Should Genetic Testing for Variants Associated with Influenza Infection Be Mandatory for Health Care Employees?

Lewis, Michelle

doi:10.1001/amajethics.2018.819

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…environmental pollution or norms of sedentary working, is often more effective and avoids blaming individuals [ 23 , 29 , 37 , 57 , 59 ]. In the occupational context, worries are expressed that this shift towards individual responsibility for health can lead to the blaming or discriminating of ill or at-risk employees instead of taking responsibility for safe working environments [ 26 , 48 , 56 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, it can also result in a situation where employees (possibly unintentionally) favor workers who are less likely to develop illness. Testing for early disease risks in the workplace should be used to include people in the workplace by improving safe and healthy workplaces and not as a means for “selection of the fittest” [ 26 , p. 98] or excluding people from the workplace [ 4 , 21 , 40 , 43 , 48 , 49 , 54 – 56 , 59 , 66 , 69 ]. Insurers might use risk information for differentiating insurance premiums or excluding people from insurance.…”

Section: Resultsmentioning

confidence: 99%

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Ethics of early detection of disease risk factors: A scoping review

Jansen,

Kamphorst,

Mulder

et al. 2024

BMC Med Ethics

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Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Ethics of early detection of disease risk factors: A scoping review

Jansen,

Kamphorst,

Mulder

et al. 2024

BMC Med Ethics

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The ethics of using COVID-19 host genomic information for clinical and public health decision-making: A survey of US health professionals

Jose,

Geller,

Bollinger

et al. 2024

Human Genetics and Genomics Advances

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Genomics and High-Consequence Infectious Diseases: A Scoping Review of Emerging Science and Potential Ethical Issues

Boyce

Garibaldi

2019

Health Security

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Host genomic research on high-consequence infectious diseases is a growing area, but the ethical, legal, and social implications of such findings related to potential applications of the research have not yet been identified. While there is a robust ethical debate about the ethical, legal, and social implications of research during an emergency, there has been less consideration of issues facing research conducted outside of the scope of emergency response. Addressing the implications of research at an early stage (anticipatory ethics) helps define the issue space, facilitates preparedness, and promotes ethically and socially responsible practices. To lay the groundwork for more comprehensive anticipatory ethics work, this article provides a preliminary assessment of the state of the field with a scoping review of host genomic research on a subset of highconsequence infectious diseases of relevance to high-level isolation units, focusing on its ethically relevant features and identifying several ethical, legal, and social implications raised by the literature. We discuss the challenges of genomic studies of low-frequency, high-risk events and applications of the science, including identifying targets to guide the development of new therapeutics, improving vaccine development, finding biomarkers to predict disease outcome, and guiding decisions about repurposing existing drugs and genetic screening. Some ethical, legal, and social implications identified in the literature included the rise of systems biology and paradigm shifts in medical countermeasure development; controversies over repurposing of existing drugs; genetic privacy and discrimination; and benefit-sharing and global inequity as part of the broader ecosystem surrounding high-level isolation units. Future anticipatory ethics work should forecast the science and its applications; identify a more comprehensive list of ethical, legal, and social implications; and facilitate evaluation by multiple stakeholders to inform the integration of ethical concerns into high-level isolation unit policy and practice.A key potential benefit of research on the genomics of the host response to infectious diseases is the discovery of new targets for the development of therapies. A paradigm example is the CCR5 delta-32 allele, which confers resistance to HIV-1 in approximately 10% of in-dividuals living in Europe and western Asia. 1 Its discovery launched research to develop therapeutics and vaccines targeting the CCR5 co-receptor. 2 Identifying pathways to new therapeutics, and other medical countermeasures like vaccines, is a central aim of a recent large-scale (8,000-

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Should Genetic Testing for Variants Associated with Influenza Infection Be Mandatory for Health Care Employees?

Cited by 3 publications

References 3 publications

Ethics of early detection of disease risk factors: A scoping review

Ethics of early detection of disease risk factors: A scoping review

The ethics of using COVID-19 host genomic information for clinical and public health decision-making: A survey of US health professionals

Genomics and High-Consequence Infectious Diseases: A Scoping Review of Emerging Science and Potential Ethical Issues

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