2 . 2023

Bioethical problems in genomics of cardiovascular diseases in precision medicine

Abstract

The precision approach in cardiovascular medicine involves the widest use of genomic and digital technologies. There is an emergence of new accuracy of localization, diagnostics and therapy of diseases, new medical classifications. The article offers a discussion of bioethical and psychological problems associated with the formation of new structural relations in the system doctor – patient in precision medicine. The most important role of medical and genetic counseling in their functioning is noted. The foundation of precision medicine is the principle of justice, which ensures not only the accessibility of medical care to the general population, but also people’s confidence in modern digital and genomic technologies. The conflict between the principle of confidentiality, which forbids the transfer of information about a proband to third parties, and the doctor’s duty to protect his relatives from the possible dangers of carrying pathological genes is discussed. The psychological significance of genetic information for patients-in-waiting is analyzed, and the problems of genetic counseling for children and their rights to an open future are discussed. Bioethical problems of the increasing use of big data technologies and chat-bots in medical and genetic counseling are discussed.

Keywords:patient autonomy; bioethics; big data; genomics; genetic information; genomic surgery; classification of diseases; medical genetic counseling; open future principle; patientin-waiting; precision medicine; privacy principle; chat-bots

Funding. Grebenshchikova E.G. – the article was prepared with the support of the Russian Science Foundation, project No. 19-18-00422; Tishchenko P.D. – the article was prepared according to the State order of the Institute of Philosophy of the Russian Academy of Sciences, the mega-theme “Science, Man and the Prospects of Technogenic Civilization”.

Conflict of interest. The authors declare no conflict of interest.

For citation: Grebenshchikova E.G., Tishchenko P.D. Bioethical problems in genomics of cardiovascular diseases in precision medicine. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (2): 7–16. DOI: https://doi.org/10.33029/2308-1198-2023-11-2-7-16 (in Russian)

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