Université de Montréal, Faculté de droit, Montreal, Canada.
Eur J Hum Genet. 2010 Jul;18(7):741-5. doi: 10.1038/ejhg.2010.30. Epub 2010 Mar 24.
The rapid emergence of large-scale genetic databases raises issues at the nexus of medical law and ethics, as well as the need, at both national and international levels, for an appropriate and effective framework for their governance. This is even more so for retrospective access to data for secondary uses, wherein the original consent did not foresee such use. The first part of this paper provides a brief historical overview of the ethical and legal frameworks governing consent issues in biobanking generally, before turning to the secondary use of retrospective data in epidemiological biobanks. Such use raises particularly complex issues when (1) the original consent provided is restricted; (2) the minor research subject reaches legal age; (3) the research subject dies; or (4) samples and data were obtained during medical care. Our analysis demonstrates the inconclusive, and even contradictory, nature of guidelines and confirms the current lack of compatible regulations. The second part of this paper uses the European Network for Genetic and Genomic Epidemiology (ENGAGE Consortium) as a case study to illustrate the challenges of research using previously collected data sets in Europe. Our study of 52 ENGAGE consent forms and information documents shows that a broad range of mechanisms were developed to enable secondary use of the data that are part of the ENGAGE Consortium.
大型基因数据库的迅速出现引发了医学法律和伦理问题,以及在国家和国际层面上需要一个适当和有效的治理框架。对于回溯性访问数据进行二次利用来说更是如此,因为原始同意并没有预见到这种使用。本文第一部分简要回顾了一般生物库中同意问题的伦理和法律框架,然后转向回溯性数据在流行病学生物库中的二次利用。当(1)原始同意受到限制;(2)未成年研究对象达到法定年龄;(3)研究对象死亡;或(4)样本和数据是在医疗过程中获得时,这种使用会引发特别复杂的问题。我们的分析表明,指导方针的不确定性,甚至是相互矛盾的,证实了当前缺乏兼容的法规。本文第二部分使用欧洲遗传和基因组流行病学网络(ENGAGE 联盟)作为案例研究,说明了在欧洲使用先前收集的数据集进行研究所面临的挑战。我们对 52 份 ENGAGE 同意书和信息文件的研究表明,为了能够对 ENGAGE 联盟数据进行二次利用,开发了广泛的机制。