Personalized medicine can impact justice system

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Enabled by pharmacogenomics, molecular imaging and other molecular biomarkers, personalized medicine may also dramatically impact the justice system in ways we are only beginning to understand, according to an editorial published in the June issue of Pharmacogenomics.

Steven H. Wong, PhD, professor of pathology, psychiatry and behavioral medicine at the Medical College of Wisconsin in Milwaukee, and toxicology scientific director at the Milwaukee County Medical Examiner’s Office, and colleagues highlighted the advent of “personalized justice” and how this complements personalized medicine and the overlapping practice of translational medicine, which holds that individual differences are caused primarily by genetic and environmental factors.

Wong and his team provided illustrative cases and scenarios, including issues associated with alcohol, antidepressants and antipsychotics, warfarin and pain management.

For example, if pharmacogenomics retrospectively reveals that a warfarin patient was at high risk and testing was not initially performed, litigation might follow–some lawyers already advertise on the internet for cases involving warfarin-related errors. There could be even more fundamental questions from a personalized justice perspective, so Wong and colleagues questioned whether courts should consider identifiable biological conditions that predispose a person to criminal behavior in weighing moral culpability.

Although personalized medicine is rapidly taking root among the medical sciences, the authors predicted a slower, more begrudging adoption by the legal profession. Nevertheless, the law’s incredibly rich experience with DNA developments may facilitate acceptance. Future legal applications may include molecular imaging and analyses – genomic, proteomic, metabolomics and epigenetics/imprintomics, Wong and colleagues predicted.

Wong and colleagues also cautioned that, in establishing personalized justice, a firm foundation should be based on sound legal principles as well as reliable and valid evidence-based studies, not ‘junk’ science and unsubstantiated case reports. With sound scientific and legal principles and correct interpretation, they argue that a firm and lasting foundation could support the emerging concept of personalized justice becoming a reality to enhance patient safety and maintain social justice.