Abstract

Precision medicine research is underway to identify targeted approaches to improving health and preventing disease. However, such endeavors raise significant privacy and confidentiality concerns. The objective of this study was to elucidate the potential benefits and harms associated with precision medicine research through in-depth interviews with a diverse group of thought leaders, including primarily U.S.-based experts and scholars in the areas of ethics, genome research, health law, historically-disadvantaged populations, informatics, and participant-centric perspectives, as well as government officials and human subjects protections leaders. The results suggest the prospect of an array of individual and societal benefits, as well as physical, dignitary, group, economic, psychological, and legal harms. Relative to the way risks and harms are commonly described in consent forms for precision medicine research, the thought leaders we interviewed arguably emphasized a somewhat different set of issues. The return of individual research results, harm to socially-identifiable groups, the value-dependent nature of many benefits and harms, and the risks to the research enterprise itself emerged as important cross-cutting themes. Our findings highlight specific challenges that warrant concentrated care during the design, conduct, dissemination, and translation of precision medicine research and in the development of consent materials and processes.

Highlights

  • Research is underway in the U.S and around the world to accelerate progress on precision medicine, including the use of genomic, environmental, and lifestyle information to identify new and more targeted ways to improve the diagnosis, treatment, and prevention of disease [1, 2]

  • Most thought leaders discussed potential benefits that could come from the Million American Study, including a range of health and non-health-related benefits to individual participants, as well as benefits to society from advancing scientific knowledge and improving human health

  • For participants in our hypothetical study, most thought leaders predicted that “the benefits are unlikely to be significant at the individual level” (01, Human Subjects) and that participation “may help somebody in the future, it’s unlikely to help you” (12, Law): One should always emphasize in research that you probably won’t benefit

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Summary

Introduction

Research is underway in the U.S and around the world to accelerate progress on precision medicine, including the use of genomic, environmental, and lifestyle information to identify new and more targeted ways to improve the diagnosis, treatment, and prevention of disease [1, 2]. Initiatives such as the All of Us Research Program [3] offer opportunities for discovery and innovation on an unprecedented scale. Such research platforms raise significant privacy and confidentiality concerns, as rapidly-evolving scientific and technologic advances have made it impossible to guarantee de-identification of genomic and other data [4, 5]. These issues require careful resolution for the protection of research participants, but for the sake of trust in the research enterprise itself [6].

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