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Genomic Research With the Newly Dead

December 20, 2016
Recent advances in next generation sequencing along with high hopes for genomic medicine have inspired interest in genomic research with the newly dead. However, applicable law does not adequately determine ethical or policy responses to such research. In this paper we propose that such research stands at a crossroads between...

Underutilization of Specimens in Biobanks

December 20, 2016

Parents’ Online Portrayals of Pediatric Treatment and Research Options

December 20, 2016
PARENTS OF SERIOUSLY ILL CHILDREN FACE difficult decisions when standard therapies are limited or ineffective. In their search for information, they may turn to websites created by other parents facing similar experiences. We conducted a qualitative content analysis of 21 websites created by families with children affected by cancer or...

Ethical, Legal, and Social Concerns About Expanded Newborn Screening

December 20, 2016
Technology will make it possible to screen for fragile X syndrome and other conditions that do not meet current guidelines for routine newborn screening. This possibility evokes at least 8 broad ethical, legal, and social concerns: (1) early identification of fragile X syndrome, an “untreatable” condition, could lead to heightened...

Clinical Trials and Medical Care

December 20, 2016
For over three decades, bioethics scholarship and research ethics guidelines have identified concerns about the boundaries between research and standard clinical care. Ethicists have argued that informed consent to participate in research should include clarification of the differences between these two activities. In 1982, Appelbaum and colleagues reported on findings...

A Place for Genetic Uncertainty

December 20, 2016
Klinefelter, Turner, and fragile X syndromes are conditions defined by a genetic or chromosomal variant. The timing of diagnosis, tests employed, specialists involved, symptoms evident, and prognoses available vary considerably within and across these syndromes, but all three share in common a diagnosis verified through a molecular or cytogenetic test....

The Many Meanings of Care in Clinical Research

December 20, 2016
The conduct of clinical research often involves two distinguishable sets of relationships: the researcher-subject relationship, and the clinician-patient relationship. Some scholars argue that being a patient in a clinical care setting and a subject in a research study are so different that anything that would promote in subjects the view...

The Many Meanings of Care in Research

December 20, 2016
The conduct of clinical research often involves two distinguishable sets of relationships: the researcher‐subject relationship, and the clinician‐patient relationship. Some scholars argue that being a patient in a clinical care setting and a subject in a research study are so different that anything that would promote in subjects the view...

Therapeutic Misconception in Early Phase Gene Transfer Trials

December 20, 2016
Many subjects in early phase clinical trials expect to benefit in some way from the research intervention. It is understandable that people hope for improvement in their condition, no matter what the evidence. Yet unreasonable expectation of medical benefit may reflect problems with informed consent: Investigators may not disclose clearly...

Changing Perspectives on the Benefits of Newborn Screening

December 20, 2016
The likelihood of benefit is fundamental to decision making about newborn screening. But benefit is construed in different ways by different stakeholders. This article begins with a review of benefit as considered historically by various expert panels and organizations. We then show how 78 conditions fared when experts recently rated...