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Personalized Medicine Set to Impact Justice System

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Enabled by pharmacogenomics, molecular imaging and other molecular biomarkers, personalized medicine promises to optimize modern medicine and minimize the potential side effects of therapeutic agents. A leading pathologist has now indicated that it may also dramatically impact the justice system, and in ways that we are only just beginning to understand.

In an extended invited Editorial published in the June issue of Pharmacogenomics, Professor Steven Wong and his colleagues highlight 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.

Steven Wong is Professor of Pathology, Psychiatry and Behavioral Medicine at the Medical College of Wisconsin, and Toxicology Scientific Director at the Milwaukee County Medical Examiner’s Office.

Prof. Wong and his team provide 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, should courts 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 predict a slower, more begrudging adoption by the legal profession. Nevertheless, the law’s incredibly rich experience with DNA developments may facilitate acceptance.

They caution 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 on ‘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.