Restricted accessResearch articleFirst published online 2013-7
Critical Illness Research Involving Collection of Genomic Data: The Conundrum Posed by Low Levels of Genomic Literacy among Surrogate Decision Makers for Critically Ill Patients
Critical illness clinical trials that entail genomic data collection pose unique challenges. In this qualitative study, we found that surrogate decision makers (SDMs) for critically ill individuals, such as those who would be approached for study participation, appeared to have a limited grasp of genomic principles. We argue that low levels of genomic literacy should neither preclude nor be in conflict with the conduct of ethically rigorous clinical trials.
Ad Hoc Statement Committee of the American Thoracic Society. (2004). The ethical conduct of clinical research involving critically ill patients in the United States and Canada. American Journal of Respiratory and Critical Care Medicine, 170, 1375–1384.
2.
BatesB. R.LynchJ. A.BevanJ. L., & ConditC. M. (2005). Warranted concerns, warranted outlooks: A focus group study of public understandings of genetic research. Social Science and Medicine, 60(2), 331–344.
3.
ChenD. T.MeschiaJ. F.BrottT. G.BrownR. D.WorrallB. B., & SIBLINGS WITH ISCHEMIA STROKE STUDY INVESTIGATORS. (2008). Stroke genetic research and adults with impaired decision-making capacity: A survey of IRB and investigator practices. Stroke, 39(10), 2732–2735.
4.
ChristensenK. D.JayaratneT. E.RobertsJ. S.KardiaS. L., & PettyE. M. (2010). Understandings of basic genetics in the United States: Results from a national survey of black and white men and women. Public Health Genomics, 13(7–8), 467–476.
5.
FreemanB. D.KennedyC. R.FrankelH. L.ClarridgeB.Bolcic-JankovicD.IversonE.. (2010). Ethical considerations in the collection of genetic data from critically ill patients: What do published studies reveal about potential directions in empirical research?Pharmacogenomics Journal, 10(2), 77–85.
6.
FreemanB. D.KennedyC. R.Bolcic-JankovicD.EastmanA. E.IversonE.ShehaneE.. (2012). Considerations in the construction of an instrument to assess attitudes regarding critical illness gene variation research. Journal of Emprical Research on Human Research Ethics, 7(1), 58–70.
7.
GongM. N.WeiZ.XuL. L.MillerD. P.ThompsonB. T., & ChristiansD. C. (2004). Polymorphisms in the surfactant Protein-B gene, gender, and the risk of direct pulmonary injury and ARDS. Chest125(1), 203–211.
8.
GongM. N.WinkelG.RhodesR.RichardsonL. D., & SilversteinJ. H. (2010). Surrogate consent for research involving adults with impaired decision making: Survey of institutional review board practices. Critical Care Medicine, 38(11), 2146–2154.
9.
IversonE.CeliousA.KennedyC. R.ShehaneE.EastmanA. E.WarrenV.. (2012). Real-time perspectives of surrogate decision makers regarding critical illness research: Findings of focus group participants. Chest, 142(6), 1433–1439.
10.
IversonE.CeliousA.KennedyC. R.ShehaneE.EastmanA. E.WarrenV., & FreemanB. D. (2013). Perspectives of surrogate decision makers for critically ill patients regarding gene variation research. Genetics in Medicine, 15(5), 368–373.
11.
PulleyJ.ClaytonE.BernardG. R.RodenD. M., & MasysD. R. (2010). Principles of human subjects protections applied in an opt-out, de-identified biobank. Clinical and Translational Science, 3(1), 42–48.
12.
RodenD. M.PulleyJ. M.BasfordM. A.BernardG. R.ClaytonE. W.BalserJ. R., & MasysD. R. (2008). Development of a large-scale de-identified DNA biobank to enable personalize medicine. Clinical Pharmacology and Therapeutics, 84(3), 362–369.