Dixon-Woods Mary, Kocman David, Brewster Liz, Willars Janet, Laurie Graeme, Tarrant Carolyn
Cambridge Centre for Health Services Research, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
Department of Health Sciences, Social Science Applied to Healthcare Research (SAPPHIRE) Group, University of Leicester, Leicester, UK.
BMC Med Ethics. 2017 Mar 23;18(1):22. doi: 10.1186/s12910-017-0182-0.
Biomedical research increasingly relies on long-term studies involving use and re-use of biological samples and data stored in large repositories or "biobanks" over lengthy periods, often raising questions about whether and when a re-consenting process should be activated. We sought to investigate the views on re-consent of participants in a longitudinal biobank.
We conducted a qualitative study involving interviews with 24 people who were participating in a longitudinal biobank. Their views were elicited using a semi-structured interview schedule and scenarios based on a hypothetical biobank. Data analysis was based on the constant comparative method.
What participants identified as requiring new consent was not a straightforward matter predictable by algorithms about the scope of the consent, but instead was contingent. They assessed whether proposed new research implied a fundamental alteration in the underlying character of the biobank and whether specific projects were within the scope of the original consent. What mattered most to them was that the cooperative bargain into which they had entered was maintained in good faith. They saw re-consent as one important safeguard in this bargain. In determining what required re-consent, they deployed two logics. First, they used a logic of boundaries, where they sought to detect any possible rupture with their existing framework of cooperation. Second, they used a logic of risk, where they assessed proposed research for any potential threats for them personally or the research endeavour. When they judged that a need for re-consent had been activated, participants saw the process as way of re-actualising and renewing the cooperative bargain.
Participants' perceptions of research as a process of mutual co-operation between volunteer and researcher were fundamental to their views on consent. Consenting arrangements for biobanks should respect the cooperative values that are important to participants, recognise the two logics used by research volunteers, and avoid rigidity. Agility may be favoured by tiered consent combined with strong oversight mechanisms; this approach requires evaluation.
生物医学研究越来越依赖长期研究,这些研究涉及在很长一段时间内对存储在大型资料库或“生物样本库”中的生物样本和数据的使用和再利用,这常常引发关于是否以及何时应启动重新征得同意程序的问题。我们试图调查纵向生物样本库参与者对重新征得同意的看法。
我们进行了一项定性研究,对参与纵向生物样本库的24人进行了访谈。使用基于假设生物样本库的半结构化访谈提纲和情景来引出他们的观点。数据分析基于持续比较法。
参与者认为需要新同意的情况并非关于同意范围的算法可预测的简单问题,而是视情况而定的。他们评估拟议的新研究是否意味着生物样本库基本性质的根本改变,以及特定项目是否在原始同意的范围内。对他们来说最重要的是他们所达成的合作协议能得到善意维持。他们将重新征得同意视为该协议中的一项重要保障。在确定需要重新征得同意的事项时,他们运用了两种逻辑。首先,他们运用边界逻辑,试图发现与他们现有合作框架的任何可能断裂。其次,他们运用风险逻辑,评估拟议的研究对他们个人或研究工作的任何潜在威胁。当他们判断需要重新征得同意的情况已被触发时,参与者将该过程视为重新实现和更新合作协议的一种方式。
参与者将研究视为志愿者与研究者之间相互合作过程的观念是他们对同意问题看法的基础。生物样本库的同意安排应尊重对参与者重要的合作价值观,认识到研究志愿者运用的两种逻辑,并避免僵化。分层同意结合强有力的监督机制可能有利于灵活性;这种方法需要评估。