The objective of this training and research project is to develop the candidate into an independent and interdisciplinary ELSI researcher, with the ability to intertwine qualitative empirical with normative approaches to issues in genetics and genomics. To accomplish this objective, I have proposed: (1) Training that builds upon my previous education and experience as a qualitative social scientist with additional training in genetics and bioethics;and (2) Research that takes a combined social scientific and bioethical approach to understanding and guiding the translational pathways of new genetic innovations. The proposed training includes coursework, directed readings, seminars and workshops, and the mentored development of an interdisciplinary ELSI research project. The long-term goal of the research project is to map out an ELSI-integrated translational pathway for genetic innovations: building a model of crucial points for, and types of, ELSI guidance throughout these translational processes.
The specific Aims of this project are: (1) To follow the unfolding translational pathway of cffDNA testing technology, as a case study in translation processes for genetic innovations;and (2) To map crucial points for ELSI guidance along the translational pathway of genetic innovations. Through individual interviews with stakeholders and observations of meetings and conferences of stakeholders, this mapping project will examine the case of cell-free fetal DNA (cffDNA) testing and the actors and networks that influence its development toward potential clinical applications. Comparing features of this process with those of other translations of genetic innovations, it will identify critical moments, turning points, and intersections at which important decisions shape the unfolding translational pathway. Finally, through collaboration with key stakeholders in cffDNA and non-invasive prenatal testing, a model will be developed that proposes types of ethical and social guidance for these crucial points that would likely be most beneficial.

Public Health Relevance

A significant part of the role of ELSI research is the identification and integration of ELSI considerations into translational research, promoting improved public health, health equity for underserved groups, concern for community values, and protection for vulnerable populations. Through detailed examination of the development of cell-free fetal DNA testing, this project will add complexity and contingency to existing models of the translational pathway. This, in turn, will lead to fuller and more situationally-responsive integration of ELSI guidance along the entire translational pathway for genetic innovations.

National Institute of Health (NIH)
National Human Genome Research Institute (NHGRI)
Research Transition Award (R00)
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Special Emphasis Panel (NSS)
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Boyer, Joy
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University of California San Francisco
Other Health Professions
Schools of Nursing
San Francisco
United States
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Stoll, Katie A; Mackison, Amanda; Allyse, Megan A et al. (2018) Conflicts of interest in genetic counseling: persistent underlying questions. Genet Med 20:1096-1097
Michie, Marsha; Allyse, Megan; Stoll, Katie A et al. (2018) Weaponizing Hope: Sources of Hope, Unrealistic Optimism, and Denial. Am J Bioeth 18:25-27
Michie, Marsha; Allyse, Megan (2018) Gene modification therapies: views of parents of people with Down syndrome. Genet Med :
Allyse, Megan; Evans, James P; Michie, Marsha (2017) Dr. Pangloss's Clinic: Prenatal Whole Genome Sequencing and a Return to Reality. Am J Bioeth 17:21-23
Mozersky, Jessica; Ravitsky, Vardit; Rapp, Rayna et al. (2017) Toward an Ethically Sensitive Implementation of Noninvasive Prenatal Screening in the Global Context. Hastings Cent Rep 47:41-49
Stoll, Katie A; Mackison, Amanda; Allyse, Megan A et al. (2017) Conflicts of interest in genetic counseling: acknowledging and accepting. Genet Med 19:864-866
Steinbach, Rosemary J; Allyse, Megan; Michie, Marsha et al. (2016) ""This lifetime commitment"": Public conceptions of disability and noninvasive prenatal genetic screening. Am J Med Genet A 170A:363-374
Gammon, B L; Kraft, S A; Michie, M et al. (2016) ""I think we've got too many tests!"": Prenatal providers' reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening. Ethics Med Public Health 2:334-342
Floyd, Erin; Allyse, Megan A; Michie, Marsha (2016) Spanish- and English-Speaking Pregnant Women's Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections. J Genet Couns 25:965-77
Michie, Marsha; Kraft, Stephanie A; Minear, Mollie A et al. (2016) Informed decision-making about prenatal cfDNA screening: An assessment of written materials. Ethics Med Public Health 2:362-371

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