There Will Be Sharing: Population Biobanks, the Duty to Inform and the Limitations of the Individualistic Conception of Autonomy
Notice bibliographique
Résumé
'Data! Data! Data!' he cried impatiently. 'I can't make bricks without clay.' --Sherlock Holmes (in Arthur Conan Doyle, The Adventure of the Copper Beeches) INTRODUCTION The principle of autonomy has been the cornerstone of the physician's duty to inform ever since paternalistic practices receded in the second half of the 20th century. (1) In the past, physicians were authorized to withhold relevant information in an effort to protect their patients from harm. (2) With the advent of comparative judgment, however, physicians were encouraged to consider whether withholding information [would] result in less harm on balance than divulging it. (3) Eventually, became a central feature of the principle of autonomy. Practically speaking, the principle of autonomy in the medical field translated to the right (of a patient) to make an informed decision free from unjustified interference by others. (4) According to one conception, to respect autonomy is: [...] to give weight to autonomous persons' considered opinions and choices while refraining from obstructing their actions unless they are clearly detrimental to others. To show lack of respect for an autonomous agent is to repudiate that person's considered judgments, to deny an individual the freedom to act on those considered judgments, or to withhold information necessary to make a considered judgment, when there are no compelling reasons to do so. (5) Based on this principle, the less an individual is expected to benefit therapeutically from a procedure, the higher the duty to inform becomes. This is true for cosmetic surgery, organ donation and non-therapeutic research. (6) In research, Canadian courts have maintained that participants are entitled to a and frank disclosure (7) and that researchers' duties in that regard are as great, if not greater, than the duties owed by physicians in the clinical setting. (8) The increasingly longitudinal and international nature of research is challenging the feasibility of maintaining such an expansive duty to inform. (9) As researchers rely less on active human participation, and more on cutting-edge technologies that generate vast amounts of data, (10) the parameters of the traditional duty to inform look increasingly porous. This is particularly true for population biobanks, which aim to study data and samples collected on a large population scale and over a long period of time. (11) In these large-scale projects, participants are informed that their data and samples will be used to establish biobanks as resources for future research in health and genomics. (12) It is very difficult to provide full in the context of a biorepository for future, unspecified research by as-yet unnamed researchers. Much ink has been spilled in the last decade on the type of consent required for these population projects. Indeed, many have debated whether or not broad consent--a model increasingly used by population studies satisfies the legal requirements of informed consent. (13) Others have focused on operational matters, examining the governance and practicability of both specific and broad consent approaches to population biobanks. (14) In contrast, this article delves deeper into the reasons why many population biobanks have resorted to broad consent and why the current legal duty to inform requirements might be inimical to such projects (in particular) and research (in general). As will be detailed later in this text, population biobanks are limited in terms of what information they can provide to research participants during the consent process. On the one hand, they are increasingly encouraged to share their findings by providing access to their repositories, but on the other hand, they are unable to provide participants with full about the future use of their data and samples at the time of recruitment. …
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».