Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584, CG, Utrecht, the Netherlands.
Statistics and Data Insights, Bayer AG, Berlin, Germany.
BMC Med Ethics. 2019 Mar 28;20(1):21. doi: 10.1186/s12910-019-0359-9.
Large-scale linkage of international clinical datasets could lead to unique insights into disease aetiology and facilitate treatment evaluation and drug development. Hereto, multi-stakeholder consortia are currently designing several disease-specific translational research platforms to enable international health data sharing. Despite the recent adoption of the EU General Data Protection Regulation (GDPR), the procedures for how to govern responsible data sharing in such projects are not at all spelled out yet. In search of a first, basic outline of an ethical governance framework, we set out to explore relevant ethical principles and norms.
We performed a systematic review of literature and ethical guidelines for principles and norms pertaining to data sharing for international health research.
We observed an abundance of principles and norms with considerable convergence at the aggregate level of four overarching themes: societal benefits and value; distribution of risks, benefits and burdens; respect for individuals and groups; and public trust and engagement. However, at the level of principles and norms we identified substantial variation in the phrasing and level of detail, the number and content of norms considered necessary to protect a principle, and the contextual approaches in which principles and norms are used.
While providing some helpful leads for further work on a coherent governance framework for data sharing, the current collection of principles and norms prompts important questions about how to streamline terminology regarding de-identification and how to harmonise the identified principles and norms into a coherent governance framework that promotes data sharing while securing public trust.
大规模链接国际临床数据集可能会对疾病病因产生独特的见解,并有助于治疗评估和药物开发。为此,多利益相关者联盟目前正在设计几个特定于疾病的转化研究平台,以实现国际卫生数据共享。尽管最近通过了欧盟《通用数据保护条例》(GDPR),但这些项目中如何管理负责任的数据共享的程序还没有完全制定出来。为了寻找一个基本的、初步的伦理治理框架,我们着手探索相关的伦理原则和规范。
我们对文献和伦理准则进行了系统回顾,以了解与国际卫生研究数据共享相关的原则和规范。
我们观察到了大量的原则和规范,这些原则和规范在四个总体主题的层面上具有相当大的一致性:社会利益和价值;风险、利益和负担的分配;尊重个人和群体;以及公众信任和参与。然而,在原则和规范的层面上,我们发现措辞和详细程度、保护原则所需的规范数量和内容以及原则和规范的使用背景方面存在很大差异。
虽然为数据共享的一致治理框架的进一步工作提供了一些有帮助的线索,但目前收集的原则和规范提出了一些重要问题,即如何简化去识别的术语,以及如何将确定的原则和规范协调一致地纳入一个治理框架,在确保公众信任的同时促进数据共享。