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什么是有意义的结果?向研究参与者披露自闭症基因组研究的结果。

What is a meaningful result? Disclosing the results of genomic research in autism to research participants.

机构信息

Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

出版信息

Eur J Hum Genet. 2010 Aug;18(8):867-71. doi: 10.1038/ejhg.2010.34. Epub 2010 Mar 17.

Abstract

Developments in genomics research have been accompanied by a controversial ethical injunction: that researchers disclose individually relevant research results to research participants. With the explosion of genomic research on complex psychiatric conditions such as autism, researchers must increasingly contend with whether--and which results--to report. We conducted a qualitative study with researchers and participants involved in autism genomics research, including 4 focus groups and 23 interviews with parents of autistic children, and 23 interviews with researchers. Respondents considered genomic research results 'reportable' when results were perceived to explain cause, and answer the question 'why;' that is, respondents set a standard for reporting individually relevant genetic research results to individual participants that is specific to autism, reflecting the metaphysical value that genetic information is seen to offer in this context. In addition to this standard of meaning, respondents required that results be deemed 'true.' Here, respondents referenced standards of validity that were context nonspecific. Yet in practice, what qualified as 'true' depended on evidentiary standards within specific research disciplines as well as fundamental, and contested, theories about how autism is 'genetic.' For research ethics, these finding suggest that uniform and context-free obligations regarding result disclosure cannot readily be specified. For researchers, they suggest that result disclosure to individuals should be justified not only by perceived meaning but also by clarity regarding appropriate evidentiary standards, and attention to the status of epistemological debates regarding the nature and cause of disorders.

摘要

基因组学研究的发展伴随着一个有争议的伦理禁令

研究人员应向研究参与者披露与个体相关的研究结果。随着自闭症等复杂精神疾病的基因组研究的爆炸式增长,研究人员必须越来越多地考虑是否以及报告哪些结果。我们对参与自闭症基因组学研究的研究人员和参与者进行了一项定性研究,包括 4 个焦点小组和 23 名自闭症儿童家长的访谈,以及 23 名研究人员的访谈。当研究结果被认为可以解释原因并回答“为什么”的问题时,受访者认为基因组研究结果是“可报告的”;也就是说,受访者为向个体参与者报告与个体相关的遗传研究结果设定了一个具体针对自闭症的标准,反映了在这种情况下遗传信息被视为具有的形而上学价值。除了这个报告标准外,受访者还要求结果被认为是“真实的”。在这里,受访者参考了与上下文无关的有效性标准。然而,在实践中,什么是“真实的”取决于特定研究学科内的证据标准,以及关于自闭症“遗传”的基本且有争议的理论。对于研究伦理来说,这些发现表明,关于结果披露的统一和与上下文无关的义务不能轻易确定。对于研究人员来说,他们应该不仅通过感知到的意义,而且还通过明确适当的证据标准,并关注关于疾病性质和病因的认识论争论的现状,来证明向个人披露结果是合理的。

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