Abstract
In this paper, we discuss the experience of a team of geneticists, working in partnership with a Brazilian social movement aimed at promoting the rights of victims of Hansen’s disease. These university researchers propose to use DNA test results to ascertain kinship connections and thereby reunite families that were sundered apart by draconian state policies of the mid-twentieth century that decreed the forced segregation of leprosy patients and the institutionalization of their children. The team’s aim is to help revert stigma and reinforce positive group identity as well as to facilitate judicial claims to moral and financial reparation from the Brazilian state. We will discuss how, notwithstanding the voluntary nature of tests, mediated at all times through the social movement, the geneticists take care to follow clear ethical guidelines in the collection and stocking of DNA samples as well as in the devolution of test results. The subsequent inclusion of anthropologists in the team brings to the fore new ethical dilemmas ranging from procedures in field research to the possible consequences of research results.
This is a preview of subscription content, access via your institution.
Notes
In 1976, by international accord, the disease was renamed “Hansen’s disease,” to avoid the discriminatory connotations of the previous term (Oliveira et al. 2003).
Decreto n° 968 (Brasil 1962).
The movement’s leaders present their political activism as a collective process as opposed to the judicial review of cases one-by-one, apparent in what scholars call the judicialization of patients’ rights in Brazil (Biehl and Petryna 2013).
WorkGroup: http://www.morhan.org.br/views/upload/relfilhossep.pdf. Acessed 03 November 2014.
The lack (or adulteration) of personal ID documents, common in Brazilian history, may have been exacerbated, here, by the question of stigma linked to leprosy (see Maricato 2014).
Saliva samples were collected from 345 people in ten cities (Rio Branco, Cruzeiro do Sul, Manaus, Vitória, Betim, Três Corações, Belém, Natal, Porto Alegre e Santa Terezinha) from nine Brazilian states (Acre, Amazonas, Espírito Santo, Minas Gerais, Pará, Pernambuco, Rio Grande do Norte, Rio Grande do Sul e São Paulo). Of these 345 samples, 284 involve comparison with a possible relative (family groups with two or three samples) and 61 are destined to a “genetic bank” involving individuals who have not located their relatives. The DNA of these individuals remains in stock, awaiting the appearance of a possible relative with whom to run the test for biological relationship.
In some cases, the other person to be tested is not present at the moment and the researchers have to schedule a new time and place to collect the corresponding sample.
The tests were run with standard PCR-STR kits using 17 genetic markers. Samples were examined twice, through independent preparations on two separate days, according to international standards of quality control. Test results were interpreted by comparing samples from two individuals and determining, through the use of genetic population indexes, the probability of a biological link.
References
Abu-Lughod L (2010) The active social life of Muslim human rights. A plea for ethnography, not polemic, with cases from Egypt and Palestine. J Middle East Women’s Studies 6(1):1–45
Bechler R (2009) Muito mais do que isolamento em questão: ciência, poder e interesses em uma análise das duas primeiras Conferências Internacionais de Lepra – Berlim 1897 e Bergen 1909. Belo Horizonte Temporalidades 2:175–201
Biehl J, Petryna A (2013) Legal remedies: therapeutic markets and the judicialization of the right to health. In: Biehl J, Petryna A (eds) When people come first: critical studies in global health. Princeton University Press, Princeton
Brasil, Ministério da Saúde (1960) Manual de Leprologia. Rio de Janeiro: Departamento Nacional de Saúde, Serviço Nacional de Lepra. http://bvsms.saude.gov.br/bvs/publicacoes/manual_leprologia.pdf. Acessed 03 November 2014
Brasil, Ministério da Saúde. Portaria n°165 de 14 de maio de 1976
Brasil. Decreto Federal n° 968, de 7 de maio de 1962
Cunha V (2010) Isolated ‘like us’ or isolated ‘among us’?: the controversy within the National Academy of Medicine over compulsory isolation of leprosy sufferers. Rio de Janeiro, História, Ciências, Saúde - Manguinhos 17(4):939–954
Curi L (2010) Excluir, isolar e conviver: um estudo sobre a lepra e a hanseníase no Brasil. Ph.D. Dissertation in History, Federal University of Minas Gerais (UFMG)
Dolgin J (2008) Biological evaluations: blood, genes, and family. Akron Law Rev 41:347–398
Fassin D (2012) Introduction: toward a critical moral anthropology. In: Fassin D (ed) A companion to moral anthropology. Wiley-Blackwell, Oxford
Fleischer S (2007) Antropólogos ‘anfíbios’? Alguns comentários sobre a relação entre Antropologia e intervenção no Brasil. Revista Anthropológicas 18(1):37–70
Fonseca C (2009) Doubt is the mother of all invention: DNA and paternity in a Brazilian setting. In: Birenbaum-Carmeli D, Inhorn M (eds) Assisting reproduction, testing genes: global encounters with new biotechnologies. Berghahn Books, London, pp 258–284
Fonseca C, Maricato G (2013) Criando comunidade: emoção, reconhecimento e depoimentos de sofrimento, vol 15. Interseções (UERJ), Rio de Janeiro, pp 252–274
Gibbon S (2004) Re-examinando a ‘genetização’: árvores familiares na genética do câncer de mama. Política e trabalho 20:35–60
Gibbon S (2013) Ancestry, temporality, and potentiality: engaging cancer genetics in Southern Brazil. Curr Anthropol 54(7):107–117
Hautaniemi P (2007) Conectando famílias de construções genéticas: testes de DNA na reunificação da família somali na Finlândia, vol 29. Cadernos Pagu, Campinas, pp 285–303
Jasanoff S (1995) Science at the bar: law, science, and technology in America. Harvard University Press, Cambridge
Kowal E, Radin J, Reardon J (2013) Indigenous body parts, mutating temporalities, and the half-lives of postcolonial techno science. Soc Stud Sci 43:465–483
Machado H, Moniz H (2014) Bases de dados genéticos forenses: Tecnologias de controlo e ordem social. Coimbra Editora, Coimbra
Maciel L (2007) Em defesa dos sãos perde Lázaro a liberdade: uma história das políticas públicas de combate à lepra no Brasil (1941-1962). PhD Tesis in History, Federal University of Fluminense (UFF)
Maricato G (2014) Direitos Humanos, papéis e hanseníase: múltiplos testemunhos na produção de provas da internação compulsória. Natal, Anais da 29ª RBA
Monteiro Y (1995) Da maldição divina a exclusão social: um estudo da hanseníase em São Paulo. Ph.D. Dissertation in Philosophy, University of São Paulo (USP)
Monteiro Y (2003) Prophylaxis and exclusion: compulsory isolation of Hansen’s disease patients in São Paulo. Rio de Janeiro, História, Ciências, Saúde - Manguinhos 10(1):95–121
Oliveira M, Mendes M, Tardin T, Cunha D, Arruda A (2003) Social representation of Hansen’s disease thirty years after the term leprosy was replaced in Brazil. Rio de Janeiro, História, Ciências, Saúde - Manguinhos 10(1):41–48
Opromolla P, Laurenti R (2011) Hansen’s disease control in the state of São Paulo: a historical analysis. Rev Saúde Pública 45(1):1–8
Penchaszadeh V (2012) Uso de la identificación genética en la reparación de la violación del derecho a la identidad durante la dictadura militar argentina. In: Penchaszadeh VB (ed) Genética y derechos humanos. Encuentros y desencuentros. Paidós, Buenos Aires, pp 263–298
Penchaszadeh V, Schuler-Faccini L (2014) Genetics and human rights. Two histories: restoring genetic identity after forced disappearance and identity suppression in Argentina and after compulsory isolation for leprosy in Brazil. Genet Mol Biol 37(1):299–304
Santos R, Maio M (2004) Race, genomics, identities and politics in contemporary Brazil. Crit Anthropol 24:347–378
Schuch P (2011) A vida social ativa da ética na antropologia. São Paulo. Revista Brasileira de Informação Bibliográfica em Ciências Sociais 71:5–24
Schuler-Faccini L, Osório C, Romariz F, Paneque M, Sequeiros J, Jardim L (2014) Genetic counseling and presymptomatic testing programs for Machado-Joseph disease: lessons from Brazil and Portugal. Genet Mol Biol 37:263–270
Víctora C (2004) Ética de pesquisa em equipe multidisciplinar. In: Víctora C et al (eds) Antropologia e ética: o debate atual no Brasil. Federal University of Fluminense (UFF), Niterói, pp 83–88
Weaver E (1944) Social service in the fight against leprosy in Brazil. Leprosy News and Notes. http://ila.ilsl.br/pdfs/v11a14.pdf. Acessed 01 November 2014
White C (2003) Carville and Curupaiti: experiences of confinement and community. Rio de Janeiro, História, Ciências, Saúde - Manguinhos 10(1):123–141
Acknowledgments
We thank Hugo Bock and Maria Luiza-Saraiva Pereira (University Federal of Rio Grande do Sul - UFRGS) for their invaluable collaboration in the laboratory analysis; to Movimento de Reintegração das Pessoas Atingidas pela Hanseníase (MORHAN) for the logistic support during field trips.
Compliance with ethical standards
The research complies with the current Brazilian Ethics Guideline in Genetics and Anthropology. Participation in the study was entirely voluntary and the confidentiality of data was respected at all times.
Conflict of interest
Claudia Lee Williams Fonseca, Flávia Costa Biondi, Glaucia Cristina Maricato, and Lavínia Schuler-Faccini declare that they have no conflict of interest. This project was funded by the Brazilian Research Council (CNPq)—National Institute of Population Medical Genetics (INAGEMP)—process 573993/2008-4.
Author information
Authors and Affiliations
Corresponding authors
Additional information
This article is part of the special issue on “Genetics and Ethics in Latin America”.
Claudia Lee Williams Fonseca and Flávia Costa Biondi contributed equally to this work.
Rights and permissions
About this article
Cite this article
Fonseca, C.L.W., Biondi, F.C., Maricato, G.C. et al. Project REENCONTRO: ethical aspects of genetic identification in families separated by the compulsory isolation of leprosy patients in Brazil. J Community Genet 6, 215–222 (2015). https://doi.org/10.1007/s12687-015-0227-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12687-015-0227-3
Keywords
- Hansen’s disease
- Human rights
- DNA
- Kinship
- Ethics
- Leprosy