Doctors Start Wrangling with Thorny PM Issues

Personalized Medicine Watch by John Russell

November 4, 2008 | If you think that personalized medicine is so distant still you don’t have to worry about its challenges, you should read a good article in American Medical News this week, “Judging genetic risks: Physicians often caught between what patients want and what science offers.”

The practical realities facing doctors are growing quickly, according to the article: “Clinical tests are available through more traditional routes such as physicians, genetic counselors, and labs, for more than 1,300 diseases, with several hundred more under research, according to the National Institutes of Health.”

“…The standard of care—medical and legal—is changing, and there's a lot more to know these days about genetic technologies,” said Lynn Fleisher, general counsel for the American College of Medical Genetics. “It's the duty of physicians to know about the information and communicate the results of that knowledge to patients.”

This is a whole lot easier said than done. Not just this, but physicians worry that regulation, while clearly needed, may go too far. For example, they don’t want their treatment options to be limited or dictated by a genetic test outcome, or suddenly be liable.  

Here’s another excerpt: “For example, case law in about 25 states recognizes wrongful birth claims. These claims allow parents of a child born with disabilities to argue that they lost their right to terminate the pregnancy after a doctor failed to detect and inform them of genetic anomalies. States that prohibit such actions still may allow plaintiffs to sue for medical negligence, or begin recognizing wrongful birth claims…As genetic testing proliferates, state-by-state interpretation is going to be up for scrutiny…

“…Among the first legal tests was a 2006 case in which a child was born in Maryland with a genetic anomaly, but the fetal test was interpreted in North Carolina. The Maryland Court of Appeals, the state's highest court, allowed the child’s parents to sue the lab under Maryland’s wrongful birth law, even though North Carolina law did not recognize the claim.”

The full article is well worth reading and can be found at

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A new high throughput microscopy technique enabled researchers at Baylor College of Medicine in Houston to analyze thousands of individual cells expressing androgen receptor, a finding that could herald new ways of evaluating the effect of drugs or other treatments on cells with normal or aberrant hormone receptors.

In a report in the current issue of Public Library of Science One (PLoS One), Dr. Michael Mancini and his collaborators reported a new, next generation high throughput image-based assay that helps determine the level and location of androgen receptor and its transcriptional activity on a cell-by-cell basis.

“This has application to personalized medicine,” said Mancini, associate professor of molecular and cellular biology at BCM and director of its Integrated Microscopy Core. “For example, we could use the high throughput microscope and robust image analysis to determine which drug might be best to turn off or repair a mutated cell that is causing disease.”

Researchers at UH explore patient preferences for personalized medicine

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