The Double Helix: Applying an Ethic of Care to the Duty to Warn Genetic Relatives of Genetic Information

Genetic testing reveals information about a patient's health status and predictions about the patient's future wellness, while also potentially disclosing health information relevant to other family members. With the increasing availability and affordability of genetic testing and the integration of genetics into mainstream medicine, the importance of clarifying the scope of confidentiality and the rules regarding disclosure of genetic findings to genetic relatives is prime. The United Nations International Declaration on Human Genetic Data urges an appreciation for principles of equality, justice, solidarity and responsibility in the context of genetic testing, including a commitment to honoring the privacy and security of the person tested. Considering this global mandate and recent professional statements in the context of a legal amendment to patient privacy policies in Australia, a fresh scrutiny of the legal history of a physician's duty to warn is warranted. This article inquiries whether there may be anything ethically or socially amiss with a potential future recommendation for health professionals or patients to universally disclose particular cancer predisposition genetic diagnosis to genetic family members. While much of the discussion remains applicable to all genetic diagnosis, the article focuses on the practice of disclosure within the context of BRCA1/2 diagnosis. An ‘ethic of care’ interpretation of legal tradition and current practice will serve to reconcile law and medical policy on the issue of physician disclosure of genetic results to family members without patient consent.     

PRIVACY, THE INDIVIDUAL AND GENETIC INFORMATION: A BUDDHIST PERSPECTIVE

Bioinformatics is a new field of study whose ethical implications involve a combination of bioethics, computer ethics and information ethics. This paper is an attempt to view some of these implications from the perspective of Buddhism. Privacy is a central concern in both computer/information ethics and bioethics, and with information technology being increasingly utilized to process biological and genetic data, the issue has become even more pronounced. Traditionally, privacy presupposes the individual self but as Buddhism does away with the ultimate conception of an individual self, it has to find a way to analyse and justify privacy that does not presuppose such a self. It does this through a pragmatic conception that does not depend on a positing of the substantial self, which is then found to be unnecessary for an effective protection of privacy. As it may be possible one day to link genetic data to individuals, the Buddhist conception perhaps offers a more flexible approach, as what is considered to be integral to an individual person is not fixed in objectivity but depends on convention.     

The impact of the Human Genome Project on medical genetics

The near completion of the Human Genome Project stands as a remarkable achievement, with enormous implications for both science and society. For scientists, it is the first step in a complex process that will lead to important advances in the diagnosis and treatment of many diseases. Society, meanwhile, must prevent genetic discrimination, and protect genetic privacy through appropriate legislation.     

Company disclosure and consumer perceptions of the privacy implications of direct-to-consumer genetic testing

This study examines the way direct-to-consumer genetic testing (DTCGT) companies communicate privacy information and how consumers understand privacy implications of DTCGT. We first conducted an analysis of DTCGT websites to determine what information they provide regarding the treatment of consumer information and samples. 86 companies offered DTCGT services that could be purchased online from Canada. We then surveyed 415 consumers (180 had purchased, 235 considered but did not purchase DTCGT). While most websites had some privacy information, few provided sufficient information for consumers to make informed purchase decisions. Nearly half of participants reported reading the company’s privacy policy and many felt they received enough information about privacy implications, but their expectations were generally not consistent with company practices. The most common expectation was that the company would share results only with them and destroy their sample after testing. We discuss these issues regarding privacy expectations in the context of DTCGT.     

Underlying ambiguities in genetic privacy legislation

Advances in genetic testing and research are creating increasing concern regarding genetic privacy. Current and proposed federal and state legislation has failed to provide adequate protection due to confusion over the meaning of privacy, inconsistency in the definition of genetic information, and lack of clarity with regard to the role of insurers in a market driven healthcare environment. Drawing on examples of current and proposed legislation, this paper explores these ambiguities with a view toward future health policy alternatives.     

Yahtzee: An Anonymized Group Level Matching Procedure

Researchers often face the problem of needing to protect the privacy of subjects while also needing to integrate data that contains personal information from diverse data sources. The advent of computational social science and the enormous amount of data about people that is being collected makes protecting the privacy of research subjects ever more important. However, strict privacy procedures can hinder the process of joining diverse sources of data that contain information about specific individual behaviors. In this paper we present a procedure to keep information about specific individuals from being “leaked” or shared in either direction between two sources of data without need of a trusted third party. To achieve this goal, we randomly assign individuals to anonymous groups before combining the anonymized information between the two sources of data. We refer to this method as the Yahtzee procedure, and show that it performs as predicted by theoretical analysis when we apply it to data from Facebook and public voter records.     

Privacy and disclosure in medical genetics examined in an ethics of care

The progress of genetic knowledge magnifies existing ethical problems in medical genetics. Among the most troubling types of problems -- for medicine, patients, and the larger society -- are those of privacy and disclosure. Examples of the range of problems involving privacy and disclosure are: 1) disclosure of false paternity to an unsuspecting husband; 2) disclosure of a patient's genetic make-up to his or her unknowing spouse; 3) disclosure of information, against a patient's wishes, to relatives at genetic risk; 4) disclosure of ambiguous test results; 5) disclosure of adventitious nonmedical information, e.g., fetal sex; and 6) disclosure to institutional third parties, such as employers and insurers....     

UK report calls for protection of genetic privacy

DNA gathered from a used coffee mug could lead to serious breaches of a person's genetic privacy. The UK government's Human Genetics Commission now recommends making theft of genetic information a criminal offence, writes Michael Gross.     

The HIPAA privacy rule and bioterrorism planning, prevention, and response

Effective bioterrorism planning, prevention, and response require information sharing between various entities, ranging from public health authorities and health-care workers to national security and law enforcement officials. While the source of much information exchanged may be nonidentifiable, many entities legitimately need access to personally identifiable health information (or "protected health information" [PHI]) in planning for and responding to a bioterrorism event. The HIPAA Privacy Rule allows for essential exchanges of health data during a public health emergency while protecting against unnecessary disclosures of PHI. In the event of a bioterrorist attack, the Privacy Rule allows covered entities to disclose PHI without individual authorization in the following instances: (1) for treatment by health-care providers, (2) to avert a serious threat to health or safety, (3) to public health authorities for public health purposes, (4) to protect national security, (5) to law enforcement under certain conditions, and (6) for judicial or administrative proceedings. Despite these favorable disclosure provisions, some privacy challenges remain. The flow of PHI may be slowed by misunderstandings of the Privacy Rule's accounting requirement. In addition, in a bioterrorism scenario, nontraditional entities may find themselves acting as health-care providers, triggering Privacy Rule provisions. Finally, the potential for de facto disclosures of individuals' disease or exposure status increases where conspicuous treatment methods, isolation, or quarantine are implemented without additional measures to protect privacy. Understanding the Privacy Rule's impact on bioterrorism planning and response ensures that various entities can conduct their activities with needed information while still protecting individual privacy.     

Redefining Genomic Privacy: Trust and Empowerment

Fulfilling the promise of the genetic revolution requires the analysis of large datasets containing information from thousands to millions of participants. However, sharing human genomic data requires protecting subjects from potential harm. Current models rely on de-identification techniques in which privacy versus data utility becomes a zero-sum game. Instead, we propose the use of trust-enabling techniques to create a solution in which researchers and participants both win. To do so we introduce three principles that facilitate trust in genetic research and outline one possible framework built upon those principles. Our hope is that such trust-centric frameworks provide a sustainable solution that reconciles genetic privacy with data sharing and facilitates genetic research.     

Disclosure of Huntington's disease to family members: the dilemma of known but unknowing parties

Predictive genetic testing presents unique issues in the legal and ethical debate concerning disclosure of information within the physician-patient relationship. A duty to disclose information to family members has been found when the disclosure is likely to result in the ability to mitigate the damaging effects of the disease. When evaluating the situation where a individual is at risk of Huntington's disease, the analysis must be different, as shown in this paper, and necessitates an ethical and legal examination of the consequences of receipt of the information on family members, those known but unknowing parties who are at risk of inheriting a genetic disease. This paper analyzes the potential legal duty of a physician to disclose or withhold genetic information from the family members of patients. Existing statutes governing genetic information do not directly address the interests of family members. Courts that have ruled on the duty to disclose medical or genetic information have analyzed these issues using traditional concepts of tort law. Yet the situation presented by Huntington's disease is unique and demands a different framework for analysis, given the late onset and lack of curative or ameliorative treatment. This paper also analyzes the ethical standards to be invoked when considering violating the privacy of a patient or a family member. The principles of autonomy and self-determination of family members are considered, versus the risk of harm and the privacy interest in not knowing potentially devastating information.     

Design and Implementation of Website Information Disclosure Assessment System

Internet application technologies, such as cloud computing and cloud storage, have increasingly changed people’s lives. Websites contain vast amounts of personal privacy information. In order to protect this information, network security technologies, such as database protection and data encryption, attract many researchers. The most serious problems concerning web vulnerability are e-mail address and network database leakages. These leakages have many causes. For example, malicious users can steal database contents, taking advantage of mistakes made by programmers and administrators. In order to mitigate this type of abuse, a website information disclosure assessment system is proposed in this study. This system utilizes a series of technologies, such as web crawler algorithms, SQL injection attack detection, and web vulnerability mining, to assess a website’s information disclosure. Thirty websites, randomly sampled from the top 50 world colleges, were used to collect leakage information. This testing showed the importance of increasing the security and privacy of website information for academic websites.     

Owning Genetic Information and Gene Enhancement Techniques: Why Privacy and Property Rights May Undermine Social Control of the Human Genome

In this article I argue that the proper subjects of intangible property claims include medical records, genetic profiles, and gene enhancement techniques. Coupled with a right to privacy these intangible property rights allow individuals a zone of control that will, in most cases, justifiably exclude governmental or societal invasions into private domains. I argue that the threshold for overriding privacy rights and intangible property rights is higher, in relation to genetic enhancement techniques and sensitive personal information, than is commonly suggested. Once the bar is raised, so-to-speak, the burden of overriding it is formidable. Thus many policy decisions that have been recently proposed or enacted – citywide audio and video surveillance, law enforcement DNA sweeps, genetic profiling, national bans on genetic testing and enhancement of humans, to name a few – will have to be backed by very strong arguments.     

An analytical model for random pseudonym change scheme in VANETs

The emerging Vehicular Ad hoc NETworks (VANETs) can improve safety, efficiency and convenience in transportation. In spite of the expected benefits, VANETs also introduce some location privacy risk by periodically broadcasting vehicular information. Pseudonym change is commonly accepted as one approach to protect location privacy in VANETs, but the effectiveness of most pseudonym change schemes has never been investigated theoretically. In this paper, focusing on the Random Pseudonym Change (RPC) scheme, we propose an analytical model to quantify its level of location privacy by calculating the size of anonymity set of a vehicle. With this model, we can analyze the probability of a vehicle changing pseudonym simultaneously with its neighbor, which can be then used to calculate the size of anonymity set of the vehicle. Further, we investigate the influence of the pseudonym lifetime distribution on the level of location privacy. Research results, which are validated via extensive simulations, show that for the RPC scheme, the uniform pseudonym lifetime distribution can provide better location privacy protection than the reciprocal pseudonym lifetime distribution. In addition, we also discuss the conditional probability of a vehicle changing pseudonym simultaneously with its neighbor given the age of pseudonym used by the neighbor at the time when the vehicle last changed pseudonym, and point out that utilizing the age of pseudonym can improve the level of location privacy.     

Assessing and managing risk when sharing aggregate genetic variant data

Access to genetic data across studies is an important aspect of identifying new genetic associations through genome-wide association studies (GWASs). Meta-analysis across multiple GWASs with combined cohort sizes of tens of thousands of individuals often uncovers many more genome-wide associated loci than the original individual studies; this emphasizes the importance of tools and mechanisms for data sharing. However, even sharing summary-level data, such as allele frequencies, inherently carries some degree of privacy risk to study participants. Here we discuss mechanisms and resources for sharing data from GWASs, particularly focusing on approaches for assessing and quantifying the privacy risks to participants that result from the sharing of summary-level data.     

蛋白质：生物界中又一类信息的储存者和传递者 ——对 prion 生物学相关知识的重新解读

蛋白质在相当一段时间内一直被认为只是 DNA 或 RNA 等遗传物质的表达形式,其单独不具有储存和传递生物信息的功能,而储存和传递生物信息却是遗传物质的两个基本属性 . 随着近年来 prion 生物学的出现和研究的逐步深入,人们已经认识到蛋白质单独就具有储存和传递生物信息的功能,从这个意义上讲,蛋白质也是一类遗传物质 . 所以很有必要站在这个角度对 prion 生物学的相关知识进行重新的梳理和再认识,通过对哺乳动物 prion 生物学和真菌 prion 生物学各自发展历程的简要回顾和最新研究成果的介绍,以及它们之间相同点和不同点的比较,总结出蛋白质储存和传递生物信息的一般规律并指出其表现形式的多样性 .     

Blockchain-based federated learning methodologies in smart environments

Blockchain technology is an undeniable ledger technology that stores transactions in high-security chains of blocks. Blockchain can solve security and privacy issues in a variety of domains. With the rapid development of smart environments and complicated contracts between users and intelligent devices, federated learning (FL) is a new paradigm to improve accuracy and precision factors of data mining by supporting information privacy and security. Much sensitive information such as patient health records, safety industrial information, and banking personal information in various domains of the Internet of Things (IoT) including smart city, smart healthcare, and smart industry should be collected and gathered to train and test with high potential privacy and secured manner. Using blockchain technology to the adaption of intelligent learning can influence maintaining and sustaining information security and privacy. Finally, blockchain-based FL mechanisms are very hot topics and cut of scientific edge in data science and artificial intelligence. This research proposes a systematic study on the discussion of privacy and security in the field of blockchain-based FL methodologies on the scientific databases to provide an objective road map of the status of this issue. According to the analytical results of this research, blockchain-based FL has been grown significantly during these 5 years and blockchain technology has been used more to solve problems related to patient healthcare records, image retrieval, cancer datasets, industrial equipment, and economical information in the field of IoT applications and smart environments.

     

Opinion: predictive testing for Huntington disease in childhood: challenges and implications.

Predictive testing for HD strongly highlights the need for autonomy and the need for each individual to decide about his or her willingness-or unwillingness-to obtain genetic information predictive of the future outcome. In respect of this principle, testing for minors should not be offered at the request of a third party, and prenatal testing which would result in the birth of a child at increased risk for HD should, where possible, be avoided. If we accede to the wishes of the parents for their children to be tested, we will have broken the primary principles of confidentiality, privacy, and individual justice that are owed to those children. This could be the thin edge of a wedge which could result in adoption agencies, educational institutions, insurance companies, and other third parties demanding genetic testing for another individual. Despite years of careful planning, predictive testing for HD is turning out to be more complex and challenging than ever expected. We need a great deal of care and concern in developing our response to this challenge. Careful long-term assessment and documentation of the impact of such testing is needed, so that the appropriate guidelines can be developed, guidelines which both protect families with HD and at the same time give individuals the opportunity to participate in predictive testing programs.     

Science and society: children and incompetent adults in genetic research: consent and safeguards

Recent changes to the legal and ethical criteria that govern the inclusion of children and incompetent adults in genetic research are likely to lead to advances in research, but might leave the rights of the participants in this research in need of additional safeguards. Here, we discuss why this might be and propose policy considerations that could help to protect the rights of these particularly vulnerable groups of research participants.     

How Safe Do Teenagers Behave on Facebook? An Observational Study

The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13–18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends'' eyes only, but a lot of information is accessible on the friends-of-friends'' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.