Intended for healthcare professionals

Rapid response to:

Analysis

Biobank research: who benefits from individual consent?

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5647 (Published 04 October 2011) Cite this as: BMJ 2011;343:d5647

Rapid Response:

Broad Consent is Informed Consent

The key step in the argument given in this piece involves the
assessment of the potential risks and benefits of these research
practices. The authors claim that the risks associated with Biobanks are
minimal and are significantly outweighed by the benefits. There are those
who disagree.(1) However, even if we could agree about the level of risk
and benefit threatened or promised by biobanking, different people would
weigh those risks and benefits differently: for some, control of personal
information is very important and for others it is less so. For this
reason, the authors' argument seems to me an unproductive route to take,
even though I am sympathetic with it.

Instead, it is a mistake to suggest that broad consent cannot be
informed consent and constitutes a breach of autonomy.(2) There are many
ordinary decisions that we make that are properly informed and exemplify
the appropriate exercise of autonomy but which do not involve 'specific'
consent. We often decide to allow others to make decisions for us. If I am
late getting to the restaurant I might call ahead to ask one of the other
diners to order for me: "You decide for me. I don't eat seafood or
sprouts."

These decisions are perfectly acceptable, autonomous decisions but
the information that makes them informed is different from the specific
individual consent case. In the broad consent cases, the relevant
information is about the person (or institution) that will be making the
decision for me. In biobanking, the relevant information might be about
the overall goals of the research supported by the Biobank and details of
the decision-making processes within the institution - how are decisions
made about suitable research and by whom?

Broad consent is a perfectly legitimate form of informed consent. We
do not need a broader notion of autonomy, we simply need a proper
understanding of the one we have.

1. Hoppe, N. Risky Business: Re-Evaluating Participant Risk in
Biobanking. In: Lenk C, Hoppe N, Beier K, Wiesemann C, editors. Human
Tissue Research: A European Perspective on the Ethical and Legal
Challenges. Oxford: Oxford University Press; 2011. p. 35-45.

2. Sheehan, M. Can Broad Consent be Informed Consent? Public Health
Ethics 2011; doi: 10.1093/phe/phr020

Competing interests: No competing interests

10 October 2011
Mark Sheehan
Oxford BRC Ethics Fellow
The Ethox Centre, University of Oxford