Medical Ethics Advisor reports on integrating precision medicine and genetic testing into clinical care and the many ethical challenges it poses in a paper from the American College of Physicians.

Timothy B. Niewold, MD, FACR, vice chair for Research in the HSS Department of Medicine says “The main goal of precision medicine and genetic testing as it relates to clinical care is to develop meaningful biological groups within a disease category or diagnosis to guide personalized treatment.”  For example, in cancer, some therapies are guided by the genotype of the tumor, targeting a specific gene and providing personalized treatment. “In immune system disorders, such as autoimmune diseases, we have not yet achieved this level of precision. But I’m hopeful,” Dr. Niewold said. “It is an exciting time in medicine.”

Dr. Niewold added, “Another ethical issue is the appropriate representation of populations and social justice."  The genetic drivers of disease can vary between world populations. Results from one population may not carry over to another population. “Thus, populations that are not studied may not benefit from new therapeutic advances,” noted Dr. Niewold. “There is a great need to be inclusive.” Since genetic information is medical in nature, it is best integrated into clinical care in a team care model, he said. 

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