Abstract
Recent advances in high-throughput genomic technologies are showing concrete results in the form of an increasing number of genome-wide association studies and in the publication of comprehensive individual genome–phenome data sets. As a consequence of this flood of information the established concepts of research ethics are stretched to their limits, and issues of privacy, confidentiality and consent for research are being re-examined. Here, we show the feasibility of the co-development of scientific innovation and ethics, using the open-consent framework that was implemented in the Personal Genome Project as an example.
Access options
Subscribe to Journal
Get full journal access for 1 year
70,80 €
only 5,90 € per issue
All prices include VAT for France.
Rent or Buy article
Get time limited or full article access on ReadCube.
from$8.99
All prices are NET prices.
References
- 1.
Anonymous. Defining a new bioethic. Nature Genet. 28, 297–298 (2001).
- 2.
Feuk, L., Carson A. R. & Scherer S. W. Structural variation in the human genome. Nature Rev. Genet. 7, 85–97 (2006).
- 3.
The ENCODE Project Consortium. Identification and analysis of functional elements in 1% of the human genome by the ENCODE pilot project. Nature 447, 799–816 (2007).
- 4.
Shendure, J. et al. Accurate multiplex polony sequencing of an evolved bacterial genome. Science 309, 1728–1732 (2005).
- 5.
Shaffer, C. Next-generation sequencing outpaces expectations. Nature Biotechnol. 25, 149 (2007).
- 6.
Daar, A. S., Scherer, S. W. & Hegele, R. A. Implications of copy-number variation in the human genome: a time for questions. Nature Rev. Genet. 7, 414 (2006).
- 7.
Lowrance, W. W. & Collins, F. S. Identifiability in genomic research. Science 317, 600–602 (2007).
- 8.
McGuire, A. L. & Gibbs, R. A. No longer de-identified. Science 312, 370–371 (2006).
- 9.
Knoppers, B. M. & Chadwick, R. Human genetic research: emerging trends in ethics. Nature Rev. Genet. 6, 75–79 (2005).
- 10.
Allen, A. L. in Genetic Secrets: Protecting Privacy and Confidentiality in the Genetics Era (ed. Rothstein, M. A.) 31–59 (Yale University Press, New Haven, 1997).
- 11.
Shendure, J., Mitra, R. D., Varma, C. & Church, G. M. Advanced sequencing technologies: methods and goals. Nature Rev. Genet. 5, 335–344 (2004).
- 12.
Check, E. Faster still and faster. Nature 448, 10–11 (2007).
- 13.
Porreca G. J. et al. Multiplex amplification of large sets of human exons. Nature Methods 4, 931–936 (2007).
- 14.
Annas G. J., Glantz L. H., Roche P. A. Drafting the genetic privacy act: science, policy and practical considerations. J. Law Med. Ethics 23, 360–366 (1995).
- 15.
Murray T. H. in Genetic Secrets: Protecting Privacy and Confidentiality in the Genetics Era (ed. Rothstein, M. A.) 60–73 (Yale University Press, New Haven, 1997)
- 16.
Anonymous. Microfiche system saves time, cuts storage by 98 per cent. Mod. Hosp. 107, 66–67 (1966).
- 17.
Curran, W. J., Hyg., S. M., Stearns, B. & Kaplan, H. Privacy, confidentiality and other legal considerations in the establishment of a centralized health-data system. N. Engl. J. Med. 281, 241–248 (1968).
- 18.
Anonymous. Sickle cell – point, counterpoint. N. Engl. J. Med. 289, 323 (1973).
- 19.
Vedder, A. KDD: The challenge to individualism. Ethics Inf. Technol. 1, 275–281 (1999).
- 20.
National Human Genome Research Institute. Genetic Information Nondiscrimination Act of 2007. National Human Genome Research Institute [online], (2007).
- 21.
Malin, B. A. & Sweeney L. How (not) to protect genomic data privacy in a distributed network: using trail re-identification to evaluate and design anonymity protection systems. J. Biomed. Inform. 37, 179–192 (2004).
- 22.
Lin, Z., Owen, A. B. & Altman, R. B. genomic research and human subject privacy. Science 305,183 (2004).
- 23.
Sweeney, L. Achieving k-anonymity privacy protection using generalization and suppression. Int. J. Uncertain. Fuzziness Knowl.-Based Syst. 10, 571–588 (2002).
- 24.
Agrawal, R. & Johnson, C. Securing electronic health records without impeding the flow of information. Int. J. Med. Inform. 76, 471–479 (2007).
- 25.
Machanavajjhala, A., Kifer, D., Gehrke, J. & Venkitasubramaniam, M. L-diversity: privacy beyond k-anonymity. ACM Trans. Knowl. Discov. Data 1, Issue 1, Article 3 [online], (2007).
- 26.
Supreme Court of California, Tarasoff v. Regents of the University of California (17 Cal.3d 425; 551 P.2d 334; 131 Cal. Rptr. 14). Public Health Law [online], (1976).
- 27.
Kipnis, K. A defense of unqualified medical confidentiality. Am. J. Bioeth. 6, 7–18 (2006).
- 28.
Beauchamp, T. L. & Childress, J. F. Principles of Biomedical Ethics 5th edn 303–312 (Oxford University Press, New York, 2001).
- 29.
Hodge, J. G. The legal and ethical fiction of 'pure' confidentiality. Am. J. Bioeth. 6, 21–22 (2006).
- 30.
EuroCOCAP Project. European Standards on Confidentiality and Privacy in Health Care. EuroSOCAP [online], (2006).
- 31.
The World Medical Association. World Medical Association International Code of Ethics (London, England, 1949). Adopted by the General Assembly (Pilanesberg, South Africa, 2006) [online], (2006).
- 32.
UK Biobank. UK Biobank Information Leaflet (vs. 27.02.2007) UK Biobank [online], (2007).
- 33.
Carman, D. & Britten, N. Confidentiality of medical records: the patient's perspective. Br. J. Gen. Pract. 45, 485–488 (1995).
- 34.
Stone, M. A., Redsell, S. A., Ling, J. T. & Hay, A. D. Sharing patient data: competing demands of privacy, trust and research in primary care. Br. J. Gen. Pract. 55, 783–789 (2005).
- 35.
Rothstein, M. A. in Genetic Secrets: Protecting Privacy and Confidentiality in the Genomics Era. (ed. Rothstein, M. A.) 451–495 (Yale University Press, New Haven, 1997)
- 36.
Hansson, M. G., Dillner, J., Bartram, C. R., Carlson, J. A. & Helgesson G. Should donors be allowed to give broad consent to future biobank research? Lancet Oncol. 7, 266–269 (2006).
- 37.
Árnason, V. Coding and consent moral challenges of the database project in Iceland. Bioethics 18, 27–49 (2004).
- 38.
Dal-Ré, R., Avendaño, C., Gil-Aguado, A., Gracia, D. & Caplan, A. L. When should re-consent of subjects participating in a clinical trial be requested? A case-oriented algorithm to assist in the decision-making process. Clin. Pharmacol. Ther. 19 Sept 2007 (doi:10.1038/sj.clpt.6100357).
- 39.
Kaiser Permanente News Center. Kaiser Permanente Unveils Groundbreaking Genetic Research Program. Kaiser Permanente [online], (2007).
- 40.
Collman, J. & Cooper, T. Breaching the security of the Kaiser Permanente internet patient portal: the organizational foundations of information security. J. Am. Med. Inform. Assoc. 14, 239–243 (2007).
- 41.
International HapMap Project. CEPH reconsent form. [online]
- 42.
Willison, D. J., Keshavjee, K., Nair, K., Goldsmith, C. & Holbrook, A. M. Patients' consent preferences for research uses of information in electronic medical records: interview and survey data. BMJ 326, 373–377 (2003).
- 43.
Baker, R., Shiels, C., Stevenson, K., Fraser, R. & Stone, M. What proportion of patients refuse consent to data collection from their records for research purposes? Br. J. Gen. Pract. 50, 655–656 (2000).
- 44.
Robling, M. R., Hood, K., Houston, H., Fay, J. & Evans, H. M. Public attitudes towards the use of primary care patient record data in medical research without consent: a qualitative study. J. Med. Ethics 30, 104–109 (2004).
- 45.
Freimer, N. B. & Sabatti, C. Variants in common disease. Nature 445, 828–830 (2007).
- 46.
Christensen, K. & Murray, J. C. What genome-wide association studies can do for medicine. N. Engl. J. Med. 356, 1094–1097 (2007).
- 47.
Hood, L., Heath, J. R., Phelps, M. E. & Lin, B. Systems biology and new technologies enable predictive and preventative medicine. Science 306, 640–643 (2004).
- 48.
Xiong, M., Feghali-Bostwick C. A., Arnett, F. C. & Zhou, X. A systems biology approach to genetic studies of complex diseases. FEBS Lett. 579, 5325–5332 (2005).
- 49.
The American Society of Human Genetics. ASHG Response to NIH on Genome-Wide Association Studies. ASHG Policy Statement Archives [online], (2006).
- 50.
Greely H. T. The uneasy ethical and legal underpinnings of large-scale genomic biobanks. Annu. Rev. Genomics Hum. Genet. 8, 343–364 (2007).
- 51.
Faden, R. R. & Beauchamp, T. L. A History and Theory of Informed Consent. 235–241 (Oxford University Press, New York, 1986).
- 52.
O'Neill O. Autonomy and Trust in Bioethics. (Cambridge University Press, Cambridge, UK, 2002).
- 53.
Church, G., Gottlieb, D., Mitra, R. & Sherley, J. Molecular and Genomic Imaging Center. Specialized Center of Excellence in Genomic Science (CEGS) P50 Proposal Harvard Molecular Technology Group & Lipper Center for Computational Genetics [online], (2003).
- 54.
Butler, D. Ghost Buster. Nature 445, 811 (2007).
- 55.
Kohane, I. S. & Altman, R. B. Health-information altruists — a potentially critical resource. N. Engl. J. Med. 353, 2074–2077 (2005).
- 56.
The GAIN Collaborative Research Group. New models of collaboration in genome-wide association studies: the Genetic Association Information Network. Nature Genet. 39, 1045–1051 (2007).
- 57.
Bovenberg, J. A. Property Rights in Blood, Genes and Data – Naturally Yours? (Nijhoff Law Specials) (Brill Academic, Leiden, 2006.)
- 58.
The subcommittee on privacy and confidentiality. Transcript of the January 28, 1998 Roundtable Discusssion: Identifiability of Data. National Committee on Vital and Health Statistics [online], (1998).
- 59.
Motluk, A. Anonymous sperm donor traced on internet. New Scientist News Service [online], (2005).
- 60.
The Personal Genome Project, Are guarantees of genome anonymity realistic? Personal Genome Project [online]
- 61.
Markoff, J. Researchers Find Way to Steal Encrypted Data. The New York Times [online], (2008).
Acknowledgements
The authors wish to thank three anonymous reviewers for their comments. J.L. thanks M. Cornel and T. Pieters of VU university medical center, Amsterdam, for discussions. R.C. gratefully acknowledges the support of the Economic and Social Research Council (ESRC). The work was part of the programme of the ESRC Centre for Economic and Social Aspects of Genomics.
Author information
Affiliations
Jeantine E. Lunshof is at the Department of Molecular Cell Physiology, c/o room M236, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
- Jeantine E. Lunshof
Ruth Chadwick is at Cardiff Law School, Cardiff University, Law Building, Museum Avenue, Cardiff, CF10 3AX, Wales, UK.
- Ruth Chadwick
Daniel B. Vorhaus is at Robinson, Bradshaw & Hinson P.A., 101 North Tryon Street, Suite 1900, Charlotte, North Carolina 28246-1900, USA.
- Daniel B. Vorhaus
George M. Church is at the Department of Genetics, Harvard Medical School, New Research Building, Room 238, 77 Avenue Louis Pasteur, Boston, Massachusetts 02115, USA.
- George M. Church
Authors
Search for Jeantine E. Lunshof in:
Search for Ruth Chadwick in:
Search for Daniel B. Vorhaus in:
Search for George M. Church in:
Competing interests
G. M. C. is currently donating profits from companies in the personal genomics space to the Personal Genome Project at the recommendation/approval of the Harvard Conflict of Interests committee.
Corresponding author
Correspondence to Jeantine E. Lunshof.
Glossary
- Genetic exceptionalism
The view that being genetic makes information, traits and properties qualitatively different and deserving of exceptional consideration.
- Non-distributive generalization
Generalizations that entail information about individuals as belonging to a particular group with specific properties. Any particular individual, however, may or may not have these properties.
- Dictionary attack
A technique for breaking a security system by trying to determine a decryption key or a password by searching a large number of possibilities.
- L-diversity
A new method for the protection of privacy against adversaries with background knowledge, which requires that the distribution of a sensitive attribute in each equivalence class has the least well-represented values.
- Open-source technology
A technology that is publicly available, freely distributed by the developer community and that is for the user community to modify and improve.
Rights and permissions
To obtain permission to re-use content from this article visit RightsLink.
About this article
Further reading
-
1.
Genomics, Big Data, and Broad Consent: a New Ethics Frontier for Prevention Science
Prevention Science (2018)
-
2.
Science and Engineering Ethics (2018)
-
3.
DNA.Land is a framework to collect genomes and phenomes in the era of abundant genetic information
Nature Genetics (2018)
-
4.
Biomedical Big Data: New Models of Control Over Access, Use and Governance
Journal of Bioethical Inquiry (2017)
-
5.
BMC Medical Ethics (2017)