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Privacy and Confidentiality in the Publication of Pedigrees
A Survey of Investigators and Biomedical Journals
Jeffrey R. Botkin, MD, MPH;
William M. McMahon, MD;
Ken R. Smith, PhD;
Jean E. Nash
JAMA. 1998;279:1808-1812.
Context.— Pedigree diagrams efficiently communicate family information to genetics investigators; however, the publication of pedigrees poses a risk to the privacy and confidentiality of individuals depicted in the diagrams. Two sets of authoritative guidelines have been published to protect the privacy and confidentiality of subjects, but the influence of these guidelines on publication practices for pedigrees is unknown.
Objective.— To determine the attitudes, practices, and experiences of investigators and journals with respect to privacy and confidentiality concerns in the publication of pedigrees.
Design.— Investigators who have published pedigrees and editors of 26 biomedical journals were surveyed. Journals were reviewed for content in their "information for authors" sections and for documentation of informed consent in articles containing pedigrees.
Outcome Measures.— Practices regarding confidentiality and privacy reported by investigators and editors.
Results.— Of 226 surveys sent to investigators, 177 were returned (78% response rate). Sixty-one investigators (36%) stated that family members were not informed that their pedigree would be published; 131 (78%) do not obtain informed consent specifically for pedigree publication and only 12 (28%) of the 43 who obtained consent obtained consent from all family members depicted. Thirty-two individuals (19%) reported having altered published pedigrees and 14 (45%) of 31 who had altered pedigrees stated that alterations were not disclosed to journals. Of the 14 journals that responded (54% response rate), only 3 reported written policies for managing potentially identifying information. Two journals reported having asked authors to alter pedigrees and 3 stated they had permitted alterations. A review of 5 genetics journals over a 2-year period revealed no documentation of consent for pedigree publication.
Conclusions.— Current practices in the publication of pedigrees do not conform with established recommendations and risk the privacy and confidentiality of subjects, often without informed consent. Attempts to address this problem through the alteration of data are being used, although this practice impairs the integrity of scientific communication.
From the Department of Pediatrics and the Division of Medical Ethics (Dr Botkin), Department of Psychiatry (Dr McMahon), Department of Family and Consumer Studies (Dr Smith), and the Department of Human Genetics (Ms Nash), University of Utah, Salt Lake City.
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