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同意及其不满:英国生物银行的案例。

Consent and its discontents: the case of UK Biobank.

作者信息

Barn Gulzaar

机构信息

Department of Philosophy, University of Amsterdam, PO box 94201, 1090 GE, Amsterdam, The Netherlands.

出版信息

Med Health Care Philos. 2025 Sep;28(3):533-547. doi: 10.1007/s11019-025-10276-5. Epub 2025 Jul 17.

Abstract

UK Biobank is a major biomedical database and research resource, holding the genetic, health, and lifestyle information of half a million adult volunteers. Its datasets are accessible to approved researchers from academic, charity, government, and commercial organisations for health-related research in the public interest. Drawing upon a range of approved projects and the downstream applications of this research, I suggest that UK Biobank datasets have been processed towards ends that are inimical to its stated aims, breaking the terms of consent under which its participants entered the study. First, I provide an overview of the broad consent model employed by UK Biobank in recruiting participants and using their data. The consent documents and participant information leaflets used exhibit information failures in their framing of health-research in terms of disease and treatment, obscuring the full range of lawful uses of participants' data. Beyond this, certain approved uses of UK Biobank data, including studies by insurance companies and direct-to-consumer genetic testing companies, arguably fall outside UK Biobank's stated aims altogether. Moreover, UK Biobank has not adequately safeguarded against "dual use" issues. Tracking the trajectory of research outputs that used biobank data, I suggest that approved uses of biobank datasets have gone on to have objectionable further applications that are not in the public interest. Such applications include the development of polygenic scores that seek to predict "intelligence" for use in commercial embryo screening services. Such tools are rife with risk of harm and are being deployed without sufficient public deliberation or oversight.

摘要

英国生物银行是一个主要的生物医学数据库和研究资源库,保存着50万名成年志愿者的基因、健康和生活方式信息。其数据集可供来自学术、慈善、政府和商业组织的经批准的研究人员用于符合公共利益的健康相关研究。借鉴一系列经批准的项目以及该研究的下游应用,我认为英国生物银行的数据集在处理过程中所追求的目标与其宣称的目标背道而驰,违反了参与者参与该研究时所签署的同意条款。首先,我概述了英国生物银行在招募参与者和使用他们的数据时所采用的广泛同意模式。所使用的同意文件和参与者信息手册在将健康研究框定为疾病和治疗方面存在信息缺失,掩盖了参与者数据的全部合法用途。除此之外,英国生物银行数据的某些经批准的用途,包括保险公司和直接面向消费者的基因检测公司所进行的研究,可以说完全超出了英国生物银行宣称的目标范围。此外,英国生物银行没有充分防范“两用”问题。追踪使用生物银行数据的研究产出轨迹,我认为生物银行数据集的经批准用途进而产生了不符合公共利益的令人反感的进一步应用。此类应用包括开发用于商业胚胎筛查服务以预测“智力”的多基因分数。此类工具充满危害风险,且在没有充分的公众审议或监督的情况下就被投入使用。

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