Valle Mansilla José Ignacio
Rev Derecho Genoma Hum. 2011 Jan-Jun(34):205-24.
Biomedical researchers often now ask subjects to donate samples to be deposited in biobanks. This is not only of interest to researchers, patients and society as a whole can benefit from the improvements in diagnosis, treatment, and prevention that the advent of genomic medicine portends. However, there is a growing debate regarding the social and ethical implications of creating biobanks and using stored human tissue samples for genomic research. Our aim was to identify factors related to both scientists and patients' preferences regarding the sort of information to convey to subjects about the results of the study and the risks related to genomic research. The method used was a survey addressed to 204 scientists and 279 donors from the U.S. and Spain. In this sample, researchers had already published genomic epidemiology studies; and research subjects had actually volunteered to donate a human sample for genomic research. Concerning the results, patients supported more frequently than scientists their right to know individual results from future genomic research. These differences were statistically significant after adjusting by the opportunity to receive genetic research results from the research they had previously participated and their perception of risks regarding genetic information compared to other clinical data. A slight majority of researchers supported informing participants about individual genomic results only if the reliability and clinical validity of the information had been established. Men were more likely than women to believe that patients should be informed of research results even if these conditions were not met. Also among patients, almost half of them would always prefer to be informed about individual results from future genomic research. The three main factors associated to a higher support of a non-limited access to individual results were: being from the US, having previously been offered individual information and considering genomic data more sensitive than other personal medical data. Moreover, the disease of patients, the educational level and the patient's country of origin were factors associated with the perception of risks related to genomic information. As a conclusion, it is mandatory to clarify the criteria required to establish when individual results from genomic research should be offered to participants.
生物医学研究人员现在经常要求受试者捐赠样本,以便存入生物样本库。这不仅对研究人员有意义,患者乃至整个社会都能从基因组医学的出现所预示的诊断、治疗和预防方面的进步中受益。然而,关于建立生物样本库以及将储存的人体组织样本用于基因组研究的社会和伦理影响的争论日益激烈。我们的目的是确定与科学家和患者偏好相关的因素,这些偏好涉及向受试者传达研究结果的信息类型以及与基因组研究相关的风险。所采用的方法是对来自美国和西班牙的204名科学家和279名捐赠者进行调查。在这个样本中,研究人员已经发表了基因组流行病学研究;而研究对象实际上自愿捐赠了用于基因组研究的人体样本。关于结果,患者比科学家更频繁地支持他们有权了解未来基因组研究的个人结果。在根据他们此前参与的研究获得遗传研究结果的机会以及他们对遗传信息与其他临床数据相比的风险认知进行调整后,这些差异具有统计学意义。只有在信息的可靠性和临床有效性得到确立的情况下,略超过半数的研究人员支持告知参与者个人基因组结果。男性比女性更有可能认为,即使不满足这些条件,也应该告知患者研究结果。在患者中,几乎一半的人总是更愿意了解未来基因组研究的个人结果。与更支持无限制获取个人结果相关的三个主要因素是:来自美国、此前曾获得个人信息以及认为基因组数据比其他个人医疗数据更敏感。此外,患者的疾病、教育水平和患者的原籍国是与对基因组信息相关风险的认知有关的因素。总之,必须明确确定何时应向参与者提供基因组研究个人结果所需的标准。