The American Journal of Bioethics · 2006 · 287 citations · 23 references
Public HealthGeneticsMedical EthicsMedical GeneticsResearch EthicsClinical Trial EthicsData ConfidentialityGenetic EthicsGenetic Research EthicsInstitutional Review BoardsParticipant ConfidentialityAccess To Genetic Test ResultsAnalytic Validity AssessmentClinical Utility AnalysisClinical Utility AssessmentGenetic ConfidentialityGenetic Information DisclosureGenetic Test Result DisclosurePersonal Meaning
Investigators and institutional review boards should integrate plans about the appropriate disclosure of individual genetic results when designing research studies. The ethical principles of beneficence, respect, reciprocity, and justice provide justification for routinely offering certain results to research participants. We propose a result-evaluation approach that assesses the expected information and the context of the study in order to decide whether results should be offered. According to this approach, the analytic validity and the clinical utility of a specific result determine whether it should be offered routinely. Different results may therefore require different decisions even within the same study. We argue that the threshold of clinical utility for disclosing a result in a research study should be lower than the threshold used for clinical use of the same result. The personal meaning of a result provides additional criteria for evaluation. Finally, the context of the study allows for a more nuanced analysis by addressing the investigators' capabilities for appropriate disclosure, participants' alternative access to the result, and their relationship with the investigators. This analysis shows that the same result may require different decisions in different contexts.
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