期刊论文详细信息
BMC Medical Ethics
The best interests of the child and the return of results in genetic research: international comparative perspectives
Bartha Maria Knoppers1  David Parry1  Ma’n H Zawati1 
[1] Centre of Genomics and Policy, McGill University, 740 Dr. Penfield Avenue, Suite 5200, Montreal, Quebec H3A 0G1, Canada
关键词: Children’s rights;    Convention on the Rights of the Child;    Genomic research;    Paediatrics;    Best interests of the child;    Return of research results;   
Others  :  1090038
DOI  :  10.1186/1472-6939-15-72
 received in 2014-02-10, accepted in 2014-09-29,  发布年份 2014
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【 摘 要 】

Background

Paediatric genomic research raises particularly challenging questions on whether and under what circumstances to return research results. In the paediatric context, decision-making is guided by the best interests of the child framework, as enshrined in the 1989 international Convention on the Rights of the Child. According to this Convention, rights and responsibilities are shared between children, parents, researchers, and the state. These "relational" obligations are further complicated in the context of genetic research.

Discussion

A comparative review of international, regional and national documents on the return of research results reveals that there is a dearth of normative documents in the paediatric context. The best interests of the child framework is increasingly complicated by a growing appreciation of pediatric autonomy and the development thereof; parental rights (particularly when parents are affected by the genomic information of their children); and the right not to know.

Summary

This comparative analysis reveals that policy-makers and legislators have responded to the above challenges in different ways. Nevertheless, in Europe as well as in Canada, there is an emerging trend towards making the return of certain results mandatory in the paediatric context, should this course of action prove to be in the best interests of the child.

【 授权许可】

   
2014 Zawati et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Wolf SM: Return of individual research results and incidental findings: facing the challenges of translational science. Annu Rev Genomics Hum Gene 2013, 14:557-577.
  • [2]Knoppers BM, Joly Y, Simard J, Durocher F: The emergence of an ethical duty to disclose genetic research results: international perspectives. EJHG 2006, 14:1170-1180.
  • [3]Knoppers BM, Rioux A, Zawati MH: Pediatric research "personalized"? International perspectives on the return of results. Pers Med 2013, 10:89-95.
  • [4]Centre of Genomics and Policy, the Maternal Infant Child and Youth Research Network: Best Practices for Health Research Involving Children and Adolescents. [ http://www.genomicsandpolicy.org/best-practices.html webcite]
  • [5]UN General Assembly: Convention on the Rights of the Child. New York: United Nations; 1989.
  • [6]Zawati MH, Knoppers BM: International normative perspectives on the return of individual research results and incidental findings in genomic biobanks. Genet Med 2012, 14:484.
  • [7]UNESCO: Universal Declaration on the Human Genome and Human Rights. Paris: UNESCO; 1997.
  • [8]Bryant D: It’s my body, isn’t it? Children, medical treatment and human rights. Monash LR 2009, 35:193.
  • [9]Reynaert D, Bouverne-de-Bie M, Vandevelde S: A review of children's rights literature since the adoption of the united nations convention on the rights of the child. Childhood 2009, 16:518.
  • [10]Cherry MJ: Parental authority and pediatric bioethical decision making. J Med Philos 2010, 35:553.
  • [11]UN Committee on the Rights of the Child: General Comment no. 12 - The Right of the Child to be Heard. Geneva: Geneva; 2009.
  • [12]Hammarberg T: The Principle of the Best Interests of the Child: What It Means and What it Demands from Adults. In Proceedings of the Building a Europe for and with children–Towards a Strategy for 2009-2011 conference: 30 May 2008. Warsaw;
  • [13]World Medical Association: Declaration of Ottawa on Child Health. Ottawa; 1998.
  • [14]Kopelman LM: Using the best interests standard to decide whether to test children for untreatable, late-onset genetic diseases. J Med Philos 2007, 32:374.
  • [15]Borry P, Evers-Kiebooms G, Cornel MC, Clarke A, Dierickx K, Public and Professional Policy Committee (PPPC) of the European Society of Human Genetics (ESHG): Genetic testing in asymptomatic minors: background considerations towards ESHG recommendations. EJHG 2009, 17:711-719.
  • [16]UN Committee on the Rights of the Child: General Comment no. 3 - HIV/AIDS and the Rights of the Child. 32nd session; 13-31 January 2003. Geneva;
  • [17]Organisation for Economic Co-Operation and Development: OECD Guidelines for Human Biobanks and Genetic Research Databases. Paris; 2009.
  • [18]Quennerstedt A: Balancing the rights of the child and the rights of parents in the convention on the rights of the child. J Hum Right 2009, 8:162.
  • [19]Lucker-Babel MF: The right of the child to express views and to be heard: an attempt to interpret article 12 of the UN convention on the rights of the child. Int’l J Child Rts 1995, 3:391.
  • [20]UN Committee on the Rights of the Child: General Comment no. 4 - Adolescent health and development in the context of the Convention on the Rights of the Child. 33rd session; 19 May-6 June 2003. Geneva;
  • [21]Mabon v Mabon EWCA Civ 2005, 634.
  • [22]UN Human Rights Council: Resolution 19/37 Rights of the Child. 19th session; 23 March 2012. New York;
  • [23]Council of Europe: European Convention for the Protection of Human Rights and Fundamental Freedoms, as amended by Protocols Nos. 11 and 14. Strasbourg; 1950.
  • [24]Daly A: The right of children to be heard in civil proceedings and the emerging law of the European Court of Human Rights. Int’l J Hum Rts 2011, 15:441.
  • [25]Neulinger and Shuruk v. Switzerland, App no 41615-07. Grand Chamber; 2010.
  • [26]Ross LF, Saal HM, David KL, Anderson RR, American Academy of Pediatrics, American College of Medical Genetics and Genomics: Technical report: ethical and policy issues in genetic testing and screening of children. Genet Med 2013, 15(3):234-245.
  • [27]Council of Europe: Convention for the Protection of Human Rights and Dignity of the Human Being With Regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. Oviedo; 1997.
  • [28]Council of Europe: Explanatory Report to the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. 1996. [ http://conventions.coe.int/Treaty/EN/Reports/Html/164.htm webcite]
  • [29]Council of Europe: Additional Protocol to the Convention on Human Rights and Biomedicine, concerning Biomedical Research. Strasbourg; 2005.
  • [30]Nielsen v. Denmark, App no 10929/84. 1988. A/144
  • [31]R (on the Application of Axon) v Secretary of State for Health. 2006. EWHC 37 (Admin)
  • [32]European Society of Human Genetics: Genetic testing in asymptomatic minors: recommendations of the ESHG. EJHG 2009, 17:720.
  • [33]Hens K, Van El CE, Borry P, Cambon-Thomsen A, Cornel MC, Forzano F, Lucassen A, Patch C, Tranebjaerg L, Vermeulen E, Salvaterra E, Tibben A, Dierickx K, PPPC of the European Society of Human Genetics: Developing a policy for paediatric biobanks: principles for good practice. EJHG 2013, 21:2.
  • [34]Van El CG, Cornel MC, Borry P, Hastings RJ, Fellmann F, Hodgson SV, Howard HC, Cambon-Thomsen A, Knoppers BM, Meijers-Heijboer H, Scheffer H, Tranebjaerg L, Dondorp W, De Wert GMWR: Whole genome sequencing in health care: recommendations of the European Society of human genetics. EJHG 2013, 21:580-584.
  • [35]Anastasova V, Mahalatchimy A, Rial-Sebbag E, Antó Boqué JM, Keil T, Sunyer J, Bousquet J, Cambon-Thomsen A: Communication of results and disclosure of incidental findings in longitudinal paediatric research. Pediatr Allergy Immunol 2013, 24:389.
  • [36]Code Civil. France; 2013. [ http://www.legifrance.gouv.fr/affichCode.do;jsessionid=142C3CE696165A43585C960A24C2D70D.tpdjo14v_3?idSectionTA=LEGISCTA000006089696&cidTexte=LEGITEXT000006070721&dateTexte=20141001 webcite]
  • [37]Code de la santé publique. France; 2013. [ http://legifrance.gouv.fr/affichCode.do?cidTexte=LEGITEXT000006072665 webcite]
  • [38]LOI n° 2012–300 du 5 mars 2012 relative aux recherches impliquant la personne humaine. France; 2012. [ http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000025441587 webcite]
  • [39]L’Ordre National des Médecins: Code de déontologie médicale. France; 2012. [ http://www.conseil-national.medecin.fr/sites/default/files/codedeont.pdf webcite]
  • [40]Gillick v West Norfolk and Wisbech Area Health Authority. 1985. 3 All ER 402 (HL)
  • [41]Act FLR: United Kingdom. 1969.
  • [42]British Medical Association: Children and young people toolkit. [ http://bma.org.uk/practical-support-at-work/ethics/children/children-and-young-people-tool-kit webcite]
  • [43]Mental Capacity Act. United Kingdom; 2005. [ http://www.legislation.gov.uk/ukpga/2005/9/pdfs/ukpga_20050009_en.pdf webcite]
  • [44]The British Society for Human Genetics: Report on the Genetic Testing of Children. [ http://www.bsgm.org.uk/media/678741/gtoc_booklet_final_new.pdf webcite]
  • [45]Re MM (Medical Treatment), Volume 1. 2000. FLR 224
  • [46]Working Party of the Clinical Genetics Society (UK): The genetic testing of children. J Med Genet 1994, 31:785.
  • [47]PHG Foundation: Next steps in the sequence: the implications of whole genome sequencing for health in the UK. 2011. [ http://www.phgfoundation.org/reports/10364/ webcite]
  • [48]Law 14/2007 of 3 July 2007 on Biomedical Research. Spain; 2007. [ http://www.isciii.es/ISCIII/es/contenidos/fd-investigacion/SpanishLawonBiomedicalResearchEnglish.pdf webcite]
  • [49]Medical Research Involving Human Subjects Act. Netherlands; 1998.
  • [50]Federation of Dutch Medical Scientific Societies: Gedragscode verantwoord omgaan met lichaamsmateriaal ten behoeve van wetenschappelijk onderzoek (Human Tissue and Medical Research: Code of conduct for responsible use). [ http://www.federa.org/sites/default/files/digital_version_first_part_code_of_conduct_in_uk_2011_12092012.pdf webcite]
  • [51]Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada: Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. 2nd edition. Ottawa: Interagency Secretariat on Research Ethics; 2010.
  • [52]Godbout E, Parent C, Saint-Jacques MC: Le meilleur intérêt de l’enfant dont la garde contestée: enjeux, contexte et pratiques. Enfances Familles Générations 2014, 20:168-188.
  • [53]Civil Code of Québec. Quebec, Canada; 1994. [ http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=2&file=/CCQ_1991/CCQ1991_A.html webcite]
  • [54]Family Law Act. British Columbia, Canada; 2013. [ http://www.bclaws.ca/civix/document/id/complete/statreg/11025_01 webcite]
  • [55]The Child and Family Services Act. Manitoba, Canada; 2012. [ http://web2.gov.mb.ca/laws/statutes/ccsm/c080e.php webcite]
  • [56]A.C. v. Manitoba (Director of Child and Family Services). 2009. SCC 30, [2009] 2 SCR 181
  • [57]Hens K, Cassiman JJ, Nys H, Dierickx K: Children, biobanks, and the scope of parental consent. EJHG 2011, 19:735-739.
  • [58]De Vries MC, Bresters D, Kaspers GJL, Houtlosser M, Wit JM, Engberts DP, Van Leeuwen E: What constitutes the best interest of a child? Views of parents, children, and physicians in a pediatric oncology setting. AJOB Primary Res 2013, 4:1.
  • [59]Archard D: Children, adults, best interests and rights. Med Law Int’l 2013, 13:55-74.
  • [60]Reading R, Bissell S, Goldhagen J, Harwin J, Masson J, Moynihan S, Parton N, Santos Pais M, Thoburn J, Webb E: Promotion of children’s rights and prevention of child maltreatment. Lancet 2009, 373:332.
  • [61]Bredenoord AL, De Vries MC, Van Delden JJM: Next generation sequencing: does the next generation still have a right to an open future? Nat Rev Gen 2013, 14:2.
  • [62]Lemke AA, Bick D, Dimmock D, Simpson P, Veith R: Perspectives of clinical genetics professionals toward genome sequencing and incidental findings: A survey study. Clin Genet 2013, 84:230-236.
  • [63]Green RC, Berg JS, Grody WW, Kalia SS, Korf BR, Martin CL, McGuire AL, Nussbaum RL, O’Daniel JM, Ormond KE, Rehm HL, Watson MS, Williams MS, Biesecker LG: ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genet Med 2013, 15:565-574.
  • [64]American College of Medical Genetics and Genomics: Incidental findings in clinical genomics: a clarification. Genet Med 2013, 15:664.
  • [65]Public Population Project in Genomics and Society: Biobank Hub – International Paediatric Research Platform. [ http://www.p3g.org/resources/biobank-hub webcite]
  • [66]Ross LF: Predictive genetic testing of children and the role of the best interest standard. J Law Med Ethics 2013, 41:899-906.
  • [67]Clayton EW, McGuire AL: The legal risks of returning results of genomics research. Genet Med 2012, 14:473-477.
  • [68]Costa J-P: The best interests of the child in the recent case law of the European Court of Human Rights. In Proceedings of an Irish-British-French Symposium on Family Law: 14 May 2011. Dublin; [ http://www.hcch.net/upload/wop/abduct2011info05_en.pdf webcite]
  • [69]Medicines for Human Use (Clinical Trials) Regulations. United Kingdom; 2004. [ http://www.legislation.gov.uk/uksi/2004/1031/contents/made webcite]
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