JMIR Publications

ABSTRACT

Background:

Precision medicine is a rapidly progressing avenue to providing the right care to the right patient at the right time and spans all medical fields and specialties. However, given its reliance on computation and timely, accurate information, actualizing precision medicine within the emergency department and its “anyone, anywhere, anytime” approach presents unique challenges which could exacerbate disparities rather than improve care. Furthermore, the data used to develop precision medicine therapies lack full representation from all patient populations and communities, limiting their effectiveness.

Objective:

To identify high priority ethical concerns facing the implementation of precision medicine in the emergency department.

Methods:

We performed a qualitative, nominal group technique study of emergency physicians with prior knowledge of precision medicine concepts.

Results:

Twelve emergency physicians identified 91 ethical concerns which were organized into a framework with three themes: values, privacy, and justice. The framework identified the need to address these themes across three time points of the precision medicine process: acquisition of data, actualization in the care setting, and the after effects of its use.

Conclusions:

Precision medicine may help to improve the quality of care provided in the emergency department, but significant hurdles exist. Our framework helps to identify high-yield ethical challenges that could serve as focus areas for future research and policy in order to guide the effective implementation of precision medicine in the emergency department.