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

Area of Science:

• Ethical considerations in healthcare innovation
• Translational research and clinical implementation science
• Health equity and access to care

Background:

• Precision medicine offers personalized healthcare but faces implementation hurdles in emergency settings.
• Emergency departments, as healthcare safety nets, must address ethical challenges to prevent exacerbating health disparities.
• Understanding these challenges is crucial before widespread adoption of precision medicine in emergency care.

Purpose of the Study:

• To identify high-priority ethical concerns for precision medicine implementation in emergency departments.
• To develop a framework for understanding and addressing these ethical challenges.
• To inform future research and policy development.

Main Methods:

• Qualitative study using a modified nominal group technique (NGT).
• Involved 12 emergency physicians with prior knowledge of precision medicine.
• Participants represented diverse practice settings and subspecialties.

Main Results:

• Identified 48 unique challenges consolidated from 82 initial ideas.
• Developed a framework with 3 themes: values, privacy, and justice.
• Highlighted concerns across data acquisition, care implementation, and after-effects, including bias and equity.

Conclusions:

• A novel framework maps ethical challenges in precision medicine implementation across values, privacy, and justice domains and temporal stages.
• Identified high-priority areas for research and policy, focusing on data representation, privacy, and equitable access.
• Addressing these challenges is vital for realizing precision medicine's potential while maintaining emergency medicine's role as a safety net.