Addressing Ethical Challenges at the Intersection of Pharmacogenomics and Primary Care Using Deliberative Consultations

Abstract

Aim: Primary care physicians will play a central role in the successful implementation of pharmacogenomics (PGx); however, important challenges remain. We explored the perspectives of stakeholders on key challenges of the PGx translation process in primary care using deliberative consultations. Methods: Primary care physicians, patients and policy-makers attended deliberations, where they discussed four ethical questions raised by PGx research and implementation in the primary care context. Results: Stakeholders voiced skepticism regarding PGx funding, commercialization, regulation, maintenance of an equal access healthcare system and restructuring of health research incentives and priorities in the public sector. Conclusion: Deliberants developed governing principles for a PGx-specific charter of ethics, aiming to protect the interests of patients, and outlined recommendations for the future of PGx in primary care.

Keywords::

• deliberative consultation
• ethics
• pharmacogenomics
• policy
• primary care
• translation

Acknowledgements

The authors would like to thank C Corradetti for his work on the methods development, moderating the consultations and content analysis.

Financial & competing interests disclosure

The authors would like to acknowledge the research funding support from the Canadian Institutes for Health Research (CIHR), the Department of Family Medicine at McGill University, as well as Genome Canada and Genome Quebec. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study was approved by McGill University’s Research Ethics Board (#A04-M53-09A). All participants signed informed consent forms and agreed to be audio-recorded during the deliberations. To maintain privacy and confidentiality, the names and other information that may have potentially identified participants were removed from deliberation transcripts.

Additional information

Funding

The authors would like to acknowledge the research funding support from the Canadian Institutes for Health Research (CIHR), the Department of Family Medicine at McGill University, as well as Genome Canada and Genome Quebec. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.