Identifying High Priority Ethical Challenges for Precision Emergency Medicine - A Nominal Group Study

Abstract

Abstract OBJECTIVE 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. METHODS We performed a qualitative, nominal group technique study of emergency physicians with prior knowledge of precision medicine concepts to identify high priority ethical concerns facing the implementation of precision medicine in the emergency department. RESULTS Twelve emergency physicians identified 91 ethical concerns which were organized into a framework with three major 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 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 concerns 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.

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