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Incidental Findings – Ethical Aspects

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Incidental Radiological Findings

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

This article deals with ethical aspects of incidental/secondary resp. discovery findings (IFs) from imaging techniques that are generated in clinical care, medical research or the context of direct-to-consumer services. After the questions and challenges, typically raised by IFs are introduced, the second part focusses on ethical prerequisites and reflects principles that are capable of providing a normative foundation in dealing with IFs. The final part presents recommendations on the basis of these principles as a guideline to ensure responsible planning as well as to take suitable measures, to avoid (or at least mitigate) the hazards of IFs.

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References

  • Appelbaum PS, Lidz CW, Grisso T (2004) Therapeutic misconception in clinical research: frequency and risk factors. IRB Ethics Hum Res 26(2):1–8. doi:10.2307/3564231

    Article  Google Scholar 

  • Baile WF, Buckmann R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES – a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5:302–311

    Article  CAS  PubMed  Google Scholar 

  • Beauchamp TL, Childress JF (2009) Principles of biomedical ethics. Oxford University Press, New York

    Google Scholar 

  • Nuffield Council on Bioethics (2010) Medical profiling and online medicine: the ethics of ‘personalised healthcare’ in a consumer age, Chapter 10. Direct to consumer body Imaging. http://nuffieldbioethics.org/wp-content/uploads/2014/07/Personalised-healthcare-Chapter-10-Direct-to-consumer-body-imaging1.pdf. Accessed 07 Mar 2016

  • Bjugn R (2015) Research findings with clinical implications. Tidsskr Nor Legeforen 135(8):755–758. doi:10.4045/tidsskr.14.0861

    Article  Google Scholar 

  • Booth TC, Waldman AD, Wardlaw JM, Taylor SA, Jackson A (2012) Management of incidental findings during imaging research in “healthy” volunteers: current UK practice. Br J Radiol 85:11–21

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brothers KB (2015) Wie konnte das passieren? Die US-amerikanische Perspektive auf Zufallsbefunde in den ACMG-Empfehlungen. In: Langanke M, Erdmann P, Robienski J, Rudnik-Schöneborn S (eds) Zufallsbefunde bei molekulargenetischen Untersuchungen. Medizinische, juristische und ethische Perspektiven. Springer, Heidelberg, pp 178–190

    Google Scholar 

  • Brothers KB, Langanke M, Erdmann P (2013) Implications of the incidentalome for clinical pharmacogenomics. Pharmacogenomics 14(11):1353–1362

    Article  CAS  PubMed  Google Scholar 

  • Chalmers I, Bracken MB, Djulbegovic B, Garattini S, Grant J, Gülmezoglu AM, Howells DW, Ioannidis JP, Oliver S (2014) How to increase value and reduce waste when research priorities are set. Lancet 383(9912):156–165

    Article  PubMed  Google Scholar 

  • Charmaz K (1993) Good days, bad days: the self and chronic illness in time. Rutgers University Press, New Brunswick

    Google Scholar 

  • Christenhusz GB, Devriendt K, Dierickx K (2013) To tell or not to tell? A systematic review of ethical reflections on incidental findings arising in genetic contexts. Eur J Hum Genet 21:248–255

    Article  PubMed  Google Scholar 

  • Cole C, Petree LE, Phillips JP, Shoemaker JM, Holdsworth M, Helitzer DL (2015) ‘Ethical responsibility’ or ‘a whole can of worms’: differences in opinion on incidental finding review and disclosure in neuroimaging research from focus group discussion with participants, parents, IRB members, investigators, physicians and community members. J Med Ethics 41(10):841–847. doi:10.1136/medethics-2014-102552

    Article  PubMed  Google Scholar 

  • Erdmann P (2015a) Zufallsbefunde aus bildgebenden Verfahren in populationsbasierter Forschung. Mentis, Münster

    Google Scholar 

  • Erdmann P (2015b) Handling incidental findings from imaging within IM related research. In: Fischer T, Langanke M, Marschall P, Michl S (eds) Individualized medicine. Ethical, economical and historical perspectives. Springer, Heidelberg, pp 231–250

    Google Scholar 

  • Erdmann P, Langanke M (2016) The ambivalence of early diagnosis – Dealing with the false-positive risk in current Alzheimer research. In: Current Alzheimer Research (accepted)

    Google Scholar 

  • Erdmann P, Fischer T, Raths S, Fleßa S, Langanke M (2015) Systemmedizin – Herausforderungen eines aktuellen Ansatzes. Deutsches Ärzteblatt 112:A1330–A1334

    Google Scholar 

  • Hoffmann M (2014) Zufallsbefunde in der epidemiologischen Forschung. In: Lenk C, Duttge G, Fangerau H (eds) Handbuch Ethik und Recht der Forschung am Menschen. Springer, Heidelberg, pp 305–311. doi:10.1007/978-3-642-35099-3_52

    Google Scholar 

  • Kohane IS, Masys DR, Altman RB (2006) The incidentalome: a threat to genomic medicine. JAMA 296(2):212–215

    Article  CAS  PubMed  Google Scholar 

  • Langanke M, Erdmann P (2011) Die MRT als wissenschaftliche Studienuntersuchung und das Problem der Mitteilung von Zufallsbefunden. Probandenethische Herausforderungen. In: Theißen H, Langanke M (eds) Tragfähige Rede von Gott. Festgabe für Heinrich Assel zum 50. Geburtstag am 9. Februar 2011. Verlag Dr. Kovač, Hamburg, pp 197–240

    Google Scholar 

  • Langanke M, Fasold J, Erdmann P, Lorbeer R, Liedtke W (2015) Informed consent in Gani_Med – a sectional design for clinical epidemiological studies within individualized medicine. In: Fischer T, Langanke M, Marschall P, Michl S (eds) Individualized medicine. Ethical, economical and historical perspectives. Springer, Heidelberg, pp 183–208

    Google Scholar 

  • Levine PA (2010) In an unspoken voice. How the body releases trauma and restores goodness. North Atlantic Books/ERGOS Institute Press, Berkley

    Google Scholar 

  • Munk MD, Peitzmann AD, Hostler DP, Wolfson AB (2010) Frequency and follow-up of incidental findings on trauma computed tomography scans: experience at a level one trauma center. J Emerg Med 38(3):346–350

    Article  PubMed  Google Scholar 

  • Presidential Commission for the Study of Bioethical Issues (eds) (2013) Anticipate and communicate. Ethical management of incidental and secondary findings in the clinical, research, and direct-to-consumer-contexts. http://bioethics.gov/node/3183. Accessed 12 Jan 2016

  • Puls R, Hamm B, Hosten N (2010) MRT ohne Radiologen – ethische Aspekte bei bevölkerungsbasierten Studien mit MR-Untersuchung. Fortschr Röntgenstr 182:469–471

    Article  CAS  Google Scholar 

  • Rudnik-Schöneborn S, Langanke M, Erdmann P, Robienski J (2014) Ethische und rechtliche Aspekte im Umgang mit genetischen Zufallsbefunden – Herausforderungen und Lösungsansätze. Ethik in der Medizin 26:105–119. doi:10.1007/s00481-013-0244-x

    Article  Google Scholar 

  • Al-Shahi Salman R, Whiteley WN, Warlow C (2007) Screening using whole-body magnetic resonance imaging scanning: who wants an incidentaloma? J Med Screen 14(1):2–4

    Article  PubMed  Google Scholar 

  • Schmidt CO, Hegenscheid K, Erdmann P, Kohlmann T, Langanke M, Völzke H, Puls R, Assel H, Biffar R, Grabe HJ (2013) Psychosocial consequences and severity of disclosed incidental findings from whole-body MRI in a general population study. Eur Radiol 23:1343–1351

    Article  PubMed  Google Scholar 

  • Schmücker R (2012) Zufallsbefunde – was gebietet die Menschenwürde? http://www.uni-muenster.de/imperia/md/content/kfg-normenbegruendung/intern/publikationen/schmuecker/36_-_schm__cker_-_zufallsbefunde_und_menschenw__rde.pdf. Accessed 07 Mar 2016

  • Strafgesetzbuch in der Fassung der Bekanntmachung vom 13. November 1998 (BGBl. I S. 3322), das durch Artikel 15 des Gesetzes vom 4. Juli 2013 (BGBl. I S. 1981) geändert worden ist. http://www.gesetze-im-internet.de/stgb/BJNR001270871.html#BJNR001270871BJNG000102307. Accessed 07 Mar 2016

  • The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1978) The Belmont report: ethical principles and guidelines for the protection of human subjects of research. Department of Health, Education, and Welfare, Washington (DC). http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html. Accessed 07 Mar 2016

  • The Royal College of Radiologists (eds) (2011) Management of incidental findings detected during research imaging. A report by representatives of research imaging centres, professional societies, regulatory bodies, funding organisations, royal colleges involved in research imaging and patient organisations, in the UK. https://www.rcr.ac.uk/sites/default/files/publication/BFCR%2811%298_ethics.pdf. Accessed 13 Jan 2016

  • WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. 64th WMA General Assembly, Fortaleza, Brazil, October 2013. http://www.wma.net/en/30publications/10policies/b3/. Accessed 07 Mar 2016

  • Wolf SM, Lawrence FP, Nelson CA, Kahn JP, Cho MK, Wright Clayton E, Fletcher JG, Georgieff MK, Hammerschmidt D, Hudson K, Illes J, Kapur V, Keane MA, Koenig BA, LeRoy BS, McFarland EG, Paradise J, Parker LS, Terry SF, Van Ness B, Wilfond BS (2008) Managing incidental findings in human subjects research: analysis and recommendations. J Law Med Ethics 36(2):219–248

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This publication originates from within the framework of the research network MENON – medical theoretical, ethical, and economical evaluation of System Medicine. The MENON Consortium is financed by the Bundesministerium für Bildung und Forschung (federal ministry of education and research) (01GP1408A and 01GP1408B).

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  1. Theologische Fakultät, Lehrstuhl für Systematische Theologie, Ernst-Moritz-Arndt-Universität Greifswald, Am Rubenowplatz 2–3, Greifswald, 17487, Germany

    Pia Erdmann

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  1. Pia Erdmann
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Correspondence to Pia Erdmann .

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Editors and Affiliations

  1. Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany

    Sabine Weckbach

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Erdmann, P. (2016). Incidental Findings – Ethical Aspects. In: Weckbach, S. (eds) Incidental Radiological Findings. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_69

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  • DOI: https://doi.org/10.1007/174_2016_69

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42579-5

  • Online ISBN: 978-3-319-42581-8

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