Whole-genome sequencing for TB source investigations: principles of ethical precision public health.
Publication date
2021-03Author
van Rie, A.de Viedma, D.G.
Meehan, Conor J.
Comas, I.
Heupink, T.H.
De Vos, E.
de Onate, W.A.
Mathys, V.
Ceyssens, P-J.
Groenen, G.
González-Candelas, F.
Forier, A.
Juengst, E.
Keyword
EpidemiologyEthics
Source investigation
Tuberculosis
Whole-genome sequencing
Public health
Community engagement
Peer-Reviewed
YesOpen Access status
closedAccess
Metadata
Show full item recordAbstract
BACKGROUND: Whole-genome sequencing (WGS) of Mycobacterium tuberculosis allows rapid, accurate inferences about the sources, location and timing of transmission. However, in an era of heightened concern for personal privacy and science distrust, such inferences could result in unintended harm and undermine the public´s trust. METHODS: We held interdisciplinary stakeholder discussions and performed ethical analyses of real-world illustrative cases to identify principles that optimise benefit and mitigate harm of M. tuberculosis WGS-driven TB source investigations.RESULTS: The speed and precision with which real-time WGS can be used to associate M. tuberculosis strains with sensitive information has raised important concerns. While detailed understanding of transmission events could mitigate harm to vulnerable patients and communities when otherwise unfairly blamed for TB outbreaks, the precision of WGS can also identify transmission events resulting in social blame, fear, discrimination, individual or location stigma, and the use of defaming language by the public, politicians and scientists. Public health programmes should balance the need to safeguard privacy with public health goals, transparency and individual rights, including the right to know who infects whom or where.CONCLUSIONS: Ethical challenges raised by real-time WGS-driven TB source investigation requires public health authorities to move beyond their current legal mandate and embrace transparency, privacy and community engagement.Version
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van Rie A, de Viedma DG and Meehan CJ (2021) Whole-genome sequencing for TB source investigations: principles of ethical precision public health. The International Journal Of Tuberculosis And Lung Disease : The Official Journal Of The International Union Against Tuberculosis And Lung Disease. 25 (3): 222-227(6).Link to Version of Record
https://doi.org/10.5588/ijtld.20.0886Type
Articleae974a485f413a2113503eed53cd6c53
https://doi.org/10.5588/ijtld.20.0886