The Human Microbiome and Public Health: Social and Ethical Considerations

Abstract

Rapid advances in human microbiome research point to an increasing range of health outcomes related to the composition of an individual's microbiome. To date, much research has focused on individual health, with a paucity of attention to public health implications. This is a critical oversight owing to the potentially shared nature of the human microbiome across communities and vertical and horizontal mechanisms for transferring microbiomes among humans. We explored some key ethical and social implications of human microbiome research for public health. We focused on (1) insights from microbiome research about damage to individual and shared microbiomes from prevalent societal practices, and (2) ethical and social implications of novel technologies developed on the basis of emerging microbiome science.

Consequences of colonialism: A microbial perspective to contemporary Indigenous health

“…In the implementation of such microbial investigations, researchers need to go beyond global health programs, and look toward community engagement and translating microbiome research into something malleable for health care providers or public health policies (O'Doherty, Virani, & Wilcox, ; Valeggia & Snodgrass, ). Most notably, these inquiries require the inclusion of Indigenous communities, especially in regards to therapeutic benefits (Lewis et al, ).…”

Navigating social and ethical challenges of biobanking for human microbiome research

“…O’Doherty, Virani, and Wilcox have argued that social and ethical implications may arise from technologies to modify the human microbiome, which can go beyond the individuals [30]. The composition and diversity of the human microbiome can change as a result of lifestyles and environmental conditions that are associated with broader sociocultural practices.…”

“…At an individual level, questions arise about the impact that an individual’s decision to modify his or her own microbiome may have on other individuals with important implications for autonomy [30]. Potentially, an individual’s microbiome may be affected by the health decisions of others without his or her awareness.…”

“…With rapid advances in human microbiome research, it is also conceivable to design public health initiatives that involve the purposeful modification of the human microbiome to yield health benefits to the broader society. Such large-scale initiatives might bypass individual health decision-making and bring about unanticipated and long-term consequences of changing the microbiomes of many individuals in a community (See O’Doherty et al for more details on public health implications of technologies developed on the basis of human microbiome research) [30]. …”

Ethical Issues in Fecal Microbiota Transplantion: Taking Into Account Identity and Family Relations

“…However, we argue that two other important issues, which are addressed by Ma and colleagues only in passing, require serious ethical concern, and might need the attention of policymakers and regulatiory bodies. These regard the possible consequences of FMT for (1) personal identity and (2) family relations, two issues which are also addressed by recent studies on micriobome research and therapy (Chuong et al 2017;O'Doherty, Virani, and Wilcox 2016).…”