Reflection On Ethical Issues Of Precision Medicine

As a new medical model,precision medicine combines biological information technology,network technology and genetic information technology with the individual characteristics of the patient and the living environment,which expects to achieve accurate prevention and treatment of the disease.According to the literature review and comprehensive analysis,the current scholars’ research mainly focuses on technical analysis and comparative research at home and abroad,which lacks of the research from the perspective of ethics.However,the development of this model involves huge crowd and many required technologies are in the immature stage,which leads to numerous ethical issues in the development process,the uncertainly benefits and risks,the difficulty of guaranteeing the privacy of the participants,the difficulty of informed consent operation and vagueness of the responsibility attribution.Benefits and risks are inseparable.There must be certain risks in the development of any new technology,but pursuing the maximization of benefits and minimizing risks are prerequisites for the study of experimentation.The risk-benefit analysis of precision medicine will be conducted from three levels of technology,economy and society.The unknown problems may confuse the direction of precision medicine development and cause confusion in value judgments and ethical analysis,which will devastate the precise medical consequences.Thus,we must adhere to the principle of safety and benefit and regard the protection of participants and social interests as the ultimate basis of ethical review.The development of big data technology and the establishment of the biological sample library brought a lot of trouble for the privacy of participants,which has expanded the scope and speed of data sharing in precision medicine and promoted the development of precision medicine.But the unique recognition of genomic big data can not only reveal personal information about current and future health,but also the health status of the family members,which creates a new home network privacy issue.Thus,it greatly enhances the importance of privacy.As a necessary condition for safeguarding individual autonomy,informed consent is the basic means to maintain the dignity of participants and ensure the rights and interests of participants.Informed consent in precision medicine involves genetic testing and data analysis,which is related to the genetic information of individuals,families,kin groups and even the entire ethnic groups.It contains a wide range of impacts and differs from other medical experiments.If traditional direct informed consent models are used directly,it may result to poor informed consent and the patient’s rights cannot be guaranteed.The practice of precision medicine should base on the participants’ knowledge,understanding and voluntary participation,and it should make sure the participants’ right to withdraw at any time and the fairly participation of volunteers in research and treatment.The responsible persons involved in the precision medicine model mainly include(potential)patients,medical personnel,governments and research institutions.According to the individual behavior of causality,these responsibilities can be divided into formal responsibility and substantive responsibility.These four kinds of responsibility bodies often involve interest conflicts in practical medical practice.The ideal performances of the responsibility body are that they not only take their own responsibilities,but also the ethical responsibilities for the relevant actors.Utilitarian theory,deontology theory,justice theory,reflection balance theory can provide a theoretical basis for the construction of an ethical assessment system for precision medicine.Therefore,the research of precision medicine should follow the principle of safety and efficiency,protect patient’s privacy and reinforce the sense of responsibility.