease risk, admixture mapping raises ethical and social concerns. While there has been much theoretical commentary regarding the ethical and social implications of population-based genetic research, empirical data from stakeholders most closely involved with these studies is limited. One of the first admixture mapping studies carried out was a scan for Multiple Sclerosis (MS) risk factors in an African-American population. Applying qualitative research methods, we used this example to explore developing views, experiences and perceptions of the ethical and social implications of admixture mapping and other population-based research-their value, risks and benefits, and the future prospects of the field. Additionally, we sought to understand how social and ethical risks might be mitigated, and the benefits of this research optimized. We draw on in-depth, one-on-one interviews with leading population geneticists, genome scientists, bioethicists, and African-Americans with MS. Here we present our findings from this unique group of key informants and stakeholders.
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10
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Screening of high-risk groups for breast and ovarian cancer in Europe: a focus on the Jewish population. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0056-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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11
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Ford CL, Harawa NT. A new conceptualization of ethnicity for social epidemiologic and health equity research. Soc Sci Med 2010; 71:251-258. [PMID: 20488602 DOI: 10.1016/j.socscimed.2010.04.008] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 03/18/2010] [Accepted: 04/01/2010] [Indexed: 11/17/2022]
Abstract
Although social stratification persists in the US, differentially influencing the well-being of ethnically defined groups, ethnicity concepts and their implications for health disparities remain under-examined. Ethnicity is a complex social construct that influences personal identity and group social relations. Ethnic identity, ethnic classification systems, the groupings that compose each system and the implications of assignment to one or another ethnic category are place-, time- and context-specific. In the US, racial stratification uniquely shapes expressions of and understandings about ethnicity. Ethnicity is typically invoked via the term, 'race/ethnicity'; however, it is unclear whether this heralds a shift away from racialization or merely extends flawed racial taxonomies to populations whose cultural and phenotypic diversity challenge traditional racial classification. We propose that ethnicity be conceptualized as a two-dimensional, context-specific, social construct with an attributional dimension that describes group characteristics (e.g., culture, nativity) and a relational dimension that indexes a group's location within a social hierarchy (e.g., minority vs. majority status). This new conceptualization extends prior definitions in ways that facilitate research on ethnicization, social stratification and health inequities. While federal ethnic and racial categories are useful for administrative purposes such as monitoring the inclusion of minorities in research, and traditional ethnicity concepts (e.g., culture) are useful for developing culturally appropriate interventions, our relational dimension of ethnicity is useful for studying the relationships between societal factors and health inequities. We offer this new conceptualization of ethnicity and outline next steps for employing socially meaningful measures of ethnicity in empirical research. As ethnicity is both increasingly complex and increasingly central to social life, improving its conceptualization and measurement is crucial for advancing research on ethnic health inequities.
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Affiliation(s)
- Chandra L Ford
- Department of Community Health Sciences, School of Public Health, Box 951772, 650 Charles E. Young Dr., South, University of California at Los Angeles, Los Angeles, CA 90095-1772, United States.
| | - Nina T Harawa
- Department of Research, Charles Drew University, Los Angeles, CA, United States; Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, CA, United States
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12
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Via M, Ziv E, Burchard EG. Recent advances of genetic ancestry testing in biomedical research and direct to consumer testing. Clin Genet 2010; 76:225-35. [PMID: 19793051 DOI: 10.1111/j.1399-0004.2009.01263.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In the post-Human Genome Project era, the debate on the concept of race/ethnicity and its implications for biomedical research are dependent on two critical issues: whether and how to classify individuals and whether biological factors play a role in health disparities. The advent of reliable estimates of genetic (or biogeographic) ancestry has provided this debate with a quantitative and more objective tool. The estimation of genetic ancestry allows investigators to control for population stratification in association studies and helps to detect biological causation behind population-specific differences in disease and drug response. New techniques such as admixture mapping can specifically detect population-specific risk alleles for a disease in admixed populations. However, researchers have to be mindful of the correlation between genetic ancestry and socioeconomic and environmental factors that could underlie these differences. More importantly, researchers must avoid the stigmatization of individuals based on perceived or real genetic risks. The latter point will become increasingly sensitive as several 'for profit companies' are offering ancestry and genetic testing directly to consumers and the consequences of the spread of the services of these companies are still unforeseeable.
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Affiliation(s)
- M Via
- Institute for Human Genetics, University of California, San Francisco, CA 94143-2911, USA.
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13
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Rubinstein WS, Jiang H, Dellefave L, Rademaker AW. Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: A call for dialogue. Genet Med 2009; 11:629-39. [DOI: 10.1097/gim.0b013e3181afd322] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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14
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Caulfield T, Fullerton SM, Ali-Khan SE, Arbour L, Burchard EG, Cooper RS, Hardy BJ, Harry S, Hyde-Lay R, Kahn J, Kittles R, Koenig BA, Lee SSJ, Malinowski M, Ravitsky V, Sankar P, Scherer SW, Séguin B, Shickle D, Suarez-Kurtz G, Daar AS. Race and ancestry in biomedical research: exploring the challenges. Genome Med 2009; 1:8. [PMID: 19348695 PMCID: PMC2651580 DOI: 10.1186/gm8] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The use of race in biomedical research has, for decades, been a source of social controversy. However, recent events, such as the adoption of racially targeted pharmaceuticals, have raised the profile of the race issue. In addition, we are entering an era in which genomic research is increasingly focused on the nature and extent of human genetic variation, often examined by population, which leads to heightened potential for misunderstandings or misuse of terms concerning genetic variation and race. Here, we draw together the perspectives of participants in a recent interdisciplinary workshop on ancestry and health in medicine in order to explore the use of race in research issue from the vantage point of a variety of disciplines. We review the nature of the race controversy in the context of biomedical research and highlight several challenges to policy action, including restrictions resulting from commercial or regulatory considerations, the difficulty in presenting precise terminology in the media, and drifting or ambiguous definitions of key terms.
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Affiliation(s)
- Timothy Caulfield
- Faculty of Law and School of Public Health Research, Health Law Institute, University of Alberta, 89 Ave and 111 St., T6G 2H5, Canada
| | - Stephanie M Fullerton
- Department of Medical History and Ethics and Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Sarah E Ali-Khan
- Program on Life Sciences Ethics and Policy, McLaughlin-Rotman Centre for Global Health, University Health Network, University of Toronto, MaRS Centre, 101 College St, Toronto, Ontario, M5G 1L7, Canada
| | - Laura Arbour
- Faculty of Medicine, Island Medical Program, University of British Columbia, 3800 Finnerty Rd, Victoria, British Columbia, V8P 5C2, Canada
| | - Esteban G Burchard
- Department of Biopharmaceutical Sciences and Department of Medicine, Divisions of Pharmaceutical Sciences and Pharmacogenetics, Pulmonary & Critical Care Medicine, and Clinical Pharmacology, University of California, San Francisco, CA 94143-2911, USA
| | - Richard S Cooper
- Department of Epidemiology & Preventive Medicine, Stritch School of Medicine, Loyola University, 2160 South First Avenue, Maywood, IL 60153, USA
| | - Billie-Jo Hardy
- Program on Life Sciences Ethics and Policy, McLaughlin-Rotman Centre for Global Health, University Health Network, University of Toronto, MaRS Centre, 101 College St, Toronto, Ontario, M5G 1L7, Canada
| | - Simrat Harry
- Faculty of Law and School of Public Health Research, Health Law Institute, University of Alberta, 89 Ave and 111 St., T6G 2H5, Canada
| | - Robyn Hyde-Lay
- Genome Alberta, 3553-31 St NW, Calgary, Alberta, T2L 2K7, Canada
| | - Jonathan Kahn
- Hamline University School of Law, 1536 Hewitt Avenue, St. Paul, MN 55104, USA
| | - Rick Kittles
- Department of Medicine, Section of Genetic Medicine, Department of Human Genetics, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| | - Barbara A Koenig
- Program in Professionalism & Bioethics, Mayo College of Medicine, 200 First St SW, Rochester, MN 55905, USA
| | - Sandra SJ Lee
- Stanford Center for Biomedical Ethics, Stanford University Medical School, 701 Welch Rd, Palo Alto, CA 94304, USA
| | - Michael Malinowski
- Paul M Hebert Law Center, Louisiana State University, 1 East Campus Drive, Baton Rouge, LA 70803, USA
| | - Vardit Ravitsky
- Department of Medical Ethics and Center for Bioethics, University of Pennsylvania, 3401 Market St, Philadelphia, PA 19104, USA
| | - Pamela Sankar
- Department of Medical Ethics and Center for Bioethics, University of Pennsylvania, 3401 Market St, Philadelphia, PA 19104, USA
| | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, and Department of Molecular Genetics, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - Béatrice Séguin
- Program on Life Sciences Ethics and Policy, McLaughlin-Rotman Centre for Global Health, University Health Network, University of Toronto, MaRS Centre, 101 College St, Toronto, Ontario, M5G 1L7, Canada
- Leslie Dan School of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario, M5S 3M2, Canada
| | - Darren Shickle
- Leeds Institute of Health Sciences, University of Leeds, 101 Clarendon Rd, Leeds, LS2 9LJ, UK
| | - Guilherme Suarez-Kurtz
- Pharmacology Division, Instituto Nacional de Câncer, Rua André Cavalcanti 37, Rio de Janeiro 20231-050, Brazil
| | - Abdallah S Daar
- Program on Life Sciences Ethics and Policy, McLaughlin-Rotman Centre for Global Health, University Health Network, University of Toronto, MaRS Centre, 101 College St, Toronto, Ontario, M5G 1L7, Canada
- Department of Public Health Sciences and of Surgery, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada
- McLaughlin Centre for Molecular Medicine, University of Toronto, MaRS Centre, 101 College St, Toronto, Ontario, M5G 1L7, Canada
- Department of Medicine, University of Toronto and University Health Network, 190 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada
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15
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Affiliation(s)
- Manuela M. Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, D-14558 Germany;
| | - Ulf Görman
- Department of Ethics, Lund University, SE-221 00 Lund, Sweden;
| | - John C Mathers
- Human Nutrition Research Center, Newcastle University, Newcastle upon Tyne, NE2 4HH United Kingdom;
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