A132

Ethical issues of consent in pharmacogenomic research on cancer patients

Helen Moore

Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, Shropshire, UK

With the advent of biotechnological advances, there has been an explosion in pharmacogenomics. This field holds great potential where we will move from a one-size fits all to a tailor-made paradigm; where each individual will be prescribed the most effective treatment; where we will not experience adverse drug reactions or undue side-effects; where the treatments will be more effective; and the end result should be that we will live longer.

Until a few years ago, only 3.75% of all cancer patients diagnosed were offered a clinical trial (NCRI 2004). Even fewer would have consented and entered into a translational sub-study. If people had the option to opt-in to such research before diagnosis, consent may be more valid; free from anxiety and duress. By taking consent once a patient has been diagnosed with cancer, they may not be making a truly autonomous decision. Do researchers explain the issues of confidentiality and privacy when the research is often open-ended or explain the issues of ownership and intellectual property rights? Translational research consent is usually obtained whilst consenting to an interventional treatment study. The ethical issues of consenting to pharmacogenomic research may be brushed aside in favour of discussing what may be considered the far more important issue of an interventional study. Currently we are approaching patients at a time of least resistance.

If we want to live in a society committed to the advancement of medicine, we need to take a leap of faith and give truly valid consent prior to diagnosis. Upon diagnosis, blood and tissue will be gifted to a biobank, giving society an endless supply of research material. The ethical issues are not insurmountable and could never justify the abolition of pharmacogenomic research but just need to be given careful consideration.