A Narrative Review of Ethical Issues in Precision Psychiatry: Mapping Unresolved Tensions Across Modalities

Area of Science:

• Neuroscience
• Psychiatry
• Bioethics

Background:

• Precision psychiatry aims for more objective and effective mental healthcare.
• Technological advancements in precision psychiatry introduce complex ethical challenges.
• Existing ethical frameworks require adaptation to address novel issues in psychiatric practice.

Purpose of the Study:

• To synthesize ethical issues in precision psychiatry through a qualitative review of 62 studies.
• To identify and analyze practical ethical tensions arising from conflicting principles.
• To map ethical concerns across key precision psychiatry modalities: genomics, neuroimaging, digital phenotyping, and AI interventions.

Main Methods:

• Narrative review methodology.
• Qualitative synthesis of ethical issues from 62 selected studies.
• Thematic analysis focusing on practical tensions and core principle conflicts.

Main Results:

• Four key positions on ethical considerations were advanced.
• Equity must be proactively integrated, not assumed.
• Interpretability is prioritized over minor accuracy improvements in subjective fields.
• Stigma is bidirectional and influenced by framing and intervention availability.
• Individualized care must prove superiority over standardized methods.

Conclusions:

• Precision psychiatry necessitates careful ethical navigation.
• Engineered equity, prioritized interpretability, managed stigma, and demonstrated superiority are vital.
• Interdisciplinary collaboration, clear guidelines, and ongoing ethical vigilance are essential for responsible implementation and public trust.