Experts reflecting on the duty to recontact patients and research participants; why professionals should take the lead in developing guidelines

Eur J Med Genet. 2020 Feb;63(2):103642. doi: 10.1016/j.ejmg.2019.03.006. Epub 2019 Mar 20.

Abstract

Sequencing technology is increasing the scale of information that could benefit patients who have been tested in the past. This raises the question whether professionals have a duty to recontact such patients or their families. There is currently no clear basis for a legal duty to recontact, and professional guidelines are limited. We conducted interviews with 14 senior professionals from the Netherlands and UK to obtain a range of opinions on what obligations are estimated to be possible or desirable. There was (near) consensus that a lack of resources currently inhibits recontacting in clinical practice, that recontacting is less desirable in research, that information on recontacting should be part of informed consent, and that a legal duty should follow professional standards. There was a diversity of opinions on the desirability of a more systematic approach, potential obligations in hybrid clinical-research projects, and who should bear responsibility for seeking updates. Based on the literature, legal framework and these interviews, we conclude that a general duty to recontact is unlikely, but that in specific circumstances a limited duty may apply if the benefit to the individual is significant and the burden on professionals not too extensive. The variation in opinion demonstrates that further deliberations are desirable. The development of guidelines-a process the European Society of Human Genetics has begun-is important to ensure that the courts, in deciding a recontacting case, can take into account what professionals consider responsible standards in this field.

Keywords: Duty of care; Duty to recontact; Genetics; Genomics.

MeSH terms

  • Data Collection
  • Duty to Recontact / ethics*
  • Duty to Recontact / legislation & jurisprudence
  • Ethics, Research
  • Genetics, Medical / ethics
  • Guidelines as Topic*
  • Humans
  • Informed Consent
  • Interviews as Topic
  • Netherlands
  • Patients / legislation & jurisprudence
  • Research Subjects / legislation & jurisprudence
  • United Kingdom