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PROMISE Study: Registry of PCa Genetics and Outcomes
Prostate Cancer | Last Active: Jun 13 8:49am | Replies (50)Comment receiving replies
Read the Promise disclosure carefully. Choose wisely.
Authorization to Use or Disclose (Release) Health Information that
Identifies You for a Research Study
If you sign this document, you give permission to the PROMISE Registry study team to use or
disclose (release) your health information that identifies you for the research study described
above.
The health information that we may use or disclose (release) for this research includes all
information in your medical record held by the cancer care provider(s) that you share with us.
The health information listed above may be used by and/or disclosed (released) to the research
sponsor, the Prostate Cancer Clinical Trials Consortium, LLC, and the other groups listed above
in the section “What happens to the information collected for this research?”
The Prostate Cancer Clinical Trials Consortium, LLC is required by law to protect your health
information. By signing this document, you authorize the Prostate Cancer Clinical Trials
Consortium, LLC to use and/or disclose (release) your health information for this research.
Those persons who receive your health information may not be required by Federal privacy laws
(such as the Privacy Rule) to protect it and may share your information with others without your
permission, if permitted by laws governing them.
Please note that you do not have to sign this Authorization, but if you do not, you may not
receive the research-related intervention.
Please note that you may change your mind and revoke (take back) this Authorization at any
time. Even if you revoke this Authorization, the Prostate Cancer Clinical Trials Consortium,
LLC maystill use or disclose health information they already have obtained about you as
necessary to maintain the integrity or reliability of the current research. To revoke this
Authorization, you must write to: pcctcpromise@mskcc.org
Statement of Consent:
I have read this consent form (or it has been read to me). All my questions about the stud
Replies to "Read the Promise disclosure carefully. Choose wisely. Authorization to Use or Disclose (Release) Health Information that..."
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It's hard to remember the last time anaything I did was not covered by some written or implied use authorization, disclosure or limit of liability form. In addition, our personal information has been hacked from healthcare providers, both large and small, and insurance companies, most recently 100 million people's private health care information stolen, without any permission or use authorization whatsoever. My benefit from it is 12 months of free credit monitoring.
When it comes to clinical trials in search of the next breakthrough treatment or cure for the cancer that plagues us; it simply isn't going to happen without patient participation. You are correct, there is a risk. Each of us can choose to decline to participate in hopes that others will take the risk and shoulder the responsibility; in which case the the study might not happen or the next breakthrough could be delayed due to lack of participation. Or, I can accept the limited risk, do my part to advance the science for my benefit, that of my family ( I can make them aware of potential hereditary diseases) and the families of everyone else who is, or will be, afflicted with prostate cancer. All of the treatments available to us today are there because those who came before us opted to take the risk. For me, it was a slam dunk decision. I hope others will continue to accept the risk required to end prostate cancer, as well.
Bill