Personalized genomic medicine is hailed as a revolution that will empower patients to take control of their own health care, but it could end up taking control away from patients and limiting their treatment choices, concludes an article in the Hastings Center Report. A commentary responding to the article, by the editorial director of Health and Family at Consumer Reports, also appears in the journal.
Genomic science provides two categories of data, the authors write: pharmacogenomic information and genomic susceptibility information. Pharmacogenomic information forecasts how an individual might respond to a particular therapy. Genomic susceptibility testing predicts a patient's chances of warding off or succumbing to an environmental threat or disease.
Genomic medicine's stakeholders—including direct-to-consumer genetic testing companies, private research centers, and the National Institutes of Health—are deeply invested in promoting how this information will benefit patients. The authors call this "empowerment rhetoric." And yet the added knowledge that comes from both pharmacogenomic information and genomic susceptibility information could have a negative impact on how much power a patient really has.
The results gleaned from pharmacogenomic information could pressure patients to comply with physicians' recommendations, the authors suggest, because molecular profiling would allow doctors to give orders with more authority. "In fact, because genomic medicine generates more risk information and makes that information the key lens for approaching health and disease, patients may actually find that they have less ability to influence health care decisions and treatments," the authors state. . .