Ethical Considerations in Pharmacogenomic Testing and Research in Pediatrics
It is critical to resolve ethical issues surrounding genome-based testing in children because of the growing availability of pharmacogenomic (PGx) testing, the establishment of pediatric DNA research databases, and the unforeseen future implications of identifying genomic variability in individual children. Ethical concerns related to pediatric genomic analysis, as well as legislation to protect children, will require frequent evaluation and will be important in fully informing patients, families, clinicians, and researchers about the potential risks and benefits of genomic testing in children. PGx testing is distinct from other forms of genetic testing and presents novel considerations of this benefit-risk relationship. If it can be done without loss of benefit, risk reduction is a moral imperative; thus, as we learn more about the technology's actual value to children, ethical issues related to PGx must be continually addressed. Because of the complexity of interpreting PGx results, even for experienced clinicians, many of the issues raised in pediatrics are relevant to adult patients and caregivers.