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儿科精准医学时代的知情同意伦理框架。

Ethical frameworks of informed consent in the age of pediatric precision medicine.

作者信息

Chen David

机构信息

Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA.

出版信息

Camb Prism Precis Med. 2024 May 6;2:e6. doi: 10.1017/pcm.2024.3. eCollection 2024.

DOI:10.1017/pcm.2024.3
PMID:38774589
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11106543/
Abstract

Precision medicine is an emergent medical paradigm that uses information technology to inform the use of targeted therapies and treatments. One of the first steps of precision medicine involves acquiring the patient's informed consent to protect their rights to autonomous medical decision-making. In pediatrics, there exists mixed recommendations and guidelines of consent-related practices designed to safeguard pediatric patient interests while protecting their autonomy. Here, we provide a high-level, clinical primer of (1) ethical informed consent frameworks widely used in clinical practice and (2) promising modern adaptations to improve informed consent practices in pediatric precision medicine. Given the rapid scientific advances and adoption of precision medicine, we highlight the dual need to both consider the clinical implementation of consent in pediatric precision medicine workflows as well as build rapport with pediatric patients and their substitute decision-makers working alongside interdisciplinary health teams.

摘要

精准医学是一种新兴的医学模式,它利用信息技术来指导靶向治疗和疗法的使用。精准医学的首要步骤之一是获得患者的知情同意,以保护他们自主进行医疗决策的权利。在儿科领域,存在着旨在保护儿科患者利益同时维护其自主权的关于同意相关做法的混合建议和指南。在此,我们提供一份高层次的临床入门指南,内容包括:(1)临床实践中广泛使用的伦理知情同意框架,以及(2)有望改进儿科精准医学知情同意实践的现代适应性方法。鉴于精准医学的科学进展迅速且应用广泛,我们强调了双重需求,既要考虑在儿科精准医学工作流程中临床实施同意的问题,也要与儿科患者及其替代决策者建立融洽关系,他们与跨学科医疗团队协同工作。

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本文引用的文献

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Comparative study on informed consent regulation in health care among Italy, France, United Kingdom, Nordic Countries, Germany, and Spain.意大利、法国、英国、北欧国家、德国和西班牙的医疗保健知情同意法规比较研究。
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Patients' perspectives related to ethical issues and risks in precision medicine: a systematic review.患者对精准医学中伦理问题和风险的看法:一项系统综述
Front Med (Lausanne). 2023 Jun 15;10:1215663. doi: 10.3389/fmed.2023.1215663. eCollection 2023.
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The need to develop digital health competencies for medical learners.医学学习者培养数字健康能力的必要性。
Med Teach. 2023 Jul;45(7):790-791. doi: 10.1080/0142159X.2023.2178886. Epub 2023 Feb 14.
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Open Data: Implications on Privacy in Healthcare Research.开放数据:对医疗保健研究中隐私的影响。
Blockchain Healthc Today. 2020 Sep 18;3. doi: 10.30953/bhty.v3.144. eCollection 2020.
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What information and the extent of information to be provided in an informed assent/consent form of pediatric drug trials.儿科药物临床试验知情同意书/同意书中应提供哪些信息及提供信息的范围。
BMC Med Ethics. 2022 Nov 16;23(1):113. doi: 10.1186/s12910-022-00856-y.
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Improving comprehension, recall and attention using multimedia-informed assent among pediatric oncology patients: A comparative randomized controlled trial.使用多媒体知情同意提高儿科肿瘤患者的理解、记忆和注意力:一项比较随机对照试验。
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To disclose, or not to disclose? Perspectives of clinical genomics professionals toward returning incidental findings from genomic research.是否披露?临床基因组学专业人员对从基因组研究中返还偶然发现的观点。
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