DNA databanks and consent: a suggested policy option involving an authorization model.
BACKGROUND
Genetic databases are becoming increasingly common as a means of determining the relationship between lifestyle, environmental exposures and genetic diseases. These databases rely on large numbers of research subjects contributing their genetic material to successfully explore the genetic basis of disease. However, as all possible research questions that can be posed of the data are unknown, an unresolved ethical issue is the status of informed consent for future research uses of genetic material.


CONCLUSIONS
In this paper, we discuss the difficulties of an informed consent model for future ineffable uses of genetic data. We argue that variations on consent, such as presumed consent, blanket consent or constructed consent fail to meet the standards required by current informed consent doctrine and are distortions of the original concept. In this paper, we propose the concept of an authorization model whereby participants in genetic data banks are able to exercise a certain amount of control over future uses of genetic data. We argue this preserves the autonomy of individuals at the same time as allowing them to give permission and discretion to researchers for certain types of research.


CONCLUSIONS
The authorization model represents a step forward in the debate about informed consent in genetic databases. The move towards an authorization model would require changes in the regulatory and legislative environments. Additionally, empirical support of the utility and acceptability of authorization is required.
Caulfield
Timothy
T
Primary Care Research Unit, Department of Family and Community Medicine, Joint Centre for Bioethics, University of Toronto, Toronto, M4N 3M5, Canada. rupshur@idirect.com
Upshur
Ross E G
RE
Daar
Abdallah
A
D016223:Advance Directives; D030541:Databases, Genetic / Q000941:ethics*; D033002:Duty to Recontact; D036281:Genetic Research / Q000941:ethics*; D006801:Humans; D007258:Informed Consent / Q000941:ethics* / Q000592:standards*; D019724:Presumed Consent / Q000941:ethics; D011640:Public Policy; D035842:Research Subjects