Ethical Principles, Constraints, and Opportunities in Clinical Proteomics

Sebastian Porsdam Mann,Peter V Treit,Philipp E Geyer,Gilbert S Omenn,Matthias Mann

doi:10.1016/j.mcpro.2021.100046

Abstract

AbstractRecent advances in MS-based proteomics have vastly increased the quality and scope of biological information that can be derived from human samples. These advances have rendered current workflows increasingly applicable in biomedical and clinical contexts. As proteomics is poised to take an important role in the clinic, associated ethical responsibilities increase in tandem with impacts on the health, privacy, and well-being of individuals. We conducted and here report a systematic literature review of ethical issues in clinical proteomics. We add our perspectives from a background of bioethics, the results of our accompanying article extracting individual-sensitive results from patient samples, and the literature addressing similar issues in genomics. The spectrum of potential issues ranges from patient reidentification to incidental findings of clinical significance. The latter can be divided into actionable and unactionable findings. Some of these have the potential to be employed in discriminatory or privacy-infringing ways. However, incidental findings may also have great positive potential. A plasma proteome profile, for instance, could inform on the general health or disease status of an individual regardless of the narrow diagnostic question that prompted it. We suggest that early discussion of ethical issues in clinical proteomics can ensure that eventual health care practices and regulations reflect the considered judgment of the community and anticipate opportunities and problems that may arise as the technology matures.

Highlights

Principles of bioethics as they relate to clinical proteomics. Systematic literature review of ethics in clinical proteomics. Prospects for preventive proteomics profiling. Importance of early discussion of ethical issues to ensure eventual regulations reflect the considered judgment of the community
We suggest that early discussion of ethical issues in clinical proteomics can ensure that eventual health care practices and regulations reflect the considered judgment of the community and anticipate opportunities and problems that may arise as the technology matures
We aim to provide a firm foundation for such an analysis, informed by our systematic review of ethical issues already identified in the clinical proteomics literature

Summary

Introduction

Over the years, the capabilities of all aspects of proteomics have vastly improved and, at the same time, a large range of specialized methods have been developed This has made MS-based proteomics an extremely versatile tool for life scientists, allowing for explorations of simple protein expression levels as well as identification of protein–protein interactions, structural investigations, posttranslational modifications, biological networks, and therapeutic targets. In a clinical context, the unbiased nature and increasing power of MS-based proteomics has increased the overall amount and the proportion of ethically sensitive data Note that this only applies to untargeted proteomics, called discovery proteomics, in which the proteome is measured to the greatest extent possible.

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Conclusion