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Rhetoric and Hype

Where’s the ‘Ethics’ in Pharmacogenomics?

  • Bioethics
  • Published:
American Journal of Pharmacogenomics

Abstract

There is increasing discussion in public and academic forums about the anticipated benefits of pharmacogenomics, as well as the attendant social and ethical implications of this research. Yet there is often an implicit assumption that the benefits of pharmacogenomics are ‘just around the corner’ and will significantly outweigh the costs. Furthermore, it is argued that the associated ethical issues are not as profound as those that emerge in other areas of genetics, and that experience gained wrestling with these other issues provides ample ethical and regulatory tools to deal with any problems arising with pharmacogenomics.

We contend that this vision of ethical and social issues associated with pharmacogenomics is not so clear-cut. The scientific evidence is more complex and contested than the public, academics, and policy makers, have been led to believe, and while there may be real clinical benefits from this research, they are not likely to arrive in the near future. Pharmacogenomics research is also occurring in a terrain occupied by a multitude of different and powerful actors, with diverse and often competing interests. It is therefore essential to investigate the broader social and political context, unravel the various interests pressuring for early implementation, and deconstruct the hype in order to appreciate a fuller range of ethical and social consequences associated with the current developments of pharmacogenomics.

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Notes

  1. 1‘Pharmacogenomics’ is the name given to a broad-based pharmaceutical industry-led initiative, based on developments brought about by the Human Genome Project, coupled with functional genomics and high-throughput screening methods, which aims to capitalize on these insights to discover new therapeutic targets and interventions and to elucidate the constellation of genes that determine the efficacy and toxicity of specific medications. ‘Pharmacogenetics’ is the term used to define the narrower spectrum of inherited differences in drug metabolism and disposition linked to individual genetic variations. Although the two terms are often used interchangeably in the literature we aim to keep the terms distinct while recognizing that this is somewhat arbitrary.

  2. 1The use of tradenames is for product identification purposes only and does not imply endorsement.

  3. 1By ‘government departments’, we mean those bodies or agencies within national governments that are responsible for particular areas of government functioning. Our intent is to generalize for types of government department and not to refer to specific national agencies, although there are obviously important national distinctions in the constitution and function of such bodies. Similarly, we believe that the international scope of medical and pharmaceutical research and the transnational nature of many of the major pharmaceutical companies make broad generalizations about attitudes towards pharmacogenomics appropriate for our discussion of rhetoric and hype.

  4. 1The Nuffield Report concedes that only some ADRs are caused by genetic differences and acknowledges that the benefits, in terms of the promise of individually tailored medicine, have been exaggerated and that developments in pharmacogenetics are likely to lead to ‘probabilistic’ rather than ‘personalised’ medicine.

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Acknowledgements

The authors would like to thank Paul Martin and Adam Hedgecoe for sharing their ideas about pharmacogenetics, and Martin Richards and Chris MacDonald for their extremely helpful comments on drafts of this paper. Bryn Williams-Jones was supported by fellowships from the Social Sciences and Humanities Research Council of Canada, and Homerton College. Oonagh Corrigan was supported by a research grant from the UK Wellcome Trust Biomedical Ethics program. ## The authors have no conflicts of interest with regards to the content of this manuscript.

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Authors and Affiliations

  1. Centre for Family Research, Faculty of Social and Political Sciences, University of Cambridge, Cambridge, UK

    Bryn Williams-Jones & Oonagh P. Corrigan

  2. Homerton College, University of Cambridge, Cambridge, UK

    Bryn Williams-Jones

  3. Cambridge Genetics Knowledge Park, University of Cambridge, Cambridge, UK

    Oonagh P. Corrigan

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  1. Bryn Williams-Jones
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Correspondence to Bryn Williams-Jones.

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Williams-Jones, B., Corrigan, O.P. Rhetoric and Hype. Am J Pharmacogenomics 3, 375–383 (2003). https://doi.org/10.2165/00129785-200303060-00004

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