Ethical and public policy challenges for pharmacogenomics.
It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders.
Department of Psychiatry and Behavioral Neuroscience; Department of Human Genetics; University of Chicago, Illinois, USA.
Elliot S
ES
Gershon
Department of Psychiatry and Behavioral Neuroscience; University of Chicago, Illinois, USA.
Ney
N
Alliey-Rodriguez
Department of Psychiatry and Behavioral Neuroscience; University of Chicago, Illinois, USA.
Kay
K
Grennan
D006801:Humans; D010597:Pharmacogenetics / Q000941:ethics* / Q000331:legislation & jurisprudence*; D011640:Public Policy
ethics; genetics; mental disorder; molecular network; pharmacogenomics; population genetics; public policy