1] Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA [2] The Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, Massachusetts, USA [3] Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA.
Genet Med. 2014 Jul;16(7):547-52. doi: 10.1038/gim.2013.190. Epub 2014 Jan 9.
Approaches to return individual results to participants in genomic research variably focus on actionability, duty to share, or participants' preferences. Our group at Boston Children's Hospital has prioritized participants' preferences by implementing the Gene Partnership, a genomic research repository, based on the "Informed Cohort" model that offers return of results in accordance with participant preferences. Recognizing that ethical oversight is essential, the Gene Partnership Informed Cohort Oversight Board was convened in 2009.
Over 3 years, the Informed Cohort Oversight Board developed guidelines for the return of individual genomic research results.
The Informed Cohort Oversight Board defined its guiding principles as follows: to respect the developing autonomy of pediatric participants and parental decision-making authority by returning results consistent with participants' preferences and to protect participants from harm. Potential harms and strategies to eliminate harm were identified. Guidelines were developed for participant preferences that consider the child's development and family dynamics. The Informed Cohort Oversight Board agreed that to prevent harm, including harms related to interfering with a child's future autonomy, there will be results that should not be returned regardless of participant preferences.
The Informed Cohort Oversight Board developed guidelines for the return of results that respect the preferences of parents, children, and adult participants while seeking to protect against harm.
基因组研究中向参与者返还个体结果的方法各不相同,主要侧重于结果的实用性、分享责任或参与者的偏好。我们波士顿儿童医院的团队通过实施“基因伙伴关系”(Gene Partnership),优先考虑了参与者的偏好。该基因库是基于“知情队列”(Informed Cohort)模型建立的,根据参与者的偏好提供结果返还。认识到伦理监督至关重要,2009 年成立了基因伙伴关系知情队列监督委员会。
在三年多的时间里,知情队列监督委员会制定了返还个体基因组研究结果的指南。
知情队列监督委员会将其指导原则定义为:通过返还符合参与者偏好的结果,尊重儿科参与者和父母决策权威的发展自主性,并保护参与者免受伤害。确定了潜在的伤害和消除伤害的策略。制定了考虑儿童发展和家庭动态的参与者偏好指南。知情队列监督委员会一致认为,为了防止伤害,包括与干扰孩子未来自主性相关的伤害,无论参与者的偏好如何,都有一些结果不应返还。
知情队列监督委员会制定了返还结果的指南,这些指南既尊重了父母、儿童和成年参与者的偏好,又寻求防止伤害。