Ethical endgames: broad consent for narrow interests; open consent for closed minds.

The ongoing legal and bioethics debates on consent requirements for collecting, storing, and utilizing human biological material for purposes of basic and applied research—that is, genomic research biobanking—have already managed to pass through three ostensibly dissimilar stages: during the last two decades or so, a mudslide of research papers, policies, and guidelines have been produced advocating anything from (1) presumed consent; to (2) expressed, full-blown informed consent; to the current mode of (3) broad consent. Although it would be tempting to reconstruct these stages according to a historical dialectic, in which the latest consent model supersedes (aufhebt) the preceding ones, a critical analysis of the debate does not suggest that a qualitatively conceptual change has taken place. In fact, one of the most remarkable features of this debate is how little has been achieved conceptually, and how much effort has been laid down in balancing the purported interests of different stakeholders. With the arrival on the scene of (4) open consent models, we argue that the concept of consent may even become reduced to a hollow repetitive ritual, devoid of any relevant moral content. Even though the different models (1–4) apply different outlooks on the distribution of interests as well as possible benefits and harms to different stakeholders involved in genomic research biobanking, in terms of the languages adopted, we are still firmly within the ethical frameworks of medical research and transplantation medicine. Consequently, the interests of research biobank donors tend to be debated as if they were identical to the interests of research subjects and patients in a medical context. This conflation of contexts arguably has some detrimental effects on our ability to ground the debate in the complex realities of genomic research biobanking, and the normative challenges it poses for individuals, institutions, and societies. Evidence suggests that the fundamental