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东亚及其他地区知情同意书的社会与沟通功能

Social and Communicative Functions of Informed Consent Forms in East Asia and Beyond.

作者信息

Yoshizawa Go, Sasongko Teguh H, Ho Chih-Hsing, Kato Kazuto

机构信息

Graduate School of Medicine, Osaka UniversitySuita, Japan.

Division of Human Biology, School of Medicine, International Medical UniversityKuala Lumpur, Malaysia.

出版信息

Front Genet. 2017 Jul 20;8:99. doi: 10.3389/fgene.2017.00099. eCollection 2017.

Abstract

The recent research and technology development in medical genomics has raised new issues that are profoundly different from those encountered in traditional clinical research for which informed consent was developed. Global initiatives for international collaboration and public participation in genomics research now face an increasing demand for new forms of informed consent which reflect local contexts. This article analyzes informed consent forms (ICFs) for genomic research formulated by four selected research programs and institutes in East Asia - the Medical Genome Science Program in Japan, Universiti Sains Malaysia Human Research Ethics Committee in Malaysia, and the Taiwan Biobank and the Taipei Medical University- Joint Institutional Review Board in Taiwan. The comparative text analysis highlights East Asian contexts as distinct from other regions by identifying communicative and social functions of consent forms. The communicative functions include re-contact options and offering interactive support for research participants, and setting opportunities for family or community engagement in the consent process. This implies that informed consent cannot be validated solely with the completion of a consent form at the initial stage of the research, and informed consent templates can facilitate interactions between researchers and participants through (even before and after) the research process. The social functions consist of informing participants of possible social risks that include genetic discrimination, sample and data sharing, and highlighting the role of ethics committees. Although international ethics harmonization and the subsequent coordination of consent forms may be necessary to maintain the quality and consistency of consent process for data-intensive international research, it is also worth paying more attention to the local values and different settings that exist where research participants are situated for research in medical genomics. More than simply tools to gain consent from research participants, ICFs function rather as a device of social communication between research communities and civic communities in liaison with intermediary agents like ethics committees, genetic counselors, and public biobanks and databases.

摘要

医学基因组学领域最近的研究和技术发展引发了一些新问题,这些问题与传统临床研究中遇到的问题截然不同,而知情同意正是为传统临床研究而制定的。国际合作与公众参与基因组学研究的全球倡议现在面临着对反映当地情况的新形式知情同意的日益增长的需求。本文分析了东亚四个选定的研究项目和机构制定的基因组研究知情同意书(ICF)——日本的医学基因组科学项目、马来西亚理科大学人类研究伦理委员会、台湾生物银行以及台湾台北医学大学联合机构审查委员会。比较文本分析通过识别同意书的沟通和社会功能,突出了东亚背景与其他地区的不同之处。沟通功能包括重新联系选项、为研究参与者提供互动支持,以及为家庭或社区参与同意过程创造机会。这意味着知情同意不能仅通过在研究初始阶段完成同意书来验证,并且知情同意模板可以通过(甚至在研究过程之前和之后)促进研究人员与参与者之间的互动。社会功能包括告知参与者可能的社会风险,这些风险包括基因歧视、样本和数据共享,并突出伦理委员会的作用。尽管国际伦理协调以及随后同意书的协调对于维持数据密集型国际研究同意过程的质量和一致性可能是必要的,但也值得更多地关注研究参与者所在的当地价值观和不同环境,这些环境存在于医学基因组学研究中。ICF不仅仅是从研究参与者那里获得同意的工具,更是研究社区与公民社区之间通过伦理委员会、遗传咨询师以及公共生物样本库和数据库等中介机构进行社会沟通的一种手段。

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