title: Contrasting Medical and Legal Standards of Evidence: A Precision Medicine Case Study.
abstract: As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system's expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients prescribed the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed.
authors.affiliation: Gary Marchant, Ph.D., J.D., M.P.P., is the Regents' Professor and Lincoln Professor of Emerging Technologies, Law & Ethics at the Sandra Day O'Connor College of Law at Arizona State University. He is also the Faculty Director of the Center for Law, Science & Innovation at ASU. He has a Ph.D. (Zoology) from the University of British Columbia, Vancouver, B.C., Canada (1986), a J.D. from Harvard Law School, Cambridge, MA (1990) and a M.P.P. from the Kennedy School of Government, Cambridge, MA (1990). Kathryn Scheckel is the Assistant Director, Special Projects in the Office of University Affairs at Arizona State University. She is a Masters student in Public Policy at ASU, Tempe, AZ (anticipated 2016). She holds a B.S. in Molecular Biosciences & Biotechnology and a B.A. in Piano from ASU, Tempe, AZ (2012). Doug Campos-Outcalt, M.D., M.P.A., is a Medical Director of Mercy Care Plan, Phoenix Arizona. He has an M.D. from the University of Arizona (1979) and an M.P.A. from Arizona State University (1985).
authors.forename: Gary E
authors.initials: GE
authors.lastname: Marchant
authors.affiliation: Gary Marchant, Ph.D., J.D., M.P.P., is the Regents' Professor and Lincoln Professor of Emerging Technologies, Law & Ethics at the Sandra Day O'Connor College of Law at Arizona State University. He is also the Faculty Director of the Center for Law, Science & Innovation at ASU. He has a Ph.D. (Zoology) from the University of British Columbia, Vancouver, B.C., Canada (1986), a J.D. from Harvard Law School, Cambridge, MA (1990) and a M.P.P. from the Kennedy School of Government, Cambridge, MA (1990). Kathryn Scheckel is the Assistant Director, Special Projects in the Office of University Affairs at Arizona State University. She is a Masters student in Public Policy at ASU, Tempe, AZ (anticipated 2016). She holds a B.S. in Molecular Biosciences & Biotechnology and a B.A. in Piano from ASU, Tempe, AZ (2012). Doug Campos-Outcalt, M.D., M.P.A., is a Medical Director of Mercy Care Plan, Phoenix Arizona. He has an M.D. from the University of Arizona (1979) and an M.P.A. from Arizona State University (1985).
authors.forename: Kathryn
authors.initials: K
authors.lastname: Scheckel
authors.affiliation: Gary Marchant, Ph.D., J.D., M.P.P., is the Regents' Professor and Lincoln Professor of Emerging Technologies, Law & Ethics at the Sandra Day O'Connor College of Law at Arizona State University. He is also the Faculty Director of the Center for Law, Science & Innovation at ASU. He has a Ph.D. (Zoology) from the University of British Columbia, Vancouver, B.C., Canada (1986), a J.D. from Harvard Law School, Cambridge, MA (1990) and a M.P.P. from the Kennedy School of Government, Cambridge, MA (1990). Kathryn Scheckel is the Assistant Director, Special Projects in the Office of University Affairs at Arizona State University. She is a Masters student in Public Policy at ASU, Tempe, AZ (anticipated 2016). She holds a B.S. in Molecular Biosciences & Biotechnology and a B.A. in Piano from ASU, Tempe, AZ (2012). Doug Campos-Outcalt, M.D., M.P.A., is a Medical Director of Mercy Care Plan, Phoenix Arizona. He has an M.D. from the University of Arizona (1979) and an M.P.A. from Arizona State University (1985).
authors.forename: Doug
authors.initials: D
authors.lastname: Campos-Outcalt
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects; D003695:Delivery of Health Care; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice; D010820:Physicians; D057285:Precision Medicine; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin