Department of Bioethics and Humanities and.
Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Clin J Am Soc Nephrol. 2020 Aug 7;15(8):1181-1189. doi: 10.2215/CJN.09670819. Epub 2020 Feb 10.
Whether individual results of genetic research studies ought to be disclosed to study participants has been debated in recent decades. Previously, the prevailing expert view discouraged the return of individual research results to participants because of the potential lack of analytic validity, questionable clinical validity and medical actionability, and questions about whether it is the role of research to provide participants with their data. With additional knowledge of participant perspectives and shifting views about the benefits of research and respect for participants, current expert consensus is moving toward support of returning such results. Significant ethical controversies remain, and there are many practical questions left to address, including appropriate procedures for returning results and the potential burden to clinicians when patients seek guidance about the clinical implications of research results. In this review, we describe current views regarding the return of genetic research results, including controversies and practical challenges, and consider the application of these issues to research on apolipoprotein L1 (), a gene recently associated with health disparities in kidney disease. Although this case is unique, it illustrates the complexities involved in returning results and highlights remaining questions.
近几十年来,是否应向研究参与者披露遗传研究的个体结果一直存在争议。此前,由于潜在的分析有效性缺乏、临床有效性和医学可操作性值得怀疑,以及研究是否应向参与者提供其数据的角色问题,专家普遍认为不应向参与者返还个体研究结果。随着对参与者观点的进一步了解,以及对研究益处和对参与者尊重的看法发生变化,目前专家共识正在转向支持返还此类结果。仍存在重大伦理争议,还有许多实际问题有待解决,包括返还结果的适当程序,以及当患者寻求有关研究结果对临床影响的指导时,临床医生可能面临的潜在负担。在这篇综述中,我们描述了目前关于遗传研究结果返还的观点,包括争议和实际挑战,并考虑将这些问题应用于载脂蛋白 L1() 研究,该基因最近与肾脏疾病中的健康差异相关。尽管这种情况是独特的,但它说明了返还结果所涉及的复杂性,并突出了仍然存在的问题。