Ethical Issues in Pediatric Precision Oncology in Singapore

IF 1.3 Q3 ETHICS

Asian Bioethics Review Pub Date : 2025-03-03 DOI:10.1007/s41649-024-00351-z

Chan Mei-Yoke

{"title":"Ethical Issues in Pediatric Precision Oncology in Singapore","authors":"Chan Mei-Yoke","doi":"10.1007/s41649-024-00351-z","DOIUrl":null,"url":null,"abstract":"<div><p>Since the human genome was sequenced in 2003, exploding knowledge and new technologies in the field of genomics have given rise to the new field of precision medicine, whereby treatment is individualized to patients based on their genomic information. However, as with any new scientific advancement and technology, precision medicine has the potential to improve health outcomes but raises ethical questions, particularly in children. Using pediatric precision oncology as an example, this paper focuses on the ethical issues in the integration of genomic information in the management of children with cancer. Pediatric precision oncology encompasses the use of the child’s cancer genomic information and sometimes germline genomic information to aid in diagnosis, risk stratification, and prognostication, as well as “precisely” treating the cancer using genomically guided targeted therapies. The main ethical issues discussed in this paper include the difficulty in obtaining informed consent from parents and assent from the child, due to information overload, emotional overwhelm, cognitive biases, among others; the ambiguity between research and clinical care, leading to therapeutic misconception and mis-estimation; the utility of this novel technology and its impact on scarce resources; and the potential to widen health disparities thus affecting justice. Recognizing and addressing these ethical challenges will help guide the responsible implementation and integration of precision medicine into routine pediatric clinical care.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 2","pages":"293 - 306"},"PeriodicalIF":1.3000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Bioethics Review","FirstCategoryId":"1085","ListUrlMain":"https://link.springer.com/article/10.1007/s41649-024-00351-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ETHICS","Score":null,"Total":0}

引用次数: 0

Abstract

Since the human genome was sequenced in 2003, exploding knowledge and new technologies in the field of genomics have given rise to the new field of precision medicine, whereby treatment is individualized to patients based on their genomic information. However, as with any new scientific advancement and technology, precision medicine has the potential to improve health outcomes but raises ethical questions, particularly in children. Using pediatric precision oncology as an example, this paper focuses on the ethical issues in the integration of genomic information in the management of children with cancer. Pediatric precision oncology encompasses the use of the child’s cancer genomic information and sometimes germline genomic information to aid in diagnosis, risk stratification, and prognostication, as well as “precisely” treating the cancer using genomically guided targeted therapies. The main ethical issues discussed in this paper include the difficulty in obtaining informed consent from parents and assent from the child, due to information overload, emotional overwhelm, cognitive biases, among others; the ambiguity between research and clinical care, leading to therapeutic misconception and mis-estimation; the utility of this novel technology and its impact on scarce resources; and the potential to widen health disparities thus affecting justice. Recognizing and addressing these ethical challenges will help guide the responsible implementation and integration of precision medicine into routine pediatric clinical care.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Asian Bioethics Review Multiple-

CiteScore

6.20

自引率

3.40%

发文量

期刊介绍： Asian Bioethics Review (ABR) is an international academic journal, based in Asia, providing a forum to express and exchange original ideas on all aspects of bioethics, especially those relevant to the region. Published quarterly, the journal seeks to promote collaborative research among scholars in Asia or with an interest in Asia, as well as multi-cultural and multi-disciplinary bioethical studies more generally. It will appeal to all working on bioethical issues in biomedicine, healthcare, caregiving and patient support, genetics, law and governance, health systems and policy, science studies and research. ABR provides analyses, perspectives and insights into new approaches in bioethics, recent changes in biomedical law and policy, developments in capacity building and professional training, and voices or essays from a student’s perspective. The journal includes articles, research studies, target articles, case evaluations and commentaries. It also publishes book reviews and correspondence to the editor. ABR welcomes original papers from all countries, particularly those that relate to Asia. ABR is the flagship publication of the Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore. The Centre for Biomedical Ethics is a collaborating centre on bioethics of the World Health Organization.