Ethical, Legal, and Social Implications of Polygenic Risk Scores in Primary Care: Consent, Governance, and Trust

Abaho Areeba Fortunate

Department of Pharmacy Kampala International University Uganda

Email address: fortunate.abaho@studwc.kiu.ac.ug

ABSTRACT

Polygenic risk scores (PRS) are increasingly promoted as tools for improving disease risk stratification and preventive care in primary healthcare settings. By aggregating the effects of thousands of common genetic variants, PRS offer probabilistic insights into an individual’s susceptibility to complex diseases beyond conventional clinical risk factors. Despite growing evidence of potential clinical utility, the integration of PRS into primary care raises significant ethical, legal, and social implications (ELSI) that remain insufficiently addressed. This paper critically examines these implications with particular focus on consent models, governance frameworks, data protection, equity, and trust in patient–clinician relationships. Drawing on international policy developments and emerging clinical experiences, the analysis explores challenges related to informed, broad, and dynamic consent; regulatory oversight and accountability; data privacy and re-identification risks; disparities arising from ancestry bias and unequal access; and the communication of probabilistic risk in time-constrained primary care settings. The paper argues that without robust governance structures, transparent consent processes, and sustained trust-building measures, the deployment of PRS risks exacerbating health inequities, undermining autonomy, and eroding public confidence in genomic medicine. It concludes by offering practical recommendations for responsible implementation, emphasizing the need for proportionate regulation, clinician education, equity-oriented validation, and patient-centred communication to ensure that PRS adoption in primary care aligns with ethical principles and public health goals.

Keywords: Polygenic Risk Scores, Primary Care, Genomic Ethics, Consent and Governance, Trust and Equity.

CITE AS: Abaho Areeba Fortunate (2026). Ethical, Legal, and Social Implications of Polygenic Risk Scores in Primary Care: Consent, Governance, and Trust. IAA Journal of Scientific Research 13(1):119-123. https://doi.org/10.59298/IAAJSR/2026/131119123