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Researcher

E.M. (Eline) Bunnik, PhD

Associate Professor

  • Department
  • Medical Ethics, Philosophy and History of Medicine
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About

Introduction

Dr. Eline M. Bunnik is an Associate Professor at the Department of Medical Ethics, Philosophy and History of Medicine at Erasmus MC. She leads research projects on medical ethics, with a special focus on the ethical implications of technological innovations for clinical practice and society at large.

Her current research projects focus on access and funding models for newly approved cancer treatments, and the ethical issues surrounding the development of transplantable bioartificial organs and stem cell technology for the purposes of personalised medicine for children with rare genetic neurodevelopmental disorders.

Eline’s background is mainly in Philosophy. In 2014, she completed a PhD-project on ethical issues in genomic testing.

She is Chair of the national indications committee for pre-implantation genetic testing (PGT), serves on various committees, and advises on national and international research projects.
She teaches medical ethics and research ethics at undergraduate, graduate and post-graduate levels, at Erasmus MC and elsewhere.

Field(s) of expertise

  • Ethical issues in compassionate use and access to innovative medical treatments
  • Ethics of organ donation and transplantation
  • Ethics of regenerative medicine
  • Ethics of predictive medicine, genetics and genomics, epigenetics, biomarkers
  • Research ethics, incidental findings, informed consent
  • Reproductive ethics, prenatal screening

Education and career

  • PhD ‘Up Close and Personal: Ethical Issues in Genomic Testing,’ Erasmus MC (2014)
  • Propedeuse Medicine at Erasmus MC (2008)
  • Research Master (MA) Philosophy (cum laude), University of Amsterdam (2005)
  • Bachelor (BA) Philosphy (cum laude), University of Amsterdam (2003)

Publications

2022

  1. Hordijk M, Vermeulen SF, Bunnik EM. The ‘false hope’ argument in discussions on expanded access to investigational drugs: a critical assessment. Medicine, Health Care and Philosophy (accepted for publication).
  2. De Jongh, Massey E, Bunnik EM. Organoids: a systematic review of ethical issues. Stem Cell Research & Therapy Stem Cell Res 2022; 13: 337. https://doi.org/10.1186/s13287-022-02950-9
    Bunnik EM, de Jongh D, Massey M, on behalf of the VANGUARD consortium. Ethics of early clinical trials of bio-artificial organs. Transplant International 06 July 2022 https://doi.org/10.3389/ti.2022.10621.
  3. Bomhof C, Bunnik EM. Physician’s perspectives on ethical issues regarding expensive anti-cancer treatments: An interview study. AJOB Empirical Bioethics (accepted for publication).
  4. Vermeulen SF, Hordijk M, Visser RJ, Bunnik EM. Do physicians have a duty to discuss expanded access to investigational drugs with their patients? A normative analysis. Journal of Law, Medicine and Ethics (accepted for publication).
  5. Dupras C, Bunnik EM. Response to Open Peer Commentaries on Toward a Framework for Assessing Privacy Risks in Multi-Omic Research and Databases. Am J Bioeth 2022 Sep;22(9):W4-W6. doi: 10.1080/15265161.2022.2105436.
  6. Bunnik EM, Smedinga M, Milne R, Georges J, Richard E, Schermer MHN. Ethical frameworks for disclosure of Alzheimer’s disease biomarkers to research participants: How to resolve conflicting norms? Ethics & Human Research (accepted for publication).
  7. Thom R. Dalle-Ave A, Bunnik EM, Krones T, van Assche K, Ruck Keene A, Cronin AJ. Inequitable access to transplants: Adults with impaired decision-making capacity. Transplant International 2022; 35: 10084.
  8. Bos W, Bunnik EM. Informed consent practices for exome sequencing: An interview study with clinical geneticists in the Netherlands. Molecular Genomics and Genomic Medicine Epub: 11 February 2022; e1882. doi: 10.1002/mgg3.1882.
  9. Bunnik EM. Delineating the scope of NIPT: Ethics meets practice. American Journal of Bioethics 2022; 22(2): 34-36.
  10. Smedinga M, Bunnik EM, Richard E, Schermer MHN. Should doctors offer biomarker testing to those afraid to develop Alzheimer’s dementia? Applying the method of reflective equilibrium for a clinical dilemma. Journal of Bioethical Inquiry 2022 March 19.

2021

  1. Dupras C, Bunnik EM. Toward a framework for assessing privacy risks in multi-omic research and databases. American Journal of Bioethics. Published online 12 January, 2021 DOI: 10.1080/15265161.2020.1863516.
  2. Bunnik EM, Dondorp W, Bredenoord A, de Wert G, Cornel MC. Mainstreaming informed consent for genomic sequencing: A call for action. European Journal of Cancer 2021; 148: 405-410.
  3. Bunnik EM, Dondorp W, Bredenoord A, de Wert G, Cornel MC. Discussing opt-out options during informed consent discussions in mainstream settings. European Journal of Cancer 2021; 155: 310-312.
  4. Oerlemans AJM, Barendregt DMH, Kooijman SC, Bunnik EM. Impact of incidental findings on young adult participants in brain imaging research: an interview study. European Radiology Epub: 12 January 2022 10.1007/s00330-021-08474-9.
  5. Bunnik EM, Smids J. Why exceptional public investment in the development of vaccines is justified for COVID-19, but not for other unmet medical needs. American Journal of Bioethics. 2021; 21(12): 22-25.
  6. Bunnik EM, Bolt LLE. Exploring the ethics of implementation of epigenomics technologies in cancer screening: A focus group study. Epigenetics Insights 2021 Dec 9;14:25168657211063618. doi: 10.1177/25168657211063618.
  7. Vermeulen S, Hordijk M, Aarts N, Bunnik EM. Factors of feasibility: An interview study of physicians’ experiences of expanded access to investigational drugs in three countries. Humanities and Social Sciences Communications 2021; 8: 275.
  8. Tromp K, Bunnik EM, Smedinga M, Richard E, Schermer MHN. Early detection of AD biomarkers and the ethical criteria for screening programs. AJOB Neuroscience 2021; 12(4): 231-233.
  9. Polak TB, Bunnik EM. Financial considerations in expanded access policy for gene therapies: A tough nut to crack? Molecular Therapy 2021; S1525-0016(21)00218-5.
  10. Bunnik EM, Siddiqui S, van Bruchem-Visser RL. Ethics of rooming-in with COVID-19 patients: Mitigating loneliness at the end of life. Journal of Critical Care 2021; 67: 182-183.
  11. Wouters RHP, van der Graaf R, Riger T, Bunnik EM, Ploem MC, de Wert GMWR, Dondorp WJ, Cornel MC, Bredenoord AL. Towards a responsible transition to Learning Healthcare Systems in precision medicine: Ethical points to consider. Journal of Personalized Medicine 2021; 11(6): 539.
  12. Mezinska S, Gallagher L, Verbrugge M, Bunnik EM. Ethical issues in genomics research on neurodevelopmental disorders: A critical interpretive review. Human Genomics 2021; 15: 16.
    Van Suylen V, Bunnik EM, Hagenaars JAM, Ertugrul IA, Bollen JAM, Mariani MA, Erasmus ME. Ex situ perfusion of hearts donated after euthanasia: A promising contribution to heart transplantation. Transplantation Direct 2021;7: e676; doi: 10.1097/TXD.0000000000001120. Published online 22 February, 2021.
  13. Smedinga M, Bunnik EM, Richard E, Schermer MHN. The framing of "Alzheimer's disease": Differences between scientific and lay literature and their ethical implications. Gerontologist. 2020 Nov 3:gnaa113. doi: 10.1093/geront/gnaa113. Online ahead of print.
  14. Bunnik EM, Aarts A. The role of physicians in expanded access to investigational drugs: A mixed-methods study of physicians’ views and experiences in the Netherlands. Journal of Bioethical Inquiry. 2021 Feb 15. doi: 10.1007/s11673-021-10090-7. Online ahead of print.
  15. Bolt LLE, Bunnik EM, Tromp K, Pashayan N, Widschwendterr M, de Beaufort I. Prevention in the age of personal responsibility: epigenetic risk-predictive screening for female cancers as a case study. Journal of Medical Ethics. 2020 Nov 18;medethics-2020-106146. doi: 10.1136/medethics-2020-106146. Online ahead of print.
  16. Kater-Kuipers A, Bakkeren I, Riedijk S, Go A, Polak M, Galjaard R-J, de Beaufort I, Bunnik EM. Non-invasive prenatal testing (NIPT): societal pressure or freedom of choice? A vignette study of Dutch citizens’ attitudes. European Journal of Human Genetics. 2021; 29: 2–10.
  17. Richter G, Borzikowsky C, Lesch W, Semler SC, Bunnik EM, Buyx A, Krawczak M. Secondary research use of personal medical data: Attitudes from patient and population surveys in the Netherlands and Germany. European Journal of Human Genetics. 2021; 29: 495–502.

2020

  1. Bomhof C, van Bodegom L, Vernooij MW, Pinxten W, de Beaufort ID, Bunnik EM. The impact of incidental findings detected during brain imaging on research participants of the Rotterdam Study: An interview study. Cambridge Quarterly of Healthcare Ethics. 2020; 29(4): 542-556.
  2. Dommershuijsen L, Darweesh SKL, Luik AI, Kieboom BCT, Koudstaal PJ, Boon AJW, Ikram MA, Ikram MK, Bunnik EM. Ethical considerations in screening for REM sleep behavior disorder in the general population. Movement Disorders. 2020; 35(11): 1939-1944.
  3. Gregory S, Bunnik EM, Callado AB, Carrie I, De Boer C, Duffus J, Fauria K, Forster S, Gove D, Knezevic I, Laquidain A, Pennetier, Saunders S, Sparks S, Rice J, Ritchie CQ, Milne R. Involving research participants in a pan-European research initiative: The EPAD Participant Panel experience. Research Involvement and Engagement. 2020; 6(1): 62.
  4. Kater-Kuipers A, de Beaufort ID, Galjaard RJH, Bunnik EM. Rethinking counselling in prenatal screening: An ethical analysis of informed consent in the context of non-invasive prenatal testing (NIPT). Bioethics. 2020; 34(7): 671-678.
  5. Bunnik EM, Timmers M, LLE Bolt. Ethical issues in research and development of epigenome-wide technologies. Epigenetics Insights. 2020; 13: 1-7.
  6. Bunnik EM, Kater-Kuipers A, Galjaard RJH, de Beaufort I. Why NIPT should be publicly funded. Journal of Medical Ethics. 2020; 46(11): 783-784.
  7. Bakkeren IM, Kater-Kuipers A, Bunnik EM, Go ATJI, Tibben A, de Beaufort I, Galjaard RJH, Riedijk S. Implementing non-invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement and an expanding scope. Journal of Genetic Counseling. 2020; 29(1): 112-121.

2019

  1. Bunnik EM, Aarts. What do patients with unmet medical needs want? A qualitative study of patients’ views and experiences with expanded access to unapproved, investigational treatments in the Netherlands. BMC Medical Ethics (in press). 
  2. Bakkeren IM, Kater-Kuipers A, Bunnik EM, et al. Implementing non-invasive prenatal testing (NIPT) in the Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement and an expanding scope. Journal of Genetic Counseling (in press) 
  3. Bunnik EM, Kater-Kuipers A, Galjaard RH, de Beaufort ID. Should pregnant women be charged for non-invasive prenatal screening? Implications for reproductive autonomy and equal access. Journal of Medical Ethics 16 September 2019. doi: 10.1136/medethics-2019-105675 [Epub ahead of print] 
  4. Bunnik EM. Let us not take the ethics out of innovative practice: A case against institutional review. American Journal of Bioethics 2019; 19(06): 36-38. 

2018

  1. Bunnik EM, Meulenberg F, de Beaufort ID. Ethical issues in the beauty salon: the development of national ethics guidelines for aestheticians in the Netherlands. Narrative Inquiry in Bioethics 2018; 8(3):247-260. 
  2. Bunnik EM, Aarts N, van de Vathorst S. Little to lose and no other options: Ethical issues in efforts to facilitate expanded access to investigational drugs. Health Policy 2018; 122(9):977-983. 
  3. Bunnik, EM, Richard E, Milne R, Schermer MHN. On the personal utility of Alzheimer's disease-related biomarker testing in the research context. Journal of Medical Ethics 2018; 44 (12), 830-834. 
  4. Kater-Kuipers A, Bunnik EM, de Beaufort ID, Galjaard RJH. Limits to the scope of non-invasive prenatal testing (NIPT): an analysis of the international ethical framework for prenatal screening and an interview study with Dutch professionals. BMC Pregnancy and Childbirth 2018; 18:409. 
  5. Kater-Kuipers A, de Beaufort ID, Galjaard RH, Bunnik EM. Ethics of routine: a critical analysis of the concept of 'routinisation' in prenatal screening. Journal of Medical Ethics 2018; 44:626-631. 
  6. Bunnik EM, Aarts N. A model for communication about longshot treatments in the context of early access to unapproved, investigational drugs. American Journal of Bioethics 2018; 18(1):34-36 
  7. Milne R, Bunnik E, Diaz A, Richard E, Badger S, Gove D, Georges J, Fauria K, Molinuevo JL, Wells K, Ritchie C, Brayne C. Perspectives on Communicating Biomarker-Based Assessments of Alzheimer's Disease to Cognitively Healthy Individuals. Alzheimers Disease 2018; 62(2):487-498. 

2017

  1. Milne RJ, Bunnik EM, Tromp K, Bemelmans S, Badger S, Gove D, Maman M, Schermer M, Truyen L, Brayne C, Richard E. Ethical issues in the development of readiness cohorts in Alzheimer’s disease research. The Journal of Prevention of Alzheimer’s Disease 2017; 4(2):125-131. 
  2. Bunnik EM, Aarts N, Chen LA. Physicians must discuss potential long-term risks of fecal microbiota transplantation to ensure informed consent. American Journal of Bioethics 2017;17(5):61-63. 
  3. Bunnik EM, Aarts N, van de Vathorst S. The changing landscape of expanded access to investigational drugs for patients with unmet medical needs: ethical implications. J Journal of Pharmaceutical Policy and Practice 2017;10:10. 
  4. Janssens ACJW, Bunnik EM, Burke W, Schermer MHN. Uninformed consent in nutrigenomic research. European Journal of Human Genetics 2017;25(7):789-790 
  5. Wouters RHP, Cornelis C, Newson AJ, Bunnik EM, Bredenoord AL. Scanning the body, sequencing the genome: Dealing with unsolicited findings. Bioethics 2017; 31(9):648-656. 
  6. Wit, de MC, Bunnik EM, Go ATJI, de Beaufort ID, Hofstra RMW, Steegers EAP, Galjaard RJH. Amniocentesis is still the best option for advanced genomic testing in case of fetal malformations. Prenatal Diagnosis 2017;3 7(13):1360-1363. 
  7. Steen, van der SL, Bunnik EM, Polak MG, Diderich KEM, Verhagen-Visser J, Govaerts LCP, Joosten M, Knapen MFCM, Go ATJI, Van Opstal D, Srebniak MI, Galjaard RJH, Tibben A, Riedijk SR. Choosing between higher and lower resolution microarrays: do pregnant women have sufficient knowledge to make informed choices consistent with their attitude? Journal of Genetic Counselling 2017; 27(1):85-94. 
  8. Bunnik EM, van Bodegom L, Pinxten W, de Beaufort ID, Vernooij MW. Ethical framework for the detection, management and communication of incidental findings in imaging studies, building on an interview study of researchers' practices and perspectives. BMC Medical Ethics 2017; 18(1):10. 

2016

  1. Bemelmans SA, Tromp K, Bunnik EM, Milne RJ, Badger S, Brayne C, Schermer MH, Richard E. Psychologial, behavioral and social effects of disclosing Alzheimer’s disease biomarkers to research participants: a systematic review. Alzheimer’s Research and Therapy 2016; 8:46. 
  2. Bunnik EM, Vernooij MW. Incidental findings in population imaging revisited. European Journal of Epidemiology 2016;31(1):1-4. 

2015

  1. Bunnik EM, Janssens ACJW, Schermer MHN. Personal utility in genomic testing: is there such a thing? Journal of Medical Ethics 2015;41(4):322-6. 
  2. Bunnik EM. Do genomic tests enhance autonomy? Journal of Medical Ethics 2015; 41(4):315-6. 

2014

  1. Bunnik EM, Schermer MH, Janssens AC. Naming and framing in genomic testing. Trends in Molecular Medicine 2014; 20(2):63-5. 
  2. Bunnik EM, Janssens AC, Schermer MH. Informed consent in direct-to-consumer personal genome testing: the outline of a model between specific and generic consent. Bioethics 2014; 28(7):343-51. 

2013

  1. Bunnik EM, de Jong A, Nijsingh N, de Wert GMWR. The new genetics and informed consent: Differentiating choice to preserve autonomy. Bioethics 2013; 27(6):348-355. 
  2. Bunnik EM, Janssens ACJW, Schermer MHN. A tiered-layered-staged model for informed consent in personal genome testing. European Journal of Human Genetics 2013; 21(6): 596-601.

2012

  1. Bunnik EM, Janssens AC, Schermer MH. The role of disease characteristics in the ethical debate on personal genome testing. BMC Medical Genomics 2012; 5:4.

2011

  1. Bunnik EM, Schermer MH, Janssens AC. Personal genome testing: test characteristics to clarify the discourse on ethical,legal and societal issues. BMC Medical Ethics 2011; 12:11.

2009

  1. Bunnik E, Janssens AC, Schermer M. How attitudes research contributes to overoptimistic expectations of personal genometesting. American Journal of Bioethics 2009; 9(6-7):23-5.

Teaching activities

  • Lectures and working group sessions for medical students
  • Supervision of PhD-students, master students, minor students
  • Ethics courses for medical specialists in training, primary care practitioners in training, PhD-students and postdoctoral researchers
  • Guest lectures, panel discussions, teaching activities for professionals or general publics at Erasmus MC and elsewhere
  • Basis Kwalificatie Onderwijs (BKO) [University Teaching Qualification] (2016)

Other positions

At Erasmus MC

  • Medisch-ethische toetsingscommissie (METC)
  • Toetsingscommissie niet-WMO onderzoek
  • Commissie Medisch Ethische Vraagstukken (MEV) 
  • Commissie Nevenbevindingen (Klinische Genetica)

National

  • Landelijke indicatiecommissie PGT (voorzitter)
  • Data Access Board, Hartwig Medical Foundation
  • Ethics and Law working group at Vereniging voor Klinisch Genetici Nederland (VKGN)
  • Maatschappelijk Verantwoord Innoveren (MVI) Jong, NWO 
  • Ad hoc commissie Wetenschappelijk Integriteit (2021)
  • Commissie Bewaartermijn implantaatgegevens, Gezondheidsraad (2018-2019)

International

  • Ethical Legal and Psychosocial Aspects of Transplantation (ELPAT) of the European Society for Organ Transplantation (ESOT)
  • Ethics advisor of numerous European research projects, including EPAD, AMYPAD, COSYN, MINDDS, EnGage, WEAKID, EUscreen, Screen4Care

Scholarships, grants, and awards

Grants

  • ZonMw: PSIDER:  Standardized, IPSC-based medicine for immediate application in monogenic neurodevelopmental disorders. (2021)
  • Horizon2020: VANGUARD: Bioartificial pancreas to cure type 1 diabetes. (2020)
  • KWF: Ethical access and reimbursement models for expensive new cancer treatments: How to reconcile diverging values? (2019)
  • NWO, Maatschappelijk Verantwoord Innoveren (MVI): Epigenome-wise: ethical, legal and societal issues of new assays for DNAmethylation in cancer diagnostics and screening. (2018)
  • ZonMw, Personalised Medicine: Consortium ethics and law of personalised medicine and next-generation sequencing. (2018)
  • BBMRI-NL, Voucher for biobank science: Guidelines for the detection, management and communication of incidental findings. (2016)
  • ZonMw, Ethics and Health: Towards an ethically robust scope of NIPT. (2016)
  • Erasmus MC Grants:to report or not to report? The ethics of broadening the scope of noninvasive prenatal testing (NIPT). (2015)
  • NWO, MVI: Nice to meet? Meeting unmet medical needs: a social innovation to facilitate early access to investigational drugs. (2015)

Scholarships

  • WiRe fellowship, University of Münster (2019)
  • Female Career Development Programme, Erasmus MC (2018)

Awards

  • Netherlands Association for Community Genetics and Public Health Genomics (NACGG) Innovation Award (2012)
  • Talent programme of Nuffic (2005)

Related

Departments and research centers

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Clinical genetics
research

Medical Ethics, Philosophy and History of Medicine