Social and Ethical Implications of Precision Medicine

Abstract

Precision medicine has significant potential to improve the lives of both individuals and populations, but targeted therapies can be expensive, have serious adverse effects and are not always as effective as hoped. It is crucial, therefore, that the “right” targeted therapies are developed, and that these are tested, regulated, funded and used in practice in the “right” ways. It is not always easy, however, to determine what is right because precision medicine affects, and is shaped by, many different stakeholder groups—including patients, clinicians, government and industry—each of which has its own, often strongly held and competing, concerns and commitments. These, in turn, determine what they consider to be good and right.

In each case, these perspectives are underpinned by values such as autonomy (which in this context usually refers to self-­determination), beneficence (doing good), non-­maleficence (not causing harm), justice, solidarity, and integrity. People also value the pursuit of knowledge and the social benefits that derive from scientific inquiry. In this chapter, the ethical issues raised by precision medicine are summarised with reference to such values and ideas. The aim is not to fully articulate stakeholders’ perspectives or to provide answers to ethical dilemmas, but rather to map the moral territory of precision medicine. This chapter focuses on the ethics of the development, regulation and funding, and clinical use of “targeted therapies” developed using genomic technologies.