Pharmacogenomics: out of the lab and into the community

Pharmacogenomics is the study of the inherited basis of differences in resp onse to drugs. These interindividual differences are often more than tenfol d; a 'slow metabolizer' or 'low-responsive' individual might therefore requ ire ten times less than the recommended dose of a drug than a 'rapid metabo lizer' or 'high-responsive' person, and the slow metabolizer is often more likely to experience drug toxicity than a rapid metabolizer. Our knowledge is developing rapidly to the point that the physician will soon use DNA-bas ed tests to aid in decision-making with respect to the most appropriate dru g and dosage given to each patient. If the patient's DNA is available, howe ver, what boundaries should be placed on that DNA? If the patient's genotyp e becomes known to the physician (and presumably to the patient him- or her self), what ethical questions might arise and how will they be resolved? Th is article discusses these issues and outlines some of the possible solutio ns.