Textbook of Personalized Medicine - Second Edition [2015]

(Ron) #1

K.K. Jain, Textbook of Personalized Medicine, DOI 10.1007/978-1-4939-2553-7_21, 655
© Springer Science+Business Media New York 2015


Chapter 21


Ethical Aspects of Personalized Medicine


Introduction to Ethical Issues


Most of the ethical aspects of personalized medicine are based on pharmacogenetics,
genetic screening and impact on healthcare. Understanding the social effects of
genomics requires an analysis of the ways in which genetic information and a
genetic approach to disease affect people individually, within their families and
communities, and in their social and working lives. This information will lead to
measures for the prevention of stigmatization and discrimination of different popu-
lations on ethnic grounds.


Ethical Issues of Pharmacogenetics


Some of the ethical questions raised by pharmacogenetics include the following:



  • The issue of ensuring equality in medical care, when genetics can predict which
    patients are less likely to benefi t from the available pharmacotherapy.

  • Another dilemma would be the right to deny an available treatment to specifi c
    patient populations according to information derived from pharmacogenetic
    studies.
    The Nuffi eld Council on Bioethics in a report published in 2003 has reviewed this
    topic ( http://www.nuffi eldbioethics.org/pharmacogenetics ). The report addressed a num-
    ber of diffi cult questions, ranging from consent and confi dentiality of the genetic
    information yielded from the tests to whether the tests should be available over the
    counter or through the Internet. It raised concerns that pharmacogenetics may cause
    inequality in health care and that patients may be subdivided according to racial or
    ethnic categories. The working party concluded that because there is considerable
    genetic variation within ethnic groups it is highly unlikely that being in a particular
    group could be used to determine whether or not a patient takes a pharmacogenetic
    test. However, the report recommended that pharmacogenetic tests be validated in

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