Anticipating ethical aspects of the use of biomarkers in the workplace: A tool for stakeholders

This research aimed to understand how occupational health stakeholders represented the various ethical concerns raised by the use of biomarkers of exposure, effects and susceptibility to harmful agents. These representations were investigated by seven homogeneous focus group interviews and an Internet discussion forum. The following stakeholders took part in this research: workers, physicians, nurses, researchers, employers, industrial hygienists, trade-union representatives and employees of the Quebec Board of Health and Safety in the Workplace. The data were analyzed qualitatively using a constant comparison technique. The main ethical problems raised by the stakeholders were organized around three emergent themes: a narrative of science, the validation of biomarkers and the protection of workers. From these themes emanate the principal ethical problems raised by the stakeholders: confidentiality, the interpretation of data, consent and information, as well as an advantages/disadvantages ratio. These problems are described as ethical tension zones. The analysis also takes into account the impact of the representations that each group of stakeholders has of each other and the ethical problems that can arise. Because it is drawn from a study of stakeholders' representations, the resulting analytical model might also be used to anticipate the root of ethical problems generated by the use of the biomarkers in an occupational health context. (c) 2007 Elsevier Ltd. All rights reserved.