Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • EELS (Ethical Economic Legal and Social) Article
  • Published:

EELS (Ethical, Economic, Legal & Social) Paper

Pharmacogenetics and ethical considerations: why care?

The Pharmacogenomics Journal volume 7, pages 293–296 (2007)Cite this article

Pharmacogenetics is an area of research encompassing a variety of different goals and applications (for an overview see Nuffield Council on Bioethics1). Basic research interests include for example drug metabolism pathways. Clinical applications like the enhancement of drug safety and efficacy through more precise prescriptions and the more precise treatments of molecular disease subgroups are prominent goals in the (still not widespread) public perception of the field. Yet very important aims lie also in the realm of drug development, for example the development of pharmacogenetically optimized or ‘neutral’ drugs, the improvement of clinical studies through patient selection, and the discovery of new targets.

As some of these goals are more realistic to achieve than others and since different applications could be associated with differing societal consequences, it is hardly possible to summarize the ethical aspects for all of these applications without losing specificity. Also, due to the uncertainties of future developments in the field, thoughts on the ethical aspects are somewhat preliminary at this point. However, some aspects of pharmacogenetics are likely to have a potentially profound impact on medical practice, research and on society as a whole. Therefore, much thought has been invested in the anticipation of ethical, legal and social aspects of pharmacogenetics, resulting in the publication of several comprehensive studies1, 2, 3 and an impressive number of research and review papers on these issues.4, 5, 6, 7, 8 The more general issues needing to be addressed have been identified and there is a widespread notion that more focused discussions of particular aspects are needed, which is also reflected in the number of original research papers featuring different aspects.9, 10, 11

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Nuffield Council on Bioethics. Pharmacogenetics: Ethical Issues. Nuffield Council on Bioethics: London, 2003.

  2. Rippe KP, Bachmann A, Faisst K, Oggier W, Pauli-Magnus C, Probst-Hensch N et al. (TA SWISS): Pharmakogenetik und Pharmakogenomik. TA 48/2004. Bern 2004.

  3. European Commission. Ethical, Legal and Social Aspects of Genetic Testing: Research, Development and Clinical Applications. Report of the STRATA Expert Group: Brussels, 2004.

  4. Mahlknecht U, Voelter-Mahlknecht S . Pharmacogenomics: questions and concerns. Curr Med Res Opin 2005; 21: 1041–1047.

    Article  Google Scholar 

  5. van Delden J, Bolt I, Kalis A, Derijks J, Leufkens H . Tialor-made pharmacotherapy: future developments and ethical challenges in the field of pharmacogenomics. Bioethics 2004; 18: 303–321.

    Article  Google Scholar 

  6. Netzer C, Biller-Andorno N . Pharmacogenetic testing, informed consent and the problem of secondary information. Bioethics 2004; 18: 344–360.

    Article  Google Scholar 

  7. Smart A, Martin P, Parker M . Tailored medicine: whom will it fit? The ethics of patient and disease stratification. Bioethics 2004; 18: 322–343.

    Article  Google Scholar 

  8. Schubert L . Ethical implications of pharmacogenetics – do slippery slope arguments matter? Bioethics 2004; 18: 361–378.

    Article  Google Scholar 

  9. Lee S . Racializing drug design: implications of pharmacogenomics for health disparities. Am J Public Health 2005; 95: 2133–2138.

    Article  Google Scholar 

  10. Mackenzie R . Reprogenetics and pharmacogenetics: in whose best interests? Med Law 2005; 24: 343–354.

    PubMed  Google Scholar 

  11. La Caze A . Does pharmacogenomics provode and ethical challenge to the utilisation of cost-effectiveness analysis by public health systems? Pharmacoeconomics 2005; 23: 445–447.

    Article  Google Scholar 

  12. Marx-Stoelting L . Pharmakogenetik. LIT: Muenster, 2006 accepted.

    Google Scholar 

  13. Beauchamp TL, Childress JF . Principles of Biomedical Ethics, 5th edn. Oxford University Press: Oxford, 2001.

    Google Scholar 

  14. Schmedders M, Aken Jv, Feuerstein G, Kollek R . Individualized pharmacogenetic therapy: a critical analysis. Community Genet 2003; 6: 114–119.

    PubMed  Google Scholar 

  15. Kollek R, Feuerstein G, Schmedders M, van Aken J . Pharmakogenetik: Implikationen für Patienten und Gesundheitswesen: Anspruch und Wirklichkeit der ‘individualisierten Medizin’. Nomos: Baden-Baden, 2004.

    Google Scholar 

  16. Gurwitz D, Lunshoff JE, Dedoussis G, Flordellis CS, Fuhr U, Kirchheiner J et al. Pharmacogenomics education: international society of pharmacogenomics recommendations for medical, pharmaceutical, and health schools deans of education. Pharmacogenom J 2005; 5: 221–225.

    Article  CAS  Google Scholar 

  17. Frueh FW, Goodsaid F, Rudman A, Huang SM, Lesko LJ . The need for education in pharmacogenomics: a regulatory perspective. Pharmacogenom J 2005; 5: 218–220.

    Article  CAS  Google Scholar 

  18. Melzer D, Raven A, Detmer DE, Ling T, Zimmern RL . My Very Own Medicine: What Must I Know? Information Policy for Pharmacogenetics 2003.

  19. Morley KI, Hall WD . Using pharmacogenetics and pharmacogenomics in the treatment of pychiatric disorders: some ethical and economical considerations. J Mol Med 2004; 82: 21–30.

    Article  Google Scholar 

  20. Lindpaintner K . Pharmacogenetics and the future of medical practice: conceptual considerations. Pharmacogenomics 2001; 1: 23–26.

    Article  CAS  Google Scholar 

  21. Green MJ, Botkin JR . ‘Genetic Exceptionalism’ in medicine: clarifying the differences between genetic and nongenetic tests. Ann Internal Med 2003; 138: 571–576.

    Article  Google Scholar 

  22. Freund CL, Clayton EW . Pharmacogenomics and children: meeting the ethical challenges. Am J Pharmacogenom 2003; 3: 309–404.

    Article  Google Scholar 

Download references

Acknowledgements

I would like to thank Philip and David Marx-Stöelting, Professor Eve-Marie Engels and Professor Vera Hemleben for their support and the Heinrich-Böell-Foundation for funding.

Author information

Authors and Affiliations

  1. Interdepartmental Centre for Ethics in the Sciences and Humanities, University of Tübingen, Tübingen, Germany

    L Marx-Stölting

Authors
  1. L Marx-Stölting
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L Marx-Stölting.

Additional information

Duality of Interest

None declared

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marx-Stölting, L. Pharmacogenetics and ethical considerations: why care?. Pharmacogenomics J 7, 293–296 (2007). https://doi.org/10.1038/sj.tpj.6500425

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.tpj.6500425

This article is cited by

Search

Advanced search

Quick links