Skip to main content
Top
Published in: Journal of Genetic Counseling 4/2014

01-08-2014 | Original Research

Genetic Counseling Practice in Next Generation Sequencing Research: Implications for the Ethical Oversight of the Informed Consent Process

Authors: Nathalie Egalite, Iris Jaitovich Groisman, Beatrice Godard

Published in: Journal of Genetic Counseling | Issue 4/2014

Login to get access

Abstract

The potential for next generation sequencing research (NGS) to generate individual genetic results could have implications for the informed consent process and the provision of genetic counseling. We undertook a content analysis of informed consent templates and guidelines produced by Canadian institutional review boards, purposively sampling documents used by researchers to obtain consent from participants in genetics studies. Our goal was to examine the extent to which the informed consent documents addressed genetic counseling and the return of individual genetic results. Our analysis reveals that the majority of informed consent documents did not mention genetic counseling while several did not mention the return of results. We found differences in the ways in which documents addressed availability of counseling, eligibility criteria for referral to a genetic counselor, genetic counselor involvement, provision of services to family members of participants and incidental findings. From an ethical standpoint, consent documents should provide appropriate information so that participants may make an informed decision about their participation in research. The need to ensure adequate counseling for study populations in an NGS research context will necessarily involve adapting values that underlie care in genetic counseling practice. If the interests of research participants are to be truly promoted, the drafting and review of informed consent documents should give proper due to genetic counseling.
Footnotes
1
We maintained total anonymity of the IRBs that were the source of the texts analyzed herein. We analyzed the IRB-approved consent forms for NGS research in mental health as one set to avoid identification of the research groups and because the number of documents was insufficient for comparative purposes. Content written in French—as per the language of the informed consent document—was translated and is presented here in English.
 
Literature
go back to reference Austin, J. C., & Honer, W. G. (2007). The genomic era and serious mental illness: a potential application for psychiatric genetic counseling. Psychiatric Services, 58(2), 254–261.PubMedCrossRef Austin, J. C., & Honer, W. G. (2007). The genomic era and serious mental illness: a potential application for psychiatric genetic counseling. Psychiatric Services, 58(2), 254–261.PubMedCrossRef
go back to reference Baret, L., & Godard, B. (2011). Opinions and intentions of parents of an autistic child toward genetic research results: two typical profiles. European Journal of Human Genetics, 19(11), 1127–1132.PubMedPubMedCentralCrossRef Baret, L., & Godard, B. (2011). Opinions and intentions of parents of an autistic child toward genetic research results: two typical profiles. European Journal of Human Genetics, 19(11), 1127–1132.PubMedPubMedCentralCrossRef
go back to reference Biesecker, B. B., & Peay, H. L. (2003). Ethical issues in psychiatric genetics research: points to consider. Psychopharmacology, 171(1), 27–35.PubMedCrossRef Biesecker, B. B., & Peay, H. L. (2003). Ethical issues in psychiatric genetics research: points to consider. Psychopharmacology, 171(1), 27–35.PubMedCrossRef
go back to reference Braggio, E., Egan, J. B., Fonseca, R., & Stewart, A. K. (2013). Lessons from next-generation sequencing analysis in hematological malignancies. Blood Cancer Journal, 3, e127.PubMedPubMedCentralCrossRef Braggio, E., Egan, J. B., Fonseca, R., & Stewart, A. K. (2013). Lessons from next-generation sequencing analysis in hematological malignancies. Blood Cancer Journal, 3, e127.PubMedPubMedCentralCrossRef
go back to reference Bras, J., Guerreiro, R., & Hardy, J. (2012). Use of next-generation sequencing and other whole-genome strategies to dissect neurological disease. Nature Review Neuroscience, 13(7), 453–464.CrossRef Bras, J., Guerreiro, R., & Hardy, J. (2012). Use of next-generation sequencing and other whole-genome strategies to dissect neurological disease. Nature Review Neuroscience, 13(7), 453–464.CrossRef
go back to reference Bredenoord, A. L., Kroes, H. Y., Cuppen, E., Parker, M., & van Delden, J. J. (2011). Disclosure of individual genetic data to research participants: the debate reconsidered. Trends in Genetics, 27(2), 41–47.PubMedCrossRef Bredenoord, A. L., Kroes, H. Y., Cuppen, E., Parker, M., & van Delden, J. J. (2011). Disclosure of individual genetic data to research participants: the debate reconsidered. Trends in Genetics, 27(2), 41–47.PubMedCrossRef
go back to reference Council for International Organization of Medical Sciences. (2002). International ethical guidelines for biomedical research involving human subjects. Geneva: CIOMS. Council for International Organization of Medical Sciences. (2002). International ethical guidelines for biomedical research involving human subjects. Geneva: CIOMS.
go back to reference Cowan, J., Morales, A., Dagua, J., & Hershberger, R. E. (2008). Genetic testing and genetic counseling in cardiovascular genetic medicine: overview and preliminary recommendations. Congestive Heart Failure, 14(2), 97–105.PubMedCrossRef Cowan, J., Morales, A., Dagua, J., & Hershberger, R. E. (2008). Genetic testing and genetic counseling in cardiovascular genetic medicine: overview and preliminary recommendations. Congestive Heart Failure, 14(2), 97–105.PubMedCrossRef
go back to reference de Ligt, J., Willemsen, M. H., van Bon, B. W., Kleefstra, T., Yntema, H. G., Kroes, T., et al. (2012). Diagnostic exome sequencing in persons with severe intellectual disability. New England Journal of Medicine, 367(20), 1921–1929.PubMedCrossRef de Ligt, J., Willemsen, M. H., van Bon, B. W., Kleefstra, T., Yntema, H. G., Kroes, T., et al. (2012). Diagnostic exome sequencing in persons with severe intellectual disability. New England Journal of Medicine, 367(20), 1921–1929.PubMedCrossRef
go back to reference Dove, E. S., Avard, D., Black, L., & Knoppers, B. M. (2013). Emerging issues in paediatric health research consent forms in Canada: working towards best practices. BMC Medical Ethics, 14, 5.PubMedPubMedCentralCrossRef Dove, E. S., Avard, D., Black, L., & Knoppers, B. M. (2013). Emerging issues in paediatric health research consent forms in Canada: working towards best practices. BMC Medical Ethics, 14, 5.PubMedPubMedCentralCrossRef
go back to reference Finn, C. T., & Smoller, J. W. (2006). Genetic counseling in psychiatry. Harvard Review of Psychiatry, 14(2), 109–121.PubMedCrossRef Finn, C. T., & Smoller, J. W. (2006). Genetic counseling in psychiatry. Harvard Review of Psychiatry, 14(2), 109–121.PubMedCrossRef
go back to reference Gershon, E. S. (2013). Risk counselling for family members in bipolar disorder and schizophrenia. International Journal of Neuropsychopharmacology, 16(3), 713–714.PubMedCrossRef Gershon, E. S. (2013). Risk counselling for family members in bipolar disorder and schizophrenia. International Journal of Neuropsychopharmacology, 16(3), 713–714.PubMedCrossRef
go back to reference Gilissen, C., Hoischen, A., Brunner, H. G., & Veltman, J. A. (2012). Disease gene identification strategies for exome sequencing. European Journal of Human Genetics, 20(5), 490–497.PubMedPubMedCentralCrossRef Gilissen, C., Hoischen, A., Brunner, H. G., & Veltman, J. A. (2012). Disease gene identification strategies for exome sequencing. European Journal of Human Genetics, 20(5), 490–497.PubMedPubMedCentralCrossRef
go back to reference Green, R. C., Berg, J. S., Grody, W. W., Kalia, S. S., Korf, B. R., Martin, C. L., et al. (2013). ACMG Recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genetics in Medicine, 15(7), 565–574.PubMedPubMedCentralCrossRef Green, R. C., Berg, J. S., Grody, W. W., Kalia, S. S., Korf, B. R., Martin, C. L., et al. (2013). ACMG Recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genetics in Medicine, 15(7), 565–574.PubMedPubMedCentralCrossRef
go back to reference Groisman, I. J., Mathieu, G., & Godard, B. (2012). Use of next generation sequencing technologies in research and beyond: are participants with mental health disorders fully protected? BMC Medical Ethics, 13(1), 36.PubMedPubMedCentralCrossRef Groisman, I. J., Mathieu, G., & Godard, B. (2012). Use of next generation sequencing technologies in research and beyond: are participants with mental health disorders fully protected? BMC Medical Ethics, 13(1), 36.PubMedPubMedCentralCrossRef
go back to reference Hawkins, A. K., & Ho, A. (2012). Genetic counseling and the ethical issues around direct to consumer genetic testing. Journal of Genetic Counseling, 21(3), 367–373.PubMed Hawkins, A. K., & Ho, A. (2012). Genetic counseling and the ethical issues around direct to consumer genetic testing. Journal of Genetic Counseling, 21(3), 367–373.PubMed
go back to reference Hoge, S. K., & Appelbaum, P. S. (2012). Ethics and neuropsychiatric genetics: a review of major issues. International Journal of Neuropsychopharmacology, 25, 1–11. Hoge, S. K., & Appelbaum, P. S. (2012). Ethics and neuropsychiatric genetics: a review of major issues. International Journal of Neuropsychopharmacology, 25, 1–11.
go back to reference Hoop, J. G. (2008). Ethical considerations in psychiatric genetics. Harvard Review of Psychiatry, 16(6), 322–338.PubMedCrossRef Hoop, J. G. (2008). Ethical considerations in psychiatric genetics. Harvard Review of Psychiatry, 16(6), 322–338.PubMedCrossRef
go back to reference Johnson, J. O., Mandrioli, J., Benatar, M., Abramzon, Y., Van Deerlin, V. M., Trojanowski, J. Q., et al. (2010). Exome sequencing reveals VCP mutations as a cause of familial ALS. Neuron, 68(5), 857–864.PubMedPubMedCentralCrossRef Johnson, J. O., Mandrioli, J., Benatar, M., Abramzon, Y., Van Deerlin, V. M., Trojanowski, J. Q., et al. (2010). Exome sequencing reveals VCP mutations as a cause of familial ALS. Neuron, 68(5), 857–864.PubMedPubMedCentralCrossRef
go back to reference Kaye, J., Boddington, P., de Vries, J., Hawkins, N., & Melham, K. (2010). Ethical implications of the use of whole genome methods in medical research. European Journal of Human Genetics, 18(4), 398–403.PubMedCrossRef Kaye, J., Boddington, P., de Vries, J., Hawkins, N., & Melham, K. (2010). Ethical implications of the use of whole genome methods in medical research. European Journal of Human Genetics, 18(4), 398–403.PubMedCrossRef
go back to reference Kiezun, A., Garimella, K., Do, R., Stitziel, N. O., Neale, B. M., McLaren, P. J., et al. (2012). Exome sequencing and the genetic basis of complex traits. Nature Genetics, 44(6), 623–630.PubMedPubMedCentralCrossRef Kiezun, A., Garimella, K., Do, R., Stitziel, N. O., Neale, B. M., McLaren, P. J., et al. (2012). Exome sequencing and the genetic basis of complex traits. Nature Genetics, 44(6), 623–630.PubMedPubMedCentralCrossRef
go back to reference Knoppers, B. M., Joly, Y., Simard, J., & Durocher, F. (2006). The emergence of an ethical duty to disclose genetic research results: international perspectives. European Journal of Human Genetics, 14(11), 1170–1178.CrossRefPubMed Knoppers, B. M., Joly, Y., Simard, J., & Durocher, F. (2006). The emergence of an ethical duty to disclose genetic research results: international perspectives. European Journal of Human Genetics, 14(11), 1170–1178.CrossRefPubMed
go back to reference Krier, J. B., & Green, R. C. (2013). Management of incidental findings in clinical genomic sequencing. Current Protocols in Human Genetics, 77, 9.23.1–9.23.13. Krier, J. B., & Green, R. C. (2013). Management of incidental findings in clinical genomic sequencing. Current Protocols in Human Genetics, 77, 9.23.1–9.23.13.
go back to reference Lyon, G., Jiang, T., Van Wijk, R., Wang, W., Bodily, P., Xing, J., et al. (2011). Exome sequencing and unrelated findings in the context of complex disease research: ethical and clinical implications. Discovery Medicine, 12(62), 41–55.PubMedPubMedCentral Lyon, G., Jiang, T., Van Wijk, R., Wang, W., Bodily, P., Xing, J., et al. (2011). Exome sequencing and unrelated findings in the context of complex disease research: ethical and clinical implications. Discovery Medicine, 12(62), 41–55.PubMedPubMedCentral
go back to reference Markel, D. S., & Yashar, B. M. (2004). The interface between the practice of medical genetics and human genetic research: what every genetic counselor needs to know. Journal of Genetic Counseling, 13(5), 351–368.PubMedCrossRef Markel, D. S., & Yashar, B. M. (2004). The interface between the practice of medical genetics and human genetic research: what every genetic counselor needs to know. Journal of Genetic Counseling, 13(5), 351–368.PubMedCrossRef
go back to reference Mathieu, G., Groisman, I. J., & Godard, B. (2013). Next generation sequencing in psychiatric research: what study participants need to know about research findings. The International Journal of Neuropsychopharmacology, 16(9), 2119–2127.PubMedCrossRef Mathieu, G., Groisman, I. J., & Godard, B. (2013). Next generation sequencing in psychiatric research: what study participants need to know about research findings. The International Journal of Neuropsychopharmacology, 16(9), 2119–2127.PubMedCrossRef
go back to reference McGuire, A. L., Caulfield, T., & Cho, M. K. (2008). Research ethics and the challenge of whole-genome sequencing. Nature Reviews Genetics, 9, 152–156.PubMedPubMedCentralCrossRef McGuire, A. L., Caulfield, T., & Cho, M. K. (2008). Research ethics and the challenge of whole-genome sequencing. Nature Reviews Genetics, 9, 152–156.PubMedPubMedCentralCrossRef
go back to reference McMahon, W. M., Baty, B. J., & Botkin, J. (2006). Genetic counseling and ethical issues for autism. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 142C(1), 52–57.CrossRef McMahon, W. M., Baty, B. J., & Botkin, J. (2006). Genetic counseling and ethical issues for autism. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 142C(1), 52–57.CrossRef
go back to reference Meltzer, L. A. (2006). Undesirable implications of disclosing individual genetic results to research participants. The American Journal of Bioethics, 6(6), 28–30.PubMedCrossRef Meltzer, L. A. (2006). Undesirable implications of disclosing individual genetic results to research participants. The American Journal of Bioethics, 6(6), 28–30.PubMedCrossRef
go back to reference Metzker, M. L. (2010). Sequencing technologies—the next generation. Nature Reviews Genetics, 11(1), 31–46.PubMedCrossRef Metzker, M. L. (2010). Sequencing technologies—the next generation. Nature Reviews Genetics, 11(1), 31–46.PubMedCrossRef
go back to reference National Society of Genetic Counselors. (2006). The code of ethics of the National Society of Genetic Counselors. Journal of Genetic Counseling, 15(5), 309–311.CrossRef National Society of Genetic Counselors. (2006). The code of ethics of the National Society of Genetic Counselors. Journal of Genetic Counseling, 15(5), 309–311.CrossRef
go back to reference Ng, S. B., Buckingham, K. J., Lee, C., Bigham, A. W., Tabor, H. K., Dent, K. M., et al. (2010). Exome sequencing identifies the cause of a mendelian disorder. Nature Genetics, 42(1), 30–35.PubMedCrossRef Ng, S. B., Buckingham, K. J., Lee, C., Bigham, A. W., Tabor, H. K., Dent, K. M., et al. (2010). Exome sequencing identifies the cause of a mendelian disorder. Nature Genetics, 42(1), 30–35.PubMedCrossRef
go back to reference Panoutsopoulou, K., Tachmazidou, I., & Zeggini, E. (2013). In search of low-frequency and rare variants affecting complex traits. Human Molecular Genetics, 22(R1), R16–R21.PubMedPubMedCentralCrossRef Panoutsopoulou, K., Tachmazidou, I., & Zeggini, E. (2013). In search of low-frequency and rare variants affecting complex traits. Human Molecular Genetics, 22(R1), R16–R21.PubMedPubMedCentralCrossRef
go back to reference Parker, L. S. (2002). Ethical issues in bipolar disorders pedigree research: privacy concerns, informed consent, and grounds for waiver. Bipolar Disorders, 4(1), 1–16.PubMedCrossRef Parker, L. S. (2002). Ethical issues in bipolar disorders pedigree research: privacy concerns, informed consent, and grounds for waiver. Bipolar Disorders, 4(1), 1–16.PubMedCrossRef
go back to reference Sijmons, R. H., Van Langen, I. M., & Sijmons, J. G. (2011). A clinical perspective on ethical issues in genetic testing. Accountability in Research, 18(3), 148–162.PubMedCrossRef Sijmons, R. H., Van Langen, I. M., & Sijmons, J. G. (2011). A clinical perspective on ethical issues in genetic testing. Accountability in Research, 18(3), 148–162.PubMedCrossRef
go back to reference Simon, C. M., Williams, J. K., Shinkunas, L., Brandt, D., Daack-Hirsch, S., & Driessnack, M. (2011). Informed consent and genomic incidental findings: IRB chair perspectives. Journal of Empirical Research on Human Research Ethics, 6(4), 53–67.PubMedPubMedCentralCrossRef Simon, C. M., Williams, J. K., Shinkunas, L., Brandt, D., Daack-Hirsch, S., & Driessnack, M. (2011). Informed consent and genomic incidental findings: IRB chair perspectives. Journal of Empirical Research on Human Research Ethics, 6(4), 53–67.PubMedPubMedCentralCrossRef
go back to reference Tabor, H. K., Berkman, B. E., Hull, S. C., & Bamshad, M. J. (2011). Genomics really gets personal: how exome and whole genome sequencing challenge the ethical framework of human genetics research. American Journal of Medical Genetics Part A, 155A(12), 2916–2924.PubMedPubMedCentralCrossRef Tabor, H. K., Berkman, B. E., Hull, S. C., & Bamshad, M. J. (2011). Genomics really gets personal: how exome and whole genome sequencing challenge the ethical framework of human genetics research. American Journal of Medical Genetics Part A, 155A(12), 2916–2924.PubMedPubMedCentralCrossRef
go back to reference Tabor, H. K., Stock, J., Brazg, T., McMillin, M. J., Dent, K. M., Yu, J. H., et al. (2012). Informed consent for whole genome sequencing: a qualitative analysis of participant expectations and perceptions of risks, benefits, and harms. American Journal of Medical Genetics Part A, 158A(6), 1310–1319.PubMedPubMedCentralCrossRef Tabor, H. K., Stock, J., Brazg, T., McMillin, M. J., Dent, K. M., Yu, J. H., et al. (2012). Informed consent for whole genome sequencing: a qualitative analysis of participant expectations and perceptions of risks, benefits, and harms. American Journal of Medical Genetics Part A, 158A(6), 1310–1319.PubMedPubMedCentralCrossRef
go back to reference Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405.CrossRef Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405.CrossRef
Metadata
Title
Genetic Counseling Practice in Next Generation Sequencing Research: Implications for the Ethical Oversight of the Informed Consent Process
Authors
Nathalie Egalite
Iris Jaitovich Groisman
Beatrice Godard
Publication date
01-08-2014
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 4/2014
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-014-9703-x

Other articles of this Issue 4/2014

Journal of Genetic Counseling 4/2014 Go to the issue