All you need it Trust? Public perspectives on consenting to participate in genomic research in the Sri Lankan district of Colombo

Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are raised concerns about participants' understanding of genomic research, which raises concerns about the validity of informed consent achieved in such research. This article reports a qualitative study carried out aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) Theme ‘Scientific literacy’ describes an apparent lack of scientific knowledge that seems to affect a participant’s ability to understand the research, b) Theme ‘Motivation’ describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) Theme ‘Trust’ describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must the basis of this trust and work to be worthy of that trust and work to ensure that misconceptions are actively addressed.