Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T22:56:05.587Z Has data issue: false hasContentIssue false

Canadian Research Ethics Board Leadership Attitudes to the Return of Genetic Research Results to Individuals and Their Families

Published online by Cambridge University Press:  01 January 2021

Extract

The return of individual genetic results to research participants has been widely discussed in the context of an explosion of genetic research utilizing an ever more rapid and inexpensive array of sequencing and bioinformatics platforms. To date, a number of consensus statements guide researchers as to the breadth and limits of their obligations for offering genomic research results to participants. Typically these recommendations are rooted in the result’s clinical validity, actionability, and potential health consequences, and are predicated on the informed consent of the participant. An emerging discussion is the challenging question of the degree to which researchers may additionally have responsibility for offering results to family members of the research participant. Some have argued that ethical obligations to relatives intensify as the significance and actionability of the result increase, while others claim that obligations to next of kin should follow the clinical model where the decision to share genetic results falls to the patient. A detailed reflection on the many ethical issues that arise in considering whether such a responsibility exists, and if so how to honor it, is presented in this issue of JLME by Wolf et al.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beskow, L. M. Burke, W., “Offering Individual Genetic Research Results: Context Matters,” Science Translational Medicine 2, no. 38 (2010): 38cm20; Biesecker, L. G., “Secondary Variants and Human Subjects Research,” Genetics in Medicine 15, no. 2 (2013): 157; Bovenberg, J. Meulenkamp, T. Smets, E. Gevers, S., “Biobank Research: Reporting Results to Individual Participants,” European Journal of Health Law 16, no. 3 (2009): 229–247; Clayton, E. W., “Incidental Findings in Genetics Research Using Archived DNA,” Journal of Law, Medicine & Ethics 36, no. 2 (2008): 286–291; Evans, J. P., “Editorial: Return of Results to the Families of Children in Genomic Sequencing: Tallying Risks and Benefits,” Genetics in Medicine 15, no. 6 (2013): 435–436; Holm, I. A. et al. , “Guidelines for Return of Research Results from Pediatric Genomic Studies: Deliberations of the Boston Children's Hospital Gene Partnership Informed Cohort Oversight Board,” Genetics in Medicine 16, no. 7 (2014): 547–552; McGuire, A. L. et al. , “Point-Counterpoint. Ethics and Genomic Incidental Findings,” Science 340, no. 6136 (2013): 1047–1048; Wolf, S. M. et al. , “Managing Incidental Findings in Human Subjects Research: Analysis and Recommendations,” Journal of Law, Medicine & Ethics 36, no. 2 (2008): 219–248; Daack-Hirsch, S. et al. , “Information Is Information: A Public Perspective on Incidental Findings in Clinical and Research Genome-Based Testing,” Clinical Genetics 84, no. 1 (2013): 11–18.CrossRefGoogle Scholar
Fabsitz, R. R. et al. , “Ethical and Practical Guidelines for Reporting Genetic Research Results,” Circulation: Cardiovascular Genetics 3, no. 6 (2010): 574580; Fullerton, S. M. et al. , “Meeting the Governance Challenges of Next-Generation Biorepository Research,” Science Translational Medicine 2, no. 15 (2010): 15cm3; Kaye, J. et al. , “Managing Clinically Significant Findings in Research: The UK 10K Example,” European Journal of Human Genetics 22, no. 9 (2014): 1100–1104; Knoppers, B. M. et al. , “Population Studies: Return of Research Results and Incidental Findings Policy Statement,” European Journal of Human Genetics 21, no. 3 (2013): 245–247; Presidential Commission for the Study of Bioethical Issues, Anticipate and Communicate: Ethical Management of Incidental and Secondary Findings in the Clinical, Research, and Direct-to-Consumer Contexts (2013), available at <http://bioethics.gov/sites/default/files/FINALAnticipateCommunicate_PCSBI_0.pdf> (last visited April 30, 2015); Levenson, D., “Guideline Support the Return of Incidental Genomic Findings,” American Journal of Medical Genetics 161, no. 6 (2013): Vii-viii.Google Scholar
McGuire, A. L. Caulfield, T. Cho, M. K., “Research Ethics and the Challenge of Whole-Genome Sequencing,” Nature Reviews Genetics 9, no. 2 (2008): 152156.CrossRefGoogle Scholar
Rothstein, M. A., “Should Researchers Disclose Results to Descendants?” American Journal of Bioethics 13, no. 10 (2013): 6465; Stol, Y. H. et al. , “Informing Family Members About a Hereditary Predisposition to Cancer: Attitudes and Practices Among Clinical Geneticists,” Journal of Medical Ethics 36, no. 7 (2010): 391–395; Liao, S. M., “Is There a Duty to Share Genetic Information?” Journal of Medical Ethics 35, no. 5 (2009): 306–309.CrossRefGoogle Scholar
Wolf, S. M. et al. , “Returning a Research Participant's Genomic Results to Relatives: Analysis and Recommendations,” Journal of Law, Medicine & Ethics 43, no. 3 (2015): 440463.CrossRefGoogle Scholar
Fernandez, C. V. et al. , “Attitudes of Researchers to the Return to Participants of Incidental and Targeted Genomic Findings Obtained in a Research Setting,” Genetics in Medicine 15, no. 7 (2013): 558564; Kozanczyn, C. Collins, K. Fernandez, C. V., “Offering Results to Research Subjects: U.S. Institutional Review Board Policy,” Accountability in Research 14, no. 4 (2007): 255–267; Simon, C. M. et al. , “Informed Consent and Genomic Incidental Findings: IRB Chair Perspectives,” Journal of Empirical Research on Human Research Ethics 6, no. 4 (2011): 53–67; Williams, J. K. et al. , “Researcher and Institutional Review Board Chair Perspectives on Incidental Findings in Genomic Research,” Genetic Testing and Molecular Biomarkers 16, no. 6 (2012): 508–513; Zawati, M. H. et al. , “Reporting Results from Whole-Genome and Whole-Exome Sequencing in Clinical Practice: A Proposal for Canada?” Journal of Medical Genetics 51, no. 1 (2013): 68–70; Mac-Neil, S. D. Fernandez, C. V., “Informing Research Participants of Research Results: Analysis of Canadian University Based Research Ethics Board Policies,” Journal of Medical Ethics 32, no. 1 (2006): 49–54; Keane, M. A., “Institutional Review Board Approaches to the Incidental Findings Problem,” Journal of Law, Medicine & Ethics 36, no. 2 (2008): 352–355.CrossRefGoogle Scholar
Fernandez, C. V. et al. , “Attitudes of Canadian Researchers Toward the Return to Participants of Incidental and Targeted Genomic Findings Obtained in a Pediatric Research Setting,” Genetics in Medicine 15, no. 7 (2013): 558564; Henderson, G. E. et al. , “What Research Ethics Should Learn from Genomics and Society Research: Lessons from the ELSI Congress of 2011,” Journal of Law, Medicine & Ethics 40, no. 4 (2012): 1008–1024; Downing, N. R. et al. , “Genetics Specialists' Perspectives on Disclosure of Genomic Incidental Findings in the Clinical Setting,” Patient Education and Counselling 90, no. 1 (2013): 133–138.CrossRefGoogle Scholar
Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada, Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (2010), available at <http://www.pre.ethics.gc.ca/pdf/eng/tcps2/TCPS_2_FINAL_Web.pdf> (last visited August 12, 2015) [hereinafter Tri-Council Policy Statement]; Council of Europe, Additional Protocol to the Convention on Human Rights and Biomedicine, Concerning Biomedical Research (2005), available at <http://conventions.coe.int/Treaty/en/Treaties/Html/195.htm> (last visited August 12, 2015); National Institutes of Health (NIH), NCI Best Practices for Biospecimen Resources (2011), available at <http://biospecimens.cancer.gov/practices/2011bp.asp> (last visited August 12, 2015).+(last+visited+August+12,+2015)+[hereinafter+Tri-Council+Policy+Statement];+Council+of+Europe,+Additional+Protocol+to+the+Convention+on+Human+Rights+and+Biomedicine,+Concerning+Biomedical+Research+(2005),+available+at++(last+visited+August+12,+2015);+National+Institutes+of+Health+(NIH),+NCI+Best+Practices+for+Biospecimen+Resources+(2011),+available+at++(last+visited+August+12,+2015).>Google Scholar
Council of Europe, supra note 8; Beier, K. et al. , “The Ethical and Legal Regulation of Human Tissue and Biobank Research in Europe – Proceedings of the Tiss.EU Project (2011),” available at <http://www.oapen.org/search?identifier=407336> (last visited August 12, 2015).+(last+visited+August+12,+2015).>Google Scholar
Beskow, L. M. O'Rourke, P. P., “Return of Genetic Research Results to Participants and Families: IRB Perspectives and Roles,” Journal of Law, Medicine & Ethics 43, no. 3 (2015): 502513.Google Scholar
Fluid Surveys Ultra Version, available at <http://fluidsurveys.com/> (last visited August 12, 2015).+(last+visited+August+12,+2015).>Google Scholar
Beskow, L. M. Smolek, S. J., “Prospective Biorepository Participants' Perspectives on Access to Research Results,” Journal of Empirical Research in Human Research Ethics 4, no. 3 (2009): 99111; Meacham, M. C. et al. , “Researcher Perspectives on Disclosure of Incidental Findings in Genetic Research,” Journal of Empirical Research Human Research Ethics 5, no. 3 (2010): 31–41; Halverson, C. M. E. Ross, L. F., “Attitudes of African-American Parents about Biobank Participation and Return of Results for Themselves and Their Children,” Journal of Medical Ethics 38, no. 9 (2012): 561–566; Murphy, J. et al. , “Public Expectations for Return of Results from Large-Cohort Genetic Research,” American Journal of Bioethics 8, no. 11 (2008): 36–43; Bui, E. T. et al. , “Do Participants in Genome Sequencing Studies of Psychiatric Disorders Wish to Be Informed of Their Results? A Survey Study,” PLoS One 9, no. 7 (2014): E101111, available at <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077756/> (last visited August 12, 2015); Beskow, L. M. et al. , “IRB Chairs' Perspectives on Genotype-Driven Recruitment,” IRB 34, no. 3 (2012): 1–10.CrossRefGoogle Scholar
Fernandez, C. V. et al. , “Attitudes of Parents toward the Return of Targeted and Incidental Genomic Research Findings in Children,” Genetics in Medicine 16, no. 8 (2014): 633640; Meulenkamp, T. M. et al. , “Communication of Biobanks' Research Results: What Do (Potential) Participants Want?” American Journal of Medical Genetics 152A, no. 10 (2010): 2482–2492; Tabor, H. K. et al. , “Genomics Really Gets Personal: How Exome and Whole Genome Sequencing Challenge the Ethical Framework of Human Genetics Research,” American Journal of Medical Genetics 155, no. 12 (2011): 2916–2924; Trinidad, S. B. et al. , “Genomic Research and Wide Data Sharing: Views of Prospective Participants,” Genetics in Medicine 12, no. 8 (2010): 486–495.CrossRefGoogle Scholar
Wolf, S. M., “Return of Individual Research Results & Incidental Findings: Facing the Challenges of Translational Science,” Annual Review of Genomic and Human Genomics 14 (2013): 557577; Wright, G. E. et al. , “Ethical and Legal Implications of Whole Genome and Whole Exome Sequencing in African Populations,” BMT Medical Ethics 14, no. 1 (2013): 21–36; Fernandez, C. V. Kodish, E. Weijer, C., “Returning Research Results to Subjects: An Ethical Imperative,” IRB: Ethics & Human Research 25, no. 3 (2003): 12–19; Avard, D. et al. , “Researchers' Perceptions of the Ethical Implications of Pharmacogenomics Research with Children,” Public Health Genomics 12, no. 3 (2009): 191–201; Costain, G. Bassett, A. S., “Incomplete Knowledge of the Clinical Context as a Barrier to Interpreting Incidental Genetic Research Findings,” American Journal of Bioethics 13, no. 2 (2013): 58–60; Yu, J. H. et al. , “Attitudes of Genetics Professionals Toward the Return of Incidental Results from Exome and Whole-Genome Sequencing,” American Journal of Human Genetics 95, no. 1 (2014): 77–84.CrossRefGoogle Scholar
Kaufman, D. et al. , “Public Opinion About the Importance of Privacy in Biobank Research,” American Journal of Human Genetics 85, no. 5 (2009): 643654; Jamal, L. et al. , “Research Participants' Attitudes towards the Confidentiality of Genomic Sequence Information,” European Journal of Human Genetics 22 (2013): 964–968; Milner, L. C. Liu, E. Y. Garrison, N. A., “Relationships Matter: Ethical Considerations for Returning Results to Family Members of Deceased Subjects,” American Journal of Bioethics 13, no. 10 (2013): 66–67; American Medical Association Opinion 2.131 – Disclosure of Familial Risk in Genetic Testing (2003), available at <http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2131.page?> (last visited August 12, 2015).CrossRefGoogle Scholar
See Beskow, O'Rourke, , supra note 10.Google Scholar
Kohlmeier, G. Z. A., “The Risky Business of Lifestyle Genetic Testing: Protecting against Harmful Disclosure of Genetic Information,” University of California Los Angeles Journal of Law and Technology 11 (2007): 557; National Health and Medical Research Council, “Use and Disclosure of Genetic Information without Consent: A Decision-Making Tool for Health Practitioners—Who, When, Why and How?” Internal Medicine Journal 41, no. 8 (2011): 634–638.Google Scholar
Tri-Council Policy Statement, supra note 8.Google Scholar
Hoffman, D. E. Fortenberry, E. Ravel, J., “Are Changes to the Common Rule Necessary to Address Evolving Areas of Research? A Case Study Focusing on the Human Microbiome Project,” Journal of Law, Medicine & Ethics 41, no. 2 (2013): 454469.CrossRefGoogle Scholar
Thorogood, A. et al. , “An Implementation Framework for the Feedback of Individual Research Results And Incidental Findings in Research,” BMC Medical Ethics 15, no. 1 (2014): 88; Zawati, et al. , supra note 6; Henderson, G. E. et al. , “The Challenge of Informed Consent and Return of Results in Translational Genomics: Empirical Analysis and Recommendations,” Journal of Law, Medicine & Ethics 42, no. 3 (2014): 344–355.CrossRefGoogle Scholar
Green, R. C. et al. , “ACMG Recommendations for Reporting of Incidental Findings in Clinical Exome and Genome Sequencing,” Genetics in Medicine 15, no. 7 (2013): 565574; Jarvik, G. P. et al. , “Return of Genomic Results To Research Participants: The Floor, the Ceiling, and the Choices in Between,” American Journal of Human Genetics 94, no. 6 (2014): 818–826; Burke, W. et al. , “Recommendations for Returning Genomic Incidental Findings? We Need to Talk!” Genetics in Medicine 15, no. 11 (2013): 854–859; Ross, L. F. Rothstein, M. A. Clayton, E., “Mandatory Extended Searches in All Genome Sequencing: ‘Incidental Findings,’ Patient Autonomy, and Shared Decision Making,” JAMA 310, no. 4 (2013): 367–368.CrossRefGoogle Scholar