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关于共享包括患者家庭成员在内的基因组数据的伦理问题。

Ethical concerns on sharing genomic data including patients' family members.

作者信息

Takashima Kyoko, Maru Yuichi, Mori Seiichi, Mano Hiroyuki, Noda Tetsuo, Muto Kaori

机构信息

Department of Public Policy, The Institute of Medical Science, The University of Tokyo, Shirokanedai 4-6-1, Minato-ku, Tokyo, 108-8639, Japan.

Medical Genomics Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

出版信息

BMC Med Ethics. 2018 Jun 18;19(1):61. doi: 10.1186/s12910-018-0310-5.

Abstract

BACKGROUND

Platforms for sharing genomic and phenotype data have been developed to promote genomic research, while maximizing the utility of existing datasets and minimizing the burden on participants. The value of genomic analysis of trios or family members has increased, especially in rare diseases and cancers. This article aims to argue the necessity of protection when sharing data from both patients and family members.

MAIN TEXT

Sharing patients' and family members' data collectively raises an ethical tension between the value of datasets and the rights of participants, and increases the risk of re-identification. However, current data-sharing policies have no specific safeguards or provisions for familial data sharing. A quantitative survey conducted on 10,881 general adults in Japan indicated that they expected stronger protection mechanisms when their family members' clinical and/or genomic data were shared together, as compared to when only their data were shared. A framework that respects decision-making and the right of withdrawal of participants, including family members, along with ensuring usefulness and security of data is needed. To enable this, we propose recommendations on ancillary safeguards for familial data sharing according to the stakeholders, namely, initial researchers, genomic researchers, data submitters, database operators, institutional review boards, and the public and participants.

CONCLUSIONS

Families have played significant roles in genetic research, and its value is re-illuminated in the era of genomic medicine. It is important to make progress in data sharing while simultaneously protecting the privacy and interests of patients and families, and return its benefits to them.

摘要

背景

为促进基因组研究,同时最大化现有数据集的效用并最小化参与者的负担,已开发出用于共享基因组和表型数据的平台。三人组或家庭成员的基因组分析价值有所增加,尤其是在罕见病和癌症领域。本文旨在论证在共享患者及其家庭成员的数据时进行保护的必要性。

正文

集体共享患者及其家庭成员的数据在数据集价值与参与者权利之间引发了伦理紧张关系,并增加了重新识别的风险。然而,当前的数据共享政策没有针对家族数据共享的具体保障措施或规定。对日本10881名普通成年人进行的一项定量调查表明,与仅共享他们自己的数据相比,当他们家庭成员的临床和/或基因组数据被一起共享时,他们期望有更强的保护机制。需要一个尊重包括家庭成员在内的参与者的决策和退出权,同时确保数据有用性和安全性的框架。为实现这一点,我们根据利益相关者,即初始研究者、基因组研究者、数据提交者、数据库运营者、机构审查委员会以及公众和参与者,就家族数据共享的辅助保障措施提出建议。

结论

家庭在基因研究中发挥了重要作用,其价值在基因组医学时代得到了重新彰显。在推进数据共享的同时保护患者和家庭的隐私与利益,并将其益处回馈给他们,这一点很重要。

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