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Ethical considerations for modern molecular pathology.

Shoko Vos1, Paul J van Diest1, Margreet Gem Ausems2

  • 1Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.

The Journal of Pathology
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Summary

Molecular pathology advances cancer care, but ethical considerations in DNA sequencing lag. Pathologists must address these complex issues for responsible use in oncology.

Keywords:
cancerethicsgeneticsmolecular pathologynext-generation sequencingpathologypersonalized medicine

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Area of Science:

  • Oncology
  • Pathology
  • Genetics

Background:

  • Molecular pathology is crucial for targeted cancer care.
  • Technological advances in molecular pathology have outpaced ethical guidelines.
  • Existing ethical guidelines for DNA sequencing are often not specific to oncology.

Purpose of the Study:

  • To discuss ethical issues in molecular pathology, specifically tumor DNA sequencing.
  • To highlight the need for ethical frameworks in clinical cancer care.
  • To provide recommendations for pathologists regarding molecular analyses.

Main Methods:

  • Perspective piece discussing ethical considerations throughout the tumor DNA sequencing process (preanalytical to postanalytical).
  • Review of existing ethical guidelines in clinical genetics and biomedical research.
  • Analysis of unique and complex ethical challenges in molecular pathology.

Main Results:

  • Significant ethical issues arise in molecular pathology, including data interpretation, informed consent, and data usage.
  • DNA sequencing can yield sensitive, potentially unsolicited findings, posing new challenges for pathology.
  • Differences exist in tumor sequencing analysis processes between laboratories, indicating a need for standardization.

Conclusions:

  • Pathologists must take responsibility for the ethical use of molecular analyses in cancer care.
  • Adaptation of existing ethical scholarship from clinical genetics is recommended for molecular pathology.
  • Addressing ethical issues is vital for the responsible development of molecular pathology and clinical cancer care.