Blasimme Alessandro, Brall Caroline, Vayena Effy
Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland.
Ethical, Legal, and Social Implications (ELSI) Advisory Group, Swiss Personalized Health Network (SPHN), Bern, Switzerland.
Front Genet. 2020 Dec 11;11:585820. doi: 10.3389/fgene.2020.585820. eCollection 2020.
In 2017 the Swiss federal government established the Swiss Personalized Health Network (SPHN), a nationally coordinated data infrastructure for genetic research. The SPHN advisory group on Ethical, Legal, and Social Implications (ELSI) was tasked with the creation of a recommendation to ensure ethically responsible reporting of genetic research findings to research participants in SPHN-funded studies. Following consultations with expert stakeholders, including geneticists, pediatricians, sociologists, university hospitals directors, patient representatives, consumer protection associations, and insurers, the ELSI advisory group issued its recommendation on "Reporting actionable genetic findings to research participants" in May 2020. In this paper we outline the development of this recommendation and the provisions it contains. In particular, we discuss some of its key features, namely: (1) that participation in SPHN-funded studies as a research subject is conditional to accepting that medically relevant genetic research findings will be reported; (2) that a Multidisciplinary Expert Panel (MEP) should be created to support researchers' decision-making processes about reporting individual genetic research findings; (3) that such Multidisciplinary Expert Panel will make case-by-case decisions about whether to allow reporting of genetic findings, instead of relying on a pre-defined list of medically relevant variants; (4) that research participants shall be informed of the need to disclose genetic mutations when applying for private insurance, which may influence individual decisions about participation in research. By providing an account of the procedural background and considerations leading to the SPHN recommendation on "Reporting actionable genetic findings to research participants," we seek to promote a better understanding of the proposed guidance, as well as to contribute to the global dialog on the reporting of genetic research findings.
2017年,瑞士联邦政府设立了瑞士个性化健康网络(SPHN),这是一个全国范围内协调的基因研究数据基础设施。SPHN伦理、法律和社会影响(ELSI)咨询小组的任务是制定一项建议,以确保在SPHN资助的研究中,以符合伦理的方式向研究参与者报告基因研究结果。在与包括遗传学家、儿科医生、社会学家、大学医院院长、患者代表、消费者保护协会和保险公司在内的专家利益相关者进行磋商后,ELSI咨询小组于2020年5月发布了关于“向研究参与者报告可操作的基因研究结果”的建议。在本文中,我们概述了该建议的制定过程及其包含的条款。特别是,我们讨论了它的一些关键特征,即:(1)作为研究对象参与SPHN资助的研究的条件是接受将报告与医学相关的基因研究结果;(2)应设立一个多学科专家小组(MEP),以支持研究人员关于报告个体基因研究结果的决策过程;(3)这样的多学科专家小组将逐案决定是否允许报告基因研究结果,而不是依赖于预先定义的与医学相关的变异列表;(4)研究参与者在申请私人保险时应被告知披露基因突变的必要性,这可能会影响个人参与研究的决定。通过介绍导致SPHN关于“向研究参与者报告可操作的基因研究结果”建议的程序背景和考虑因素,我们旨在促进对拟议指南的更好理解,并为关于基因研究结果报告的全球对话做出贡献。