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As medicine targets personal DNA profiles, researchers examine ethics and patient experiences

Published on August 5, 2004 at 6:00 AM · No Comments

Researchers at the University of York are beginning a major study into the ethical and personal issues raised by a potential revolution in healthcare, which could incorporate individualised medical care – pharmacogenetics - into clinical practice.

The use of genetic testing as a routine part of medical treatment opens exciting horizons, but brings with it the responsibility to understand the concerns individuals may have about DNA sampling, and about wider issues such as the possible impact of genetic information. Much of the science of pharmacogenetics is known, but there are many potential hurdles to overcome before the technology is introduced into routine medical use.

Over the next three years Professor Andrew Webster, Dr Graham Lewis and a team in the Science and Technology Studies Unit (SATSU) at York will work with colleagues across the UK monitoring patients’ reactions to warfarin, commonly used to prevent blood clots. The team from York will interview some of the 2,400 patients who will be selected for the study. Of the 2,400 patients, 2000 will be hospital-based and 400 will be recruited through GP surgeries as warfarin can be prescribed by GPs.

Patients’ responses will be mapped against their personal DNA profiles and the SATSU team will interview them to see how they feel about DNA samples being taken, and how publicly acceptable this would be, and the hurdles to introducing the technique.

Warfarin is a very useful drug currently taken by 600,000 patients in the UK, but a small proportion of those who take it suffer serious side effects, even sometimes death. If a patient’s genetic makeup is known beforehand, doctors can prescribe far more accurately so that there are fewer serious side effects.

But the serious ethical issues to be considered, such as reading individual genetic codes from DNA samples, affect both patients and the clinical staff who will have to introduce the new and complex technologies. Clinical staff experiences of these processes are also examined through interviews. Dr Lewis commented; “it is important to study how attitudes and perceptions change with the introduction of new medical technologies like pharmacogenetics, and that means studying the experiences of doctors and nursing staff as well as patients.”

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