Résumés
Résumé
La recherche empirique sur la problématique de la discrimination génétique (DG) au Québec est généralement limitée. À ce titre, cette étude vise, au moyen d’une méthodologie qualitative, à explorer et à recueillir les opinions, les expériences et les connaissances des Québécois à l’égard de la DG. En concordance avec les objectifs exploratoires de cette étude, nous avons choisi l’approche du forum en ligne afin de pouvoir extraire des données qualitatives représentant le plus fidèlement possible les perspectives du public québécois sur différents thèmes touchant la DG. L’expérience du forum indique que des craintes tangibles existent par rapport à la DG au Québec, et que s’exprime le besoin d’un débat de société sur cet important enjeu faisant partie intégrante de la révolution génétique et des soins de santé personnalisés.
Abstract
Empirical research regarding genetic discrimination (GD) in the province of Quebec is largely limited. As such, this study aims, through a qualitative methodology, to explore and collect the opinions, experiences and knowledge of Quebecers regarding GD. In accordance with the exploratory objectives of this study, we chose the online forum approach as a means to extract qualitative data that would most accurately represent the perspectives of the Quebec public on various themes relating to GD. Participants’ comments on the forum indicate that there are tangible fears concerning DG in Quebec as well as a need for social debate on this important issue, as an integral part of the genetic revolution and personalized healthcare.
Parties annexes
Bibliographie
- 1. Durmaz AA, Karaca E, Demkow U, Toruner G, Schoumans J, Cogulu O. Evolution of Genetic Techniques: Past, Present, and Beyond. BioMed Research International [Internet]. 2015 [cité 19 juin 2019];2015:1‑7. Disponible à: http://www.hindawi.com/journals/bmri/2015/461524/
- 2. Birney E, Vamathevan J, Goodhand P. Genomics in healthcare: GA4GH looks to 2022. bioRxiv [Internet]. 15 oct 2017 [cité 19 juin 2019];203554. Disponible à: https://www.biorxiv.org/content/10.1101/203554v1
- 3. Joly Y, Dupras C, Ngueng Feze I, Song L. La discrimination génétique au Québec: une approche proactive et flexible pour contrer un enjeu de société complexe [Internet]. Montreal, Canada: Centre de Génomique et Politiques (CGP); 2017 oct [cité 28 mars 2018]. Disponible à: http://www.genomequebec.com/DATA/PUBLICATION/32_fr~v~La_discrimination_genetique_au_Quebec_-_document_d_orientation_politique.pdf
- 4. Collins SA, Gesner E, Morgan S, Mar P, Maviglia S, Colburn D, et al. A Practical Approach to Governance and Optimization of Structured Data Elements [Internet]. 2015. 7 p. (Studies in Health Technology and Informatics; vol. 216). Disponible à: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84952063706&doi=10.3233%2f978-1-61499-564-7-7&partnerID=40&md5=228e424f45b89bb1a44a24ea99f33769
- 5. Otlowski M, Taylor S, Bombard Y. Genetic Discrimination: International Perspectives. Annu Rev Genom Hum Genet [Internet]. 22 sept 2012 [cité 21 nov 2019];13(1):433‑54. Disponible à: http://www.annualreviews.org/doi/10.1146/annurev-genom-090711-163800
- 6. Salman S, Ngueng Feze I, Joly Y. La divulgation de l’information génétique en assurances. Canadian Bar Review [Internet]. 2014 [cité 7 janv 2016];93:501‑36. Disponible à: https://www.researchgate.net/profile/Yann_Joly/publication/289779051_Divulgation_de_l’information_genetique_en_assurances/links/56cb233008ae1106370b73b0.pdf
- 7. Joly Y, Ngueng Feze I, Simard J. Genetic discrimination and life insurance: a systematic review of the evidence. BMC medicine [Internet]. 2013 [cité 10 juin 2013];11(1):1‑15. Disponible à: http://www.biomedcentral.com/content/pdf/1741-7015-11-25.pdf
- 8. Bombard Y, Abelson J, Simeonov D, Gauvin F-P. Citizens’ perspectives on personalized medicine: a qualitative public deliberation study. Eur J Hum Genet [Internet]. 23 janv 2013 [cité 15 mai 2013];21:1197–1201. Disponible à: http://www.nature.com/ejhg/journal/vaop/ncurrent/full/ejhg2012300a.html
- 9. Adjin-Tettey E. Potential for Genetic Discrimination in Access to Insurance: Is There a Dark Side to Increased Availability of Genetic Information. Alta L Rev [Internet]. 2012 [cité 5 janv 2016];50:577. Disponible à: http://heinonlinebackup.com/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/alblr50§ion=31
- 10. Joly Y, Burton H, Knoppers BM, Feze IN, Dent T, Pashayan N, et al. Life insurance: genomic stratification and risk classification. Eur J Hum Genet [Internet]. mai 2014 [cité 5 mai 2020]; 22(5):575‑9. Disponible à: http://www.nature.com/articles/ejhg2013228
- 11. Walker J. La discrimination génétique dans le droit canadien [Internet]. Parlement du Canada. 2014 [cité 21 mai 2015]. Disponible à: https://bdp.parl.ca/sites/PublicWebsite/default/fr_CA/ResearchPublications/201490E
- 12. Canada. Loi sur la non-discrimination génétique, LC 2017, c 3 [Internet]. 2017 [cité 30 mai 2017]. Disponible à: https://www.canlii.org/fr/ca/legis/loisa/lc-2017-c-3/derniere/lc-2017-c-3.html
- 13. ACCG. S-201: fact sheet [Internet]. Association Canadienne des Conseillers Génétiques. 2017 [cité 14 juin 2019]. Disponible à: https://www.cagc-accg.ca/doc/S201%20fact%20sheet%20-%20final%20copy%20-%20May%2017%202017.pdf
- 14. CLHIA. Industry Code: Genetic Testing Information for Insurance Underwriting [Internet]. Canadian Life and Health Insurance Association. 2017 [cité 19 juin 2017]. Disponible à: https://www.clhia.ca/domino/html/clhia/CLHIA_LP4W_LND_Webstation.nsf/page/6EBFE54D9D076C568525780E0056B1BE?OpenDocument
- 15. Bombard Y, Heim-Myers B. The Genetic Non-Discrimination Act: critical for promoting health and science in Canada. CMAJ [Internet]. 14 mai 2018 [cité 24 mai 2018];190(19): E579‑80. Disponible à: http://www.cmaj.ca/content/190/19/E579
- 16. Joly Y, Dalpé G. Vers une discrimination génétique au Canada? [Internet]. Droit-Inc. 2019 [cité 19 mars 2019]. Disponible à: http://www.droit-inc.com/article24362-Vers-une-discrimination-genetique-au-Canada
- 17. Bombard Y, Veenstra G, Friedman JM, Creighton S, Currie L, Paulsen JS, et al. Perceptions of genetic discrimination among people at risk for Huntington’s disease: a cross sectional survey. BMJ [Internet]. 9 juin 2009 [cité 13 oct 2015];338:b2175. Disponible à: http://www.bmj.com/cgi/doi/10.1136/bmj.b2175
- 18. Bombard Y, Palin J, Friedman JM, Veenstra G, Creighton S, Paulsen JS, et al. Factors associated with experiences of genetic discrimination among individuals at risk for huntington disease. Am J Med Genet [Internet]. janv 2011 [cité 21 nov 2019];156(1):19‑27. Disponible à: http://doi.wiley.com/10.1002/ajmg.b.31130
- 19. Bombard Y, Palin J, Friedman JM, Veenstra G, Creighton S, Bottorff JL, et al. Beyond the patient: The broader impact of genetic discrimination among individuals at risk of Huntington disease. Am J Med Genet [Internet]. 1 mars 2012 [cité 6 oct 2015];159B(2):217‑26. Disponible à: http://onlinelibrary.wiley.com/doi/10.1002/ajmg.b.32016/abstract
- 20. Erwin C, Williams JK, Juhl AR, Mengeling M, Mills JA, Bombard Y, et al. Perception, experience, and response to genetic discrimination in Huntington disease: The international RESPOND-HD study. Am J Med Genet [Internet]. juillet 2010 [cité 13 oct 2015];153B (5):1081‑93. Disponible à: http://onlinelibrary.wiley.com/doi/10.1002/ajmg.b.31079/abstract
- 21. Bombard Y, Miller FA, Hayeems RZ, Barg C, Cressman C, Carroll JC, et al. Public views on participating in newborn screening using genome sequencing. European Journal of Human Genetics [Internet]. nov 2014 [cité 21 juill 2020];22(11):1248‑54. Disponible à: https://www.nature.com/articles/ejhg201422
- 22. Dalpé G, Ngueng Feze I, Salman S, Joly Y, Hagan J, Lévesque E, et al. Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers. Frontiers in Genetics [Internet]. 21 sept 2017 [cité 21 sept 2017];8. Disponible à: http://journal.frontiersin.org/article/10.3389/fgene.2017.00128/full
- 23. Yan W, Sivakumar G, Xenos MA. It’s not cricket: examining political discussion in nonpolitical online space. Information, Communication & Society [Internet]. 2 nov 2018 [cité 11 juin 2019];21(11):1571‑87. Disponible à: https://doi.org/10.1080/1369118X.2017.1340499
- 24. Im E-O, Chee W. Practical Guidelines for Qualitative Research Using Online Forums. Comput Inform Nurs [Internet]. nov 2012 [cité 20 mars 2018];30(11):604‑11. Disponible à: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727223/
- 25. Tanis M. Health-Related On-Line Forums: What’s the Big Attraction? Journal of Health Communication [Internet]. 28 oct 2008 [cité 21 juin 2019];13(7):698‑714. Disponible à: https://doi.org/10.1080/10810730802415316
- 26. Griffiths MD, Lewis AM, Ortiz De Gortari AB, Kuss DJ. Online forums and solicited blogs: innovative methodologies for online gaming data collection. Studia Psychologica [Internet]. 20 sept 2016 [cité 20 mars 2018];15(2):101. Disponible à: http://czasopisma.uksw.edu.pl/index.php/sp/article/view/56
- 27. Jamison J, Sutton S, Mant J, Simoni AD. Online stroke forum as source of data for qualitative research: insights from a comparison with patients’ interviews. BMJ Open [Internet]. 1 mars 2018 [cité 20 juin 2019];8(3):e020133. Disponible à: https://bmjopen.bmj.com/content/8/3/e020133
- 28. Habermas J. Between facts and norms: An author’s reflections. Denver University Law Review. 1999;76(4):937‑42.
- 29. Bohman J. Realizing Deliberative Democracy as a Mode of Inquiry: Pragmatism, Social Facts, and Normative Theory. The Journal of Speculative Philosophy [Internet]. 2004 [cité 15 oct 2018];18(1):23‑43. Disponible à: http://muse.jhu.edu/content/crossref/journals/journal_of_speculative_philosophy/v018/18.1bohman.html
- 30. Joly Y, Dalpé G, Pinkesz M. Is Genetic Discrimination back on the Radar? A commentary on the recent Court of Appeal Reference decision on the Genetic Non-Discrimination Act (GNDA). Canadian Journal of Bioethics. août 2019;(in press).
- 31. Discourse. What is Discourse? [Internet]. Discourse - Civilized Discussion. 2019 [cité 7 juin 2019]. Disponible à: https://discourse.org/about
- 32. Joly Y, Dalpé G, Dupras C, Bévière-Boyer B, de Paor A, Dove ES, et al. Establishing the International Genetic Discrimination Observatory. Nat Genet [Internet]. mai 2020 [cité 28 sept 2020];52(5):466‑8. Disponible à: http://www.nature.com/articles/s41588-020-0606-5
- 33. Observatoire de la discrimination génétique - Accueil [Internet]. Observatoire de la discrimination génétique. 2020 [cité 27 oct 2020]. Disponible à: https://gdo.global
- 34. NVivo. Logiciel NVivo pour la recherche qualitative [Internet]. 2019 [cité 17 juin 2019]. Disponible à: http://www.qsrinternational.com/nvivo-french
- 35. Graham T, Witschge T. In search of online deliberation: Towards a new method for examining the quality of online discussions. Communications [Internet]. 2003;28(2):173‑204. Disponible à: https://www.scopus.com/inward/record.uri?eid=2-s2.0-28144439613&doi=10.1515%2fcomm.2003.012&partnerID=40&md5=960cd249f8de784486e33496457c21fd
- 36. Stromer-Galley J. Measuring deliberation’s content: A coding scheme. Journal of Public Deliberation [Internet]. 2007;3(1). Disponible à: https://www.scopus.com/inward/record.uri?eid=2-s2.0-34447299899&partnerID=40&md5=2951f70fa9aa0baa47b233cbe3115a86
- 37. Friess DM. Letting the faculty deliberate: analyzing online deliberation in academia using a comprehensive approach. Journal of Information Technology and Politics [Internet]. 2018;15(2):155‑77. Disponible à: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85045745872&doi=10.1080%2f19331681.2018.1460286&partnerID=40&md5=82fe89ed1a18901819a517447abf45cd
- 38. Government of Canada SC. Education in Canada: Key results from the 2016 Census [Internet]. 2017 [cité 2 nov 2020]. Disponible à: https://www150.statcan.gc.ca/n1/daily-quotidien/171129/dq171129a-eng.htm
- 39. Discourse. Discourse Hub [Internet]. App Store. 2019 [cité 11 juin 2019]. Disponible à: https://apps.apple.com/us/app/discourse-hub/id1173672076
- 40. Rowe G, Gammack JG. Promise and perils of electronic public engagement. Sci Public Policy [Internet]. 1 févr 2004 [cité 19 nov 2020];31(1):39‑54. Disponible à: https://academic.oup.com/spp/article/31/1/39/1672374
- 41. Williams SN. A twenty-first century citizens’ POLIS: Introducing a democratic experiment in electronic citizen participation in science and technology decision-making. Public Understanding of Science [Internet]. 2010;19(5):528‑44. Disponible à: https://www.scopus.com/inward/record.uri?eid=2-s2.0-78650965770&doi=10.1177%2f0963662509104726&partnerID=40&md5=9e6c14e8ebe3ea659882009b5fcef863
- 42. Jensen JL. Public Spheres on the Internet: Anarchic or Government-Sponsored – A Comparison. Scandinavian Political Studies [Internet]. 2003 [cité 17 juill 2020];26(4):349‑74. Disponible à: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-9477.2003.00093.x
- 43. Phoenix Strategic Perspectives Inc. 2018-19 Survey of Canadians on Privacy [Internet]. Office of the Privacy Commissioner of Canada; 2019 mai [cité 31 juill 2019]. Disponible à: https://www.priv.gc.ca/en/opc-actions-and-decisions/research/explore-privacy-research/2019/por_2019_ca/
- 44. Otlowski M, Stranger M, Taylor S, Barlow-Stewart K. Practices and Attitudes of Austrian Employers in Relation to the Use of Genetic Information: Report on a National Study. Comp Lab L & Pol’y J [Internet]. 2010 2009;31:637. Disponible à: https://heinonline.org/HOL/Page?handle=hein.journals/cllpj31&id=647&div=&collection=
- 45. Canada. Syndicat des infirmières, inhalothérapeutes, infirmières auxiliaires du Coeur du Québec (SIIIACQ) c. Centre hospitalier régional de Trois-Rivières [Internet]. 2012 QCCA 1867. Disponible à: http://canlii.ca/t/ft9kv
- 46. Canada. Loi sur la non-discrimination génétique [Internet]. LC 2017, c 3. Disponible à: https://www.canlii.org/fr/ca/legis/loisa/lc-2017-c-3/derniere/lc-2017-c-3.html
- 47. Pioro M, Mykitiuk R, Finkler L, Nisker J. Understanding the Use of’Genetic Predisposition’in Canadian Legal Decisions. McGill Journal of Law and Health [Internet]. 2013 [cité 7 mars 2017];7(1):1‑65. Disponible à: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2457019
- 48. Bombard Y, Penziner E, Suchowersky O, Guttman M, Paulsen JS, Bottorff JL, et al. Engagement with genetic discrimination: concerns and experiences in the context of Huntington disease. Eur J Hum Genet [Internet]. 24 oct 2007 [cité 20 juin 2017];16(3):279‑89. Disponible à: https://www.nature.com/articles/5201937
- 49. Joly Y, Ngueng Feze I, Song L, Knoppers BM. Comparative Approaches to Genetic Discrimination: Chasing Shadows? Trends in Genetics. 2017;33(5):299‑302.
- 50. Macdonald AS. Genetic Factors in Life Insurance: Actuarial Basis. Dans: eLS [Internet]. Chichester, UK: American Cancer Society; 2009 [cité 9 nov 2020]. Disponible à: https://onlinelibrary.wiley.com/doi/abs/10.1002/9780470015902.a0005207.pub2
- 51. Goldberg S. Insurers lose genetic testing fight [Internet]. Advisor’s Edge. 2017 [cité 17 nov 2020]. Disponible à: https://www.advisor.ca/insurance/life/insurers-lose-genetic-testing-fight/
- 52. Habermas J. The future of human nature. Cambridge, UK: Polity; 2003. 127 p.
- 53. Morar N. An Empirically Informed Critique of Habermas’ Argument from Human Nature. Sci Eng Ethics [Internet]. févr 2015 [cité 9 nov 2020];21(1):95‑113. Disponible à: http://link.springer.com/10.1007/s11948-013-9509-5
- 54. Nuffield Council on Bioethics. Genome editing and human reproduction: social and ethical issues (short guide) [Internet]. London: Nuffield Council on Bioethics; 2018 juill [cité 27 nov 2018]. Disponible à: http://nuffieldbioethics.org/wp-content/uploads/Genome-editing-and-human-reproduction-short-guide-website.pdf
- 55. Mulvihill JJ, Capps B, Joly Y, Lysaght T, Zwart HAE, Chadwick R. Ethical issues of CRISPR technology and gene editing through the lens of solidarity. Br Med Bull [Internet]. 1 juin 2017 [cité 29 août 2017];122(1):17‑29. Disponible à: https://academic.oup.com/bmb/article/122/1/17/3045812/Ethical-issues-of-CRISPR-technology-and-gene
- 56. Taylor S, Treloar S, Barlow‐Stewart K, Stranger M, Otlowski M. Investigating genetic discrimination in Australia: a large-scale survey of clinical genetics clients. Clinical Genetics [Internet]. 2008 [cité 20 juill 2020];74(1):20‑30. Disponible à: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-0004.2008.01016.x
- 57. Thomas RG. Genetics and insurance in the United Kingdom 1995–2010: the rise and fall of “scientific” discrimination. New Genetics and Society [Internet]. juin 2012 [cité 13 oct 2015];31(2):203‑22. Disponible à: http://dx.doi.org/10.1080/14636778.2012.662046
- 58. Rothstein MA. Genetic Exceptionalism & Legislative Pragmatism. Hastings Center Report [Internet]. 2005 [cité 1 mars 2017];35(4):27‑33. Disponible à: http://muse.jhu.edu/content/crossref/journals/hastings_center_report/v035/35.4rothstein.pdf
- 59. Geller G, Bernhardt BA, Holtzman NA. The Media and Public Reaction to Genetic Research. JAMA. 13 févr 2002;287(6):773.
- 60. Garon G. Passer un test génétique et risquer de voir le prix de son assurance augmenter drastiquement [Internet]. Radio-Canada.ca. 2016 [cité 30 oct 2018]. Disponible à: https://ici.radio-canada.ca/nouvelle/779390/test-genetique-discrimination-canada-assurances
- 61. Buzzetti H. Le milieu médical salue la loi contre la discrimination génétique. Le Devoir [Internet]. mai 2017 [cité 20 mars 2018]; Disponible à: http://www.ledevoir.com/politique/canada/499888/le-milieu-medical-salue-la-loi-contre-la-discrimination-genetique
- 62. Bombard Y, Cohn R, Scherer S. Why we need a law to prevent genetic discrimination. The Globe and Mail [Internet]. 17 mai 2018 [cité 26 juin 2019]; Disponible à: https://www.theglobeandmail.com/opinion/why-we-need-a-law-to-prevent-genetic-discrimination/article31936476/
- 63. Gold K. How genetic testing can be used against you – and how Bill S-201 could change that. The Globe and Mail [Internet]. 16 mai 2018 [cité 29 mai 2018]; Disponible à: https://www.theglobeandmail.com/life/health-and-fitness/health/bill-s-201-aims-to-end-genetic-discrimination-in-canada/article29494782/
- 64. Koffler Fogel S. Genetic Discrimination Means the Choice Between Life and Life Insurance. HuffPost Canada [Internet]. 12 déc 2014 [cité 14 mai 2020]; Disponible à: https://www.huffingtonpost.ca/shimon-koffler-fogel/genetic-discrimination_b_6308322.html
- 65. Hendry L. Women fear genetic test for breast cancer could boost insurance costs | CBC News. CBC [Internet]. 28 janv 2016 [cité 14 mai 2020]; Disponible à: https://www.cbc.ca/news/canada/montreal/women-fear-genetic-test-for-breast-cancer-could-drive-up-insurance-costs-1.3423137
- 66. Wauters A, Hoyweghen IV. Global trends on fears and concerns of genetic discrimination: a systematic literature review. J Hum Genet [Internet]. avr 2016 [cité 5 mai 2020];61(4):275‑82. Disponible à: https://www.nature.com/articles/jhg2015151
- 67. Cour d’appel du Québec. Dans l’affaire du: Renvoi relatif à la Loi sur la non-discrimination génétique édictée par les articles 1 à 7 de la Loi visant à interdire et à prévenir la discrimination génétique [Internet]. 2018 [cité 4 mars 2019]. Disponible à: http://canlii.ca/t/hwql3