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Bioethics in Personalized Medicine and Precision Medicine
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Bioethics in Personalized Medicine and Precision Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: 15 April 2027 | Viewed by 3738

Editors

Dr. Michael Igoumenidis

E-Mail Website
Guest Editor
Department of Nursing, University of Patras, Patras, Greece
Interests: nursing ethics; medical ethics; health resources allocation
Dr. Venetia Sofia Velonaki

E-Mail Website
Guest Editor
Department of Nursing, National and Kapodistrian University of Athens, 11517 Athens, Greece
Interests: nursing ethics and law; vulnerable populations (people with disabilities, immigrants/refugees, the elderly, etc.); health education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Personalized medicine (PM) aims to provide tailor-made prevention and treatment strategies for defined groups of individuals, with key areas including oncology, cardiology, rare diseases, infectious diseases, and pharmacogenomics. Various precision interventions are already used in health care systems around the globe and research initiatives leave promises for the rapid expansion of PM in the near-future. This growing interest has prompted considerations of several bioethical issues. Questions of justice arise when the benefits of these novel interventions are not accessible to all, whereas allocating more resources to individualistic approaches raises serious concerns from a population health perspective. There is also a risk that PM could exacerbate existing health disparities, and insurance companies or employers might discriminate based on genetic predispositions. The issues of privacy, confidentiality, transparency, and informed consent must be carefully revised to adapt to the new realities that PM entails; indeed, the whole therapeutic relationship is affected. In addition, the interpretation of genetic data and its application to treatment decisions can be complex and uncertain, threatening patient safety.

This Special Issue invites interdisciplinary contributions that explore these and other bioethical challenges emerging from personalized and precision medicine advances. We welcome discussion papers, reviews, and original research articles highlighting the ethical, legal, and social implications of recent PM advances. The aim is to foster an international dialogue among ethicists, clinicians, researchers, policymakers, and patient communities to ensure that the future of personalized and precision medicine is guided by robust ethical principles.

Dr. Michael Igoumenidis
Dr. Venetia Sofia Velonaki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher's Notice

The Special Issue has been shifted from Section Disease Biomarkers to Section Personalized Therapy in Clinical Medicine on 26 November 2025. At the time of the move, there were no publications in this Special Issue.

Keywords

  • bioethics
  • equity
  • genetic discrimination
  • health disparities
  • individualized care
  • predictive analytics

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Published Papers (4 papers)

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Research

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26 pages, 1187 KB  
Article
Ethical Considerations in Health Technology Assessment for Precision Medicine: A Delphi Study in a Greek Setting
by Nikolaos Veskoukis, Nikos Stefanopoulos, Panagiota Naoum and Kostas Athanasakis
J. Pers. Med. 2026, 16(6), 308; https://doi.org/10.3390/jpm16060308 - 5 Jun 2026
Viewed by 666
Abstract
Background/Objectives: Precision medicine has moved into routine practice, but its evaluation through Health Technology Assessment (HTA) remains ethically underdeveloped. Existing instruments do not address the distinctive ethical demands of genomic profiling, AI-based clinical decision-support, and the equitable distribution of benefits from high-cost targeted [...] Read more.
Background/Objectives: Precision medicine has moved into routine practice, but its evaluation through Health Technology Assessment (HTA) remains ethically underdeveloped. Existing instruments do not address the distinctive ethical demands of genomic profiling, AI-based clinical decision-support, and the equitable distribution of benefits from high-cost targeted therapies. Methods: A modified two-round Delphi study was conducted with a multidisciplinary panel of 18 Greek experts in bioethics, HTA, genomic medicine, nursing, and health policy. In Round 1, 32 candidate ethical statements across seven thematic domains were rated on a three-point scale; retention required a Content Validity Ratio (CVR) ≥ 0.42 and ≥80% agreement. Retained statements were re-evaluated in Round 2 with consensus defined as median ≥ 2.0 and ≥80% agreement. Reporting follows ACCORD guidelines. Results: Fifteen of 32 statements satisfied retention criteria. In Round 2, all 15 achieved consensus with a median of 3.0 and agreement of 94.4–100% (interquartile range, IQR = 0.00). Five domains constituted the final framework: fundamental ethical principles; transparency, stakeholder participation, and institutional accountability; equity and access; digital health and artificial intelligence (AI); and pandemic preparedness and system resilience. Domains addressing environmental sustainability and social acceptability did not meet the threshold. Conclusions: This study presents, to our knowledge, one of the first empirically grounded ethical frameworks for precision medicine HTA developed within an EU Member State through a formal Delphi process. The framework is operationalised through a ready-to-use ethics checklist designed for direct integration into national HTA submission and appraisal processes. Conducted in Greece—a late-aligning EU Member State—the study provides a transferable methodological template for comparable health systems across Europe. Full article
(This article belongs to the Special Issue Bioethics in Personalized Medicine and Precision Medicine)
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16 pages, 273 KB  
Communication
Personalizing Approaches in International Projects Engaging Individuals with Vulnerabilities: The Lessons Learned for a Person-Centered Research
by Stefania Chiappinotto, Chiara Moreal, Aysun Bayram, Nevenka Kregar Velikonja, Aysel Özsaban, Montserrat Solà-Pola, Alba Roselló-Novella, Kinga Zdunek, Beata Dobrowolska and Alvisa Palese
J. Pers. Med. 2026, 16(6), 296; https://doi.org/10.3390/jpm16060296 - 31 May 2026
Viewed by 625
Abstract
Background: The involvement of people living in situations of vulnerability has long been a central ethical issue in research, particularly in contexts marked by power asymmetries, limited access to resources, or restricted decisional autonomy. Although international ethical frameworks offer increasing guidance on protecting [...] Read more.
Background: The involvement of people living in situations of vulnerability has long been a central ethical issue in research, particularly in contexts marked by power asymmetries, limited access to resources, or restricted decisional autonomy. Although international ethical frameworks offer increasing guidance on protecting vulnerable participants, applying these principles in everyday research practice remains challenging, especially in qualitative and multi-country studies. This communication draws on the experience of the European Protecting You & Others project, an Erasmus+ initiative conducted across five countries. Methods: During the project design and implementation, the research team engaged in ongoing reflexive work to examine the ethical, methodological, and practical challenges encountered when defining vulnerability, involving participants living in situations of vulnerability, and adapting research activities and educational interventions to different specific needs. Reflexive notes and collective team discussions were used to identify recurrent challenges and the strategies adopted to address them. Results: Key challenges included (a) the difficulty of choosing an inclusive yet operational definition of vulnerability; (b) participants’ self-perceptions and tensions between externally assigned vulnerability; (c) risks of stigmatization associated with categorization; the use of respectful and context-appropriate language; and (d) the adoption of a shared international framework adapted to educational content across countries. Overall, vulnerability emerged as a dynamic and context-dependent condition that requires research designs, methodologies and interventions to remain open, flexible, and responsive throughout the study process. Conclusions: Studies involving people living in situations of vulnerability, particularly in international and multi-country contexts, should not rely solely on predefined classifications or standardized safeguards. Instead, adaptive procedures are needed to recognize how needs, barriers, resources, and forms of participation vary across individuals and contexts. Such openness may support more person-centered approaches to engagement, communication, and intervention adaptation, while preserving ethical consistency and methodological rigor across countries. Full article
(This article belongs to the Special Issue Bioethics in Personalized Medicine and Precision Medicine)

Review

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22 pages, 1294 KB  
Review
A Narrative Review of Ethical Issues in Precision Psychiatry: Mapping Unresolved Tensions Across Modalities
by Christos Doukas, Petros Galanis, Athanasios Douzenis, Panagiota Bali, Marie Louise Psarra, Ioannis Michopoulos, Nikolaos Smyrnis and Konstantinos Tasios
J. Pers. Med. 2026, 16(7), 337; https://doi.org/10.3390/jpm16070337 - 23 Jun 2026
Viewed by 1061
Abstract
Precision psychiatry promises a more objective and effective approach to psychiatric care, yet its implementation raises growing ethical challenges as technology advances. This narrative review offers a qualitative synthesis of the ethical issues reported in 62 studies, with emphasis on the practical tensions [...] Read more.
Precision psychiatry promises a more objective and effective approach to psychiatric care, yet its implementation raises growing ethical challenges as technology advances. This narrative review offers a qualitative synthesis of the ethical issues reported in 62 studies, with emphasis on the practical tensions that arise when core principles conflict. Rather than organising concerns around traditional ethical principles, the review maps them across the main modalities of precision psychiatry, namely genomics, neuroimaging, digital phenotyping, and AI-driven interventions. Four explicit positions are advanced. First, equity must be engineered from the outset rather than assumed. Second, interpretability should outweigh marginal gains in accuracy in a field built on subjective report. Third, stigma is bidirectional and contingent on framing and the availability of meaningful intervention. Fourth, individualised care must demonstrate clinical and economic superiority over standardised approaches. Precision psychiatry is likely to reshape psychiatric practice and the therapeutic relationship itself. Interdisciplinary collaboration, clear guidelines, and continuous ethical vigilance will be essential for responsible adoption and sustained public trust. Full article
(This article belongs to the Special Issue Bioethics in Personalized Medicine and Precision Medicine)
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17 pages, 275 KB  
Review
AI and Its Shifting Roles in the Therapeutic Relationship: Implications for Precision Medicine
by Michael Igoumenidis and Venetia-Sofia Velonaki
J. Pers. Med. 2026, 16(6), 324; https://doi.org/10.3390/jpm16060324 - 17 Jun 2026
Viewed by 758
Abstract
The emergence and increasing use of artificial intelligence (AI) in healthcare have paved the way for highly personalized and time-saving approaches in the field of precision medicine. It can be applied to determine a prognosis, diagnosis, and recommended treatment, and may also be [...] Read more.
The emergence and increasing use of artificial intelligence (AI) in healthcare have paved the way for highly personalized and time-saving approaches in the field of precision medicine. It can be applied to determine a prognosis, diagnosis, and recommended treatment, and may also be used for patient monitoring. As AI applications become more widely available, reliable and easy to use, they are rapidly reshaping the traditional roles of professionals and patients in the therapeutic relationship. On the positive side, professionals may have more time to communicate with patients and provide individualized care, whereas patients may become more empowered and autonomous due to AI-facilitated personalized information and monitoring. On the negative side, AI applications threaten to reduce the role of professionals to a mediating one in clinical decision-making, provide patients with misinformation, and lead to misunderstandings that hinder patients’ autonomy. In this narrative review, we examine the main ethical issues related to the AI-induced shift in roles in the therapeutic relationship, within four inter-related themes: the validity of claims that algorithms outperform humans in certain tasks; the ways in which AI saves time for health professionals but also takes time to properly explain and implement; the issues of trust and accountability, especially if AI suggestions lead to patient harm; and what AI’s alleged cost-effectiveness means for professionals’ employment and remuneration. Across the three roles, we find a common pattern: AI tends to absorb the technical and data-processing parts of clinical work while leaving its relational core to humans. Physicians move toward oversight and interpretation, nurses retain the attentiveness and responsiveness that define care, and patients gain tools for self-management that can widen autonomy or, left unguided, erode it. Whether the overall effect is benign depends less on the technology than on how outperformance is evidenced, how the freed time is used, how trust and accountability are anchored in people, and how cost pressures are managed. The article concludes with some suggestions for prudent use of AI in healthcare, indicating the appropriate measures that can be used to harness the power of AI without damaging the traditional cornerstones of the therapeutic relationship. Full article
(This article belongs to the Special Issue Bioethics in Personalized Medicine and Precision Medicine)
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