Ethical concerns over pharmacogenetic developments

Pharmacogenetics could promise safe and more effective treatments in the future, but there are legitimate ethical concerns that need to be addressed if it is to reach its full potential, says the Nuffield Council on Bioethics in a new report - Pharmacogenetics: ethical issues.

'It is too early to predict whether 'personalised medicines' will become a reality,' according to Professor Peter Lipton, chairman of the working party and head of the department of history and philosophy of science at the University of Cambridge. 'But it is important to encourage discussion of ethical and policy issues raised by the introduction of pharmacogenetics.'

Much of the concern centres around the need for a genetic test to establish an individual patient's genetic profile. There is currently little or no pharmacogenetics testing in practice, and the Nuffield Council makes a number of recommendations which aim to ensure that the delivery of pharmacogenetic testing is made as straightforward as possible. 'We recognise that many people feel genetic information is special. But we believe that what matters is the information that a test reveals, not whether the test is genetic," says Professor Lipton. 'The fact that information is genetic does not necessarily raise different ethical issues from other types of medical information, such as blood tests or cholesterol tests.'

The report discusses implications for the development of medicines, the use and storage of genetic information, and public policy. For example, if patients are divided into groups on the basis of genetic information some sub-groups might be so small that developing specific medicines to treat them could be prohibitively expensive. 'We recommend that incentives might be necessary to encourage pharmaceutical companies to develop medicines that would provide real benefit to only a small number of patients,' commented Professor Lipton. Another concern is that patients may be sub-divided according to racial or ethnic groupings.

'It is important to address concerns now to ensure that we can get the greatest benefit from pharmacogenetics. There must be the right combination of constraints and incentives to protect and promote the interests of patients and society as this technology is more widely introduced,' Professor Lipton concluded.

The Nuffield Council on Bioethics

The Nuffield Council on Bioethics is an independent UK-based body that examines the ethical issues raised by developments in medicine and biology. Established in 1991, it is funded by The Nuffield Foundation, the Medical Research Council and The Wellcome Trust.