Guidance in social and ethical issues related to clinical, diagnostic care and novel therapies for hereditary neuromuscular rare diseases: “translating” the translational

Pauline McCormack, Simon Woods, Annemieke Aartsma-Rus, Lynn Hagger, Agnes Herczegfalvi, Emma Heslop, Joseph Irwin, Janbernd Kirschner, Patrick Moeschen, Francesco Muntoni, Marie Christine Ouillade, Jes Rahbek, Christoph Rehmann-Sutter, Francoise Rouault, Thomas Sejersen, Elizabeth Vroom, Volker Straub, Kate Bushby, Alessandra Ferlini

Abstract

Drug trials in children engage with many ethical issues, from drug-related safety concerns to communication with patients and parents, and recruitment and informed consent procedures. This paper addresses the field of neuromuscular disorders where the possibility of genetic, mutation-specific treatments, has added new complexity. Not only must trial design address issues of equity of access, but researchers must also think through the implications of adopting a personalised medicine approach, which requires a precise molecular diagnosis, in addition to other implications of developing orphan drugs. It is against this background of change and complexity that the Project Ethics Council (PEC) was established within the TREAT-NMD EU Network of Excellence. The PEC is a high level advisory group that draws upon the expertise of its interdisciplinary membership which includes clinicians, lawyers, scientists, parents, representatives of patient organisations, social scientists and ethicists. In this paper we describe the establishment and terms of reference of the PEC, give an indication of the range and depth of its work and provide some analysis of the kinds of complex questions encountered. The paper describes how the PEC has responded to substantive ethical issues raised within the TREAT-NMD consortium and how it has provided a wider resource for any concerned parent, patient, or clinician to ask a question of ethical concern. Issues raised range from science related ethical issues, issues related to hereditary neuromuscular diseases and the new therapeutic approaches and questions concerning patients rights in the context of patient registries and biobanks. 260We conclude by recommending the PEC as a model for similar research contexts in rare diseases.

Original languageEnglish
Title of host publicationThe Ethical Challenges of Emerging Medical Technologies
Number of pages18
PublisherTaylor and Francis
Publication date01.01.2020
Pages259-276
ISBN (Print)9781472429155
ISBN (Electronic)9781000108958
DOIs
Publication statusPublished - 01.01.2020

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