Medical Ethics and Humanities Unit, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
Centre for Medical Ethics and Law, Faculty of Law and LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
BMC Public Health. 2024 Oct 26;24(1):2973. doi: 10.1186/s12889-024-20365-4.
Newborn screening programmes offer an opportunity to obtain dried blood spots (DBS) cards that contain a wealth of biological information that can be stored for long periods and have potential benefits for research and quality assurance. However, the storage and secondary uses of DBS cards pose numerous ethical, clinical, and social challenges. Empirical research exploring public attitudes is central to public policy planning as it can indicate whether or not there is broad public support, define public concerns, and ascertain the circumstances required to alleviate concerns and ensure support. This study aims to describe the clinical experience and attitudes towards newborn screening and investigate the perceptions and expectations of Hong Kong parents and healthcare providers regarding the retention of DBS cards and their usage for research.
We conducted semi-structured in-person interviews with 20 parents and healthcare providers in Hong Kong. Thematic analysis was conducted.
Awareness of the significant research value of secondary uses of dried blood spot cards is low. Parents and healthcare providers support the storage and secondary uses of DBS cards with some concerns, including privacy and confidentiality breaches, the risk of discrimination or stigmatisation based on genetic information, and their inability to oversee the use of their child's biospecimen. Parents, however, prioritise their child's health over privacy concerns and support identifiable storage using pseudonymity to gain more information about their children's health.
Child information takes precedence over potential concerns over privacy, underscoring the significance of engaging patients and the public in shaping public policy related to biobanking and healthcare research, in line with cultural and social values.
新生儿筛查计划提供了获取干血斑 (DBS) 卡的机会,这些卡片包含丰富的生物信息,可以长期保存,并且具有研究和质量保证的潜在益处。然而,DBS 卡的存储和二次使用带来了许多伦理、临床和社会挑战。探索公众态度的实证研究对于公共政策规划至关重要,因为它可以表明是否有广泛的公众支持,定义公众关注的问题,并确定减轻关注和确保支持所需的情况。本研究旨在描述对新生儿筛查的临床经验和态度,并调查香港父母和医疗保健提供者对保留 DBS 卡及其用于研究的看法和期望。
我们在香港对 20 名父母和医疗保健提供者进行了半结构化的面对面访谈。采用主题分析方法。
对 DBS 卡二次使用的重要研究价值的认识较低。父母和医疗保健提供者支持 DBS 卡的存储和二次使用,但存在一些担忧,包括隐私和机密性泄露、基于遗传信息的歧视或污名化风险,以及他们无法监督其子女生物样本的使用。然而,父母将孩子的健康置于隐私问题之上,并支持使用假名进行可识别的存储,以获取更多关于孩子健康的信息。
儿童信息优先于潜在的隐私问题,这突显了在制定与生物库和医疗保健研究相关的公共政策时,根据文化和社会价值观,让患者和公众参与其中的重要性。