Department of Medicine, Divinity School, and The MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois, USA.
Genet Med. 2015 May;17(5):331-6. doi: 10.1038/gim.2014.111. Epub 2014 Sep 18.
Genetic exceptionalism, the view that genomic information is different from other types of sensitive information and deserves exceptional types of protections, has been roundly criticized. However, the public still expresses special fears about the access others might have to their genomic information. In this article, it is argued that there may be a basis for the public perception that genomic information is special, even if it cannot be said that policies could or should be enacted to protect the privacy and confidentiality of genomic information that would be exceptional relative to the protections one would enact to protect other types of sensitive information. The special nature of genomic information lies in understanding that it is neither personal property nor mere information. A genome is, at one and the same time, a physical aspect of a person and information about that person. Genomic data are embodied information that partially constitutes as well as describes individuals and that connects them in physical ways to their ancestors and their relatives. All forms of privacy need to be protected, but some intimate aspects of our lives command special respect. To see a genome is more analogous to seeing a naked body than to seeing a social security number. This metaphor suggests that clinicians and investigators ought to respect the special concerns of patients regarding genomic information while not claiming that there are any exceptional measures one could take to protect genomic privacy. Suggestions are given for how this view might affect patient interactions, consent discussions, public policy, and public trust in genomic research and clinical genetics.
遗传特殊论认为,基因组信息不同于其他类型的敏感信息,值得给予特殊类型的保护,这种观点受到了广泛的批评。然而,公众仍然对他人获取其基因组信息表示特别担忧。本文认为,即使不能说可以制定或应该制定政策来保护基因组信息的隐私和机密性,使其相对于为保护其他类型的敏感信息而制定的保护措施具有特殊性,那么公众可能会认为基因组信息具有特殊性。基因组信息的特殊性在于理解它既不是个人财产,也不仅仅是信息。基因组既是一个人的身体方面,也是关于该人的信息。基因组数据是体现信息,它部分构成并描述个人,并以物理方式将他们与其祖先和亲属联系起来。所有形式的隐私都需要得到保护,但我们生活的某些私密方面需要特别尊重。看基因组更类似于看裸体,而不是看社会安全号码。这个比喻表明,临床医生和研究人员应该尊重患者对基因组信息的特殊关注,而不是声称可以采取任何特殊措施来保护基因组隐私。本文还就如何看待这一观点可能影响患者互动、同意讨论、公共政策以及公众对基因组研究和临床遗传学的信任提出了建议。