title: Patients' refusal to consent to storage and use of samples in Swedish biobanks: cross sectional study.
abstract: OBJECTIVE
  To estimate how many people object to storage of biological samples collected in health care in Sweden and to their use in research and how many withdraw previous consent.
  
  
  METHODS
  Cross sectional study of register data.
  
  
  METHODS
  Biobanks used in Swedish health care, 2005-6. Population Data on refusal to consent were obtained for 1.4 million biobank samples per year from 20 of 21 counties.
  
  
  METHODS
  Rates of preliminary refusal to consent, confirmed refusal, and withdrawal of consent.
  
  
  RESULTS
  Patients refused consent to either storage or use of their samples in about 1 in 690 cases; about 1 in 1600 confirmed their decision by completing a dissent form. Rather than having the samples destroyed, about 1 in 6200 patients wanted to restrict their use. Of those who had previously consented, about 1 in 19,000 withdrew their consent.
  
  
  CONCLUSIONS
  Refusal to consent to biobank research in Sweden is rare, and the interests of individuals and research interests need not be at odds. The Swedish healthcare organisation is currently obliged to obtain either consent or refusal to each potential use of each sample taken, and lack of consent to research is used as the default position. A system of presumed consent with straightforward opt out would correspond with people's attitudes, as expressed in their actions, towards biobank research.
authors.affiliation: Centre for Research Ethics and Bioethics, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden. linus.johnsson@crb.uu.se
authors.forename: Linus
authors.initials: L
authors.lastname: Johnsson
authors.forename: Mats G
authors.initials: MG
authors.lastname: Hansson
authors.forename: Stefan
authors.initials: S
authors.lastname: Eriksson
authors.forename: Gert
authors.initials: G
authors.lastname: Helgesson
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D045808:Refusal to Participate; D013548:Sweden; D014015:Tissue Banks; D009927:Tissue and Organ Procurement