Ethical Application of Precision Medicine to Schizophrenia Management

Abstract

A recent effort has been made to better characterize the genetic architecture of schizophrenia, and apply a precision medicine model to its treatment. In pursuing this approach, it is likely that ethical concerns regarding cost-benefit uncertainties, the duty to inform and confidentiality will arise. Due to the complexity of schizophrenia's genetic profile, research efforts must be weighed against the risk to human subjects and the required consumption of valuable healthcare resources. Genetic risk profiles must be judged in conjunction with actionability and must be fully explained to patients and others potentially affected. However, confidentiality should be of paramount importance due to the presence of a risk-state phenotype, meaning the associated presence of clinically detectable neurocognitive deficiencies in those with elevated schizophrenia risk profiles.

Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

“…associated with more than one diagnostic category) (Smeland et al, 2019). While polygenic risk score predictions are improving, they still lack clinical utility ( Smeland and Andreassen, 2021 ), raising ethical concerns ( Daws, 2017 ;Landi et al, 2021 ). Therefore, precision psychiatry may be more interpretive (Panel 1) than an exact science, requiring consideration of symptoms and categories of people living in society rather than objective biomarkers.…”