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¶ … ethical, financial, and legal challenges to "personalized medicine"?
There are a number of challenges associated with personalized medicine, including ethical, financial and legal challenges.
Ethical challenges; A main challenge is the way the information gained from testing for pharmacogenetics is used. The information may belong to the patient, but who should have the right to it, especially if a third party, such as an insurance company pays for the tests (Vogenberg, Barash, & Pursel, 2010). Knowing which treatments may be effective may aid health insurance firms as well as physicians in gaining effective treatment, this could lead insurance firms seeking to coerce patients into tests they do not want to have, for example, fears over additional findings of genetic weaknesses being found. There may be understandable fears that insurance firms may use the information to disclose and refuse insurance to those who may have genetic weaknesses, or be resistant to lower cost treatment options. Therefore, the ethical issue is who should be given control over the information, and how should be allowed to use it (Vogenberg, Barash, & Pursel, 2010). This issue may be exacerbated where there is treatment for a minor, as there are additional stakeholder and sociality consideration, especially if parents refuse tests (Wilcockson,...
This is costly as it will require greater resources compared to the standardised pharmacological treatments which currently dominate medicine. In the long-term there may be financial advantages for patients and insurance companies; limited research has indicated lower potential levels of subsequent hospitalization where pharmacogenetics, as well as potentially reducing long drug costs (Epstein et al., 2010). However, the cost of testing and assessment may currently outweigh the potential benefits.
Legal Challenges; New treatments and technology are often ahead of legislation. The legal issue may center on the way information is used, and who has access to it, especially with reference to privacy and insurance firms and the potential for discrimination. It is possible that medical insurance will seek to discriminate against those where genetic testing indicates the need for more costly or personalized drugs, even withdrawing after discovery. The use of these tests may…
References
Epstein, R S, Moyer T P, Aubert R E, et al. (2010), Warfarin genotyping reduces hospitalization rates results from the MM-WES, Journal of the American College of Cardiology, 55, 2804-12
Ross, S, Anand, S S, Joseph, O, Pare, G, (2012), Promises and challenges of pharmacogenetics: an overview of study design, methodological and statistical issues, JRSM Cardiovascular Disease, 1(1), retrieved http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738322/
Vogenberg, F R; Barash, C I, Pursel, M, (2010), Personalized Medicine, Part 2: Ethical, Legal, and Regulatory Issues, Pharmacy and Therapeutics, 35(11), 628-631
Wertz, D C, (2003), Ethical, social and legal issues in pharmacogenomics, The Pharmacogenomics Journal, 3(2), 194-196
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