Scenario Analysis: This scenario presents a professional challenge in navigating the complex landscape of precision oncology medicine, specifically concerning the ethical and regulatory considerations of translational research and patient registries within Sub-Saharan Africa. The core challenge lies in balancing the imperative to advance medical knowledge and improve patient outcomes through data collection and research with the paramount need to protect patient privacy, ensure informed consent, and adhere to diverse, often evolving, regulatory frameworks across different African nations. The heterogeneity of data protection laws, ethical review board capacities, and research infrastructure across the region necessitates a nuanced and context-specific approach. Careful judgment is required to ensure that innovation and data sharing do not inadvertently lead to exploitation or breaches of trust. Correct Approach Analysis: The best professional practice involves establishing a multi-stakeholder collaborative framework that prioritizes robust data governance, ethical oversight, and community engagement. This approach necessitates developing standardized, yet adaptable, protocols for data collection, anonymization, and sharing that are compliant with the most stringent applicable data protection laws within the participating Sub-Saharan African countries, while also adhering to international best practices like those recommended by the World Health Organization for health research. Crucially, it involves obtaining explicit, informed consent from patients for the use of their de-identified data in translational research and registries, ensuring they understand the potential benefits and risks. This approach fosters trust, promotes equitable benefit sharing, and ensures that research contributes meaningfully to local healthcare improvements. It aligns with the ethical principles of beneficence, non-maleficence, autonomy, and justice, and respects the sovereign right of each nation to regulate research within its borders. Incorrect Approaches Analysis: One incorrect approach involves prioritizing rapid data aggregation for global research initiatives without adequately addressing the specific legal and ethical requirements of each participating Sub-Saharan African nation. This can lead to violations of local data protection laws, such as those that may require explicit consent for data transfer or mandate specific anonymization techniques. It also risks undermining patient autonomy and trust if consent processes are not culturally appropriate or fully understood. Another incorrect approach is to assume that a single, generic consent form and data sharing agreement will suffice across the entire region. This fails to acknowledge the significant legal and cultural variations in Sub-Saharan Africa. Such an approach could result in non-compliance with specific national regulations regarding consent, data ownership, or the establishment of research registries, potentially invalidating research findings or leading to legal repercussions. A further incorrect approach is to bypass local ethical review boards and national regulatory bodies in the interest of expediency, relying solely on international ethical guidelines. This disregards the sovereign authority of African nations to govern research conducted within their territories and can lead to the implementation of research practices that are not aligned with local healthcare priorities or ethical norms, potentially causing harm or exploitation. Professional Reasoning: Professionals in this field must adopt a decision-making process that begins with a thorough understanding of the regulatory and ethical landscape of each specific country involved in the research. This involves consulting with local legal experts, ethics committees, and community representatives. The process should then focus on developing research protocols that are not only scientifically sound but also ethically robust and legally compliant, with a strong emphasis on informed consent and data privacy. Prioritizing transparency, accountability, and equitable benefit sharing with the communities from which data is derived is essential for building sustainable and trustworthy precision oncology medicine initiatives in Sub-Saharan Africa.

This scenario presents a professional challenge due to the inherent complexities of precision oncology, particularly in a Sub-Saharan African context where resource limitations and diverse healthcare infrastructures can impact equitable access to advanced diagnostics and treatments. The core tension lies in balancing the rapid advancements in genomic sequencing and targeted therapies with the practical realities of implementation, patient consent, data privacy, and ethical considerations surrounding incidental findings. Careful judgment is required to navigate these multifaceted issues, ensuring patient well-being, scientific integrity, and adherence to evolving regulatory landscapes. The approach that represents best professional practice involves a comprehensive, multi-stakeholder framework for genomic data interpretation and clinical application. This includes establishing clear protocols for informed consent that explicitly address the potential for incidental findings and the subsequent management of such information. It necessitates robust data governance structures that prioritize patient privacy and security, aligning with principles of data protection relevant to the region. Furthermore, it requires a collaborative approach involving multidisciplinary teams (clinicians, geneticists, bioinformaticians, ethicists) to review findings, determine clinical relevance, and communicate results to patients in an understandable and actionable manner. This approach is correct because it prioritizes patient autonomy, ensures responsible data handling, and promotes evidence-based clinical decision-making, all of which are foundational ethical and regulatory imperatives in precision medicine. An incorrect approach would be to proceed with the interpretation and clinical application of genomic data without a pre-defined protocol for handling incidental findings. This fails to adequately address the ethical obligation to inform patients about potential health risks discovered incidentally, thereby undermining informed consent and patient autonomy. It also creates a significant regulatory risk related to data privacy and the potential misuse of sensitive genetic information. Another incorrect approach would be to solely focus on the technical interpretation of genomic data, neglecting the critical step of communicating complex findings to patients in a culturally sensitive and comprehensible manner. This oversight can lead to patient anxiety, misunderstanding, and a failure to benefit from potentially life-saving information, violating ethical principles of beneficence and non-maleficence. It also risks non-compliance with any regional guidelines that mandate clear patient communication. A further incorrect approach would be to prioritize the immediate clinical application of any identified genetic alteration without a thorough validation process or consideration of its clinical utility within the specific patient’s context and the available treatment landscape. This can lead to the premature adoption of unproven therapies or the misinterpretation of genetic variants, potentially causing harm to the patient and misallocating scarce healthcare resources. It disregards the rigorous scientific and ethical standards required for the responsible integration of precision oncology into clinical practice. Professional reasoning in such situations should involve a systematic process of risk assessment, ethical deliberation, and adherence to established guidelines. Professionals must proactively identify potential ethical and regulatory challenges, engage in open dialogue with patients and stakeholders, and seek expert consultation when necessary. A commitment to continuous learning and adaptation to the evolving scientific and regulatory environment is paramount.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the potential for life-saving advanced therapies with the significant financial burden and resource limitations often present in Sub-Saharan Africa. Precision oncology medicine, while promising, is typically expensive and requires specialized infrastructure and expertise, which may not be universally available. The ethical imperative to provide the best possible care must be weighed against the practical realities of healthcare systems and the principle of equitable resource allocation. Careful judgment is required to ensure that decisions are both clinically sound and ethically justifiable within the prevailing context. Correct Approach Analysis: The best professional practice involves a comprehensive assessment of the patient’s clinical profile, the evidence supporting the specific precision oncology therapy, and the availability of resources and infrastructure within the local healthcare setting. This approach prioritizes patient benefit while acknowledging systemic constraints. It involves a thorough evaluation of the diagnostic capabilities, treatment facilities, and the expertise of the medical team to determine if the proposed therapy can be safely and effectively administered and monitored. Furthermore, it necessitates exploring all available funding mechanisms, including patient assistance programs, government subsidies, and research grants, to mitigate the financial burden. This approach aligns with ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and justice (fair distribution of resources). It also implicitly adheres to any relevant national health policies or guidelines that govern the adoption of expensive medical technologies. Incorrect Approaches Analysis: One incorrect approach involves immediately pursuing the most advanced and potentially life-saving precision oncology therapy solely based on its efficacy in high-resource settings, without a thorough assessment of local feasibility. This fails to consider the practical limitations of infrastructure, trained personnel, and ongoing monitoring required for such treatments, potentially leading to suboptimal outcomes or even harm if the necessary support systems are absent. This approach neglects the principle of justice by potentially diverting scarce resources from other patients who might benefit from more accessible treatments. Another incorrect approach is to dismiss precision oncology medicine entirely due to cost concerns without exploring all potential avenues for access. This can lead to a failure to provide potentially life-saving treatment to patients who could benefit, violating the principle of beneficence. It also overlooks the possibility of innovative funding solutions or phased implementation strategies that could make these therapies accessible over time. A third incorrect approach is to prioritize therapies based solely on the availability of funding without adequately considering the clinical appropriateness and potential benefit for the individual patient. While financial constraints are real, the primary driver for medical intervention must be the patient’s clinical needs and the evidence supporting the treatment’s efficacy in their specific condition. This approach risks providing ineffective or inappropriate treatments, leading to wasted resources and potential harm. Professional Reasoning: Professionals should adopt a systematic decision-making process that begins with a thorough clinical evaluation of the patient. This should be followed by a rigorous assessment of the evidence supporting the proposed precision oncology therapy, considering its efficacy, safety profile, and potential side effects. Crucially, this must be integrated with a realistic appraisal of the local healthcare infrastructure, available expertise, and ongoing support capabilities. Simultaneously, all potential funding avenues and patient assistance programs should be explored. This multi-faceted approach ensures that decisions are clinically sound, ethically defensible, and practically achievable within the specific context of Sub-Saharan Africa, promoting patient well-being and responsible resource stewardship.

Scenario Analysis: This scenario presents a professional challenge in managing a patient with a complex chronic condition requiring precision oncology medicine. The challenge lies in balancing the immediate need for symptom management with the long-term implications of treatment, all within the evolving landscape of evidence-based practice and patient autonomy. Careful judgment is required to integrate the latest research findings with the patient’s individual circumstances, preferences, and the available regulatory frameworks for advanced practice in Sub-Saharan Africa. Correct Approach Analysis: The best professional practice involves a comprehensive, evidence-based approach that prioritizes shared decision-making. This entails thoroughly reviewing the latest peer-reviewed literature and clinical guidelines relevant to the patient’s specific cancer type, stage, and genomic profile. It requires engaging in a detailed discussion with the patient and their family about all available treatment options, including their potential benefits, risks, and uncertainties, as well as palliative care and supportive measures. This approach aligns with ethical principles of beneficence, non-maleficence, and patient autonomy, and is supported by the principles of good clinical practice which mandate informed consent and patient-centered care. In the context of Sub-Saharan Africa, where resources may be constrained, this approach also emphasizes the judicious use of evidence to select the most effective and feasible interventions. Incorrect Approaches Analysis: One incorrect approach involves solely relying on anecdotal evidence or the experience of a single clinician without consulting current, robust research. This fails to adhere to the principle of evidence-based medicine, potentially leading to suboptimal or even harmful treatment decisions. It also neglects the ethical obligation to provide care that is informed by the best available scientific knowledge. Another incorrect approach is to implement a treatment plan without adequately discussing the rationale, risks, and alternatives with the patient. This violates the principle of patient autonomy and informed consent, which are fundamental ethical and often regulatory requirements in healthcare. It assumes a paternalistic model of care that is no longer considered best practice. A third incorrect approach is to dismiss novel but promising research findings due to a lack of widespread adoption or established long-term data, especially if these findings offer a significant potential benefit for a patient with limited conventional options. While caution is warranted, a complete disregard for emerging evidence can deny patients access to potentially life-altering treatments, and does not fully embrace the dynamic nature of precision oncology. This can be ethically problematic if it leads to a failure to explore all reasonable avenues for patient benefit. Professional Reasoning: Professionals should adopt a systematic decision-making process that begins with a thorough understanding of the patient’s clinical presentation and diagnostic information. This should be followed by a comprehensive literature search for the most current evidence-based guidelines and research findings relevant to the specific condition. Crucially, this evidence must then be integrated with the patient’s values, preferences, and socio-economic context through open and honest communication. The decision-making process should be iterative, allowing for adjustments as new information becomes available or the patient’s condition changes.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for timely and accurate diagnostic information with the ethical imperative to obtain informed consent and respect patient autonomy. The rapid progression of certain cancers, particularly in precision oncology, necessitates swift action, but this must not come at the expense of patient rights and established medical protocols. The selection of imaging modalities also involves considerations of cost-effectiveness, availability, and the specific diagnostic yield for the suspected malignancy, all within the context of Sub-Saharan African healthcare resource limitations. Correct Approach Analysis: The best professional practice involves a systematic approach that prioritizes patient understanding and consent before proceeding with any diagnostic intervention. This begins with a thorough clinical assessment to determine the most appropriate imaging modality based on the suspected diagnosis, stage of disease, and available resources. Crucially, this assessment must be followed by a detailed discussion with the patient, explaining the purpose of the imaging, the procedure itself, potential risks and benefits, and any alternatives. Obtaining informed consent is a non-negotiable ethical and regulatory requirement. Once consent is secured, the selected imaging is performed, and the interpretation is conducted by a qualified radiologist or oncologist with expertise in interpreting complex oncological imaging. This approach ensures patient rights are upheld, diagnostic accuracy is maximized through appropriate modality selection, and the interpretation is performed by a specialist. Incorrect Approaches Analysis: Proceeding with imaging without a clear discussion of the procedure, its purpose, and potential risks, even if the clinical suspicion is high, constitutes a failure to obtain informed consent. This violates fundamental ethical principles of patient autonomy and can have legal ramifications. Similarly, selecting an imaging modality based solely on availability without considering its diagnostic efficacy for the specific suspected cancer, or without consulting with a radiologist for interpretation, risks misdiagnosis or delayed diagnosis, which is detrimental to patient care and deviates from best practice standards. Relying on a junior clinician’s interpretation without specialist oversight, especially in complex oncological cases, also falls short of the required standard of care and could lead to incorrect treatment decisions. Professional Reasoning: Professionals should adopt a patient-centered decision-making framework. This involves: 1. Comprehensive Clinical Assessment: Thoroughly evaluate the patient’s history, physical examination findings, and relevant laboratory results to form a differential diagnosis. 2. Diagnostic Modality Selection: Based on the differential diagnosis, consider the sensitivity, specificity, availability, and cost-effectiveness of various imaging techniques. Consult with radiology specialists when necessary. 3. Informed Consent Process: Engage in a clear, understandable discussion with the patient about the proposed imaging, including its rationale, procedure, potential benefits, risks, and alternatives. Ensure the patient has the opportunity to ask questions and voluntarily agrees to the procedure. 4. Imaging Performance and Interpretation: Ensure the imaging is performed according to established protocols and interpreted by a qualified professional with expertise in oncological imaging. 5. Treatment Planning: Integrate imaging findings with other clinical data to formulate an appropriate treatment plan.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for continuous professional development and maintaining competency in a rapidly evolving field like precision oncology with the practicalities of an individual’s performance and the institution’s commitment to quality assurance. The examination blueprint’s weighting and scoring are designed to reflect the criticality of different knowledge areas, and retake policies are in place to ensure a minimum standard of competence is met. Misinterpreting these policies can lead to unfair assessment outcomes or a compromise in patient care standards. Correct Approach Analysis: The best professional approach involves a thorough understanding of the examination blueprint’s weighting and scoring mechanisms, recognizing that these are established by the examination board to reflect the relative importance of different domains within precision oncology. This understanding should then be applied to the retake policy, which typically outlines specific conditions and limitations for re-examination. Adhering to the stated retake policy, which might involve a waiting period, additional training, or a different examination format after multiple failures, is paramount. This approach ensures fairness, upholds the integrity of the assessment process, and aligns with the regulatory expectation that practitioners meet defined competency standards before engaging in advanced practice. The examination board’s policies are the definitive guide for assessment and remediation. Incorrect Approaches Analysis: One incorrect approach is to assume that a single failed attempt automatically warrants immediate re-examination without considering the specific retake policy. This disregards the structured process designed to allow for remediation and learning, potentially undermining the purpose of the retake policy. Another incorrect approach is to focus solely on the perceived difficulty of the examination content without consulting the blueprint or retake policy. While content difficulty is a factor, the examination board’s established weighting and scoring, along with the retake stipulations, are the governing factors for assessment outcomes and remediation pathways. Finally, attempting to negotiate or circumvent the established retake policy based on personal circumstances or perceived unfairness, without following the formal appeals process outlined by the examination board, is professionally unacceptable. This bypasses the established governance and can lead to inconsistent application of standards. Professional Reasoning: Professionals facing such situations should first consult the official examination blueprint and the detailed retake policy provided by the examination board. These documents are the primary sources of information. If there is ambiguity, seeking clarification directly from the examination board is the appropriate step. Decision-making should be guided by adherence to established policies and a commitment to maintaining professional standards, ensuring that any remediation or re-examination process is conducted fairly and transparently.

Scenario Analysis: This scenario is professionally challenging because it requires a precision oncology practitioner to balance the rapid advancement of a highly specialized field with the practical constraints of professional development and resource allocation. The practitioner must identify and engage with the most effective and efficient preparation methods for an advanced examination, ensuring that their learning is both comprehensive and time-bound, without compromising existing clinical responsibilities or succumbing to information overload. The need for a structured, evidence-based approach to learning is paramount in a field as complex and evolving as precision oncology. Correct Approach Analysis: The best approach involves a systematic review of the examination syllabus, identifying key knowledge domains and skill requirements. This should be followed by a curated selection of high-quality, peer-reviewed resources, including recent clinical guidelines, seminal research papers, and reputable online learning modules specifically designed for advanced practice in precision oncology. A structured timeline, incorporating regular self-assessment through practice questions and case studies, is crucial. This approach is correct because it aligns with principles of adult learning, evidence-based practice, and professional accountability. Regulatory frameworks for medical professionals emphasize continuous learning and competence, and this method ensures that preparation is targeted, efficient, and grounded in current scientific understanding, thereby upholding the standard of care expected in precision oncology. Incorrect Approaches Analysis: One incorrect approach is to rely solely on a broad overview of general oncology literature and a few popular textbooks without specific reference to the examination’s defined scope. This fails to address the specialized nature of precision oncology and may lead to gaps in critical knowledge areas, potentially violating the professional obligation to possess specialized competence. Another unacceptable approach is to prioritize attending numerous broad oncology conferences without a clear strategy for integrating the information into targeted exam preparation. While conferences offer valuable insights, an unfocused approach can lead to information overload and inefficient use of time, potentially neglecting the specific learning objectives of the advanced practice examination. This can be seen as a failure to exercise due diligence in professional development. A further incorrect approach is to delay preparation until a few weeks before the examination and then attempt to cram a vast amount of information. This method is counterproductive for advanced learning, as it does not allow for deep understanding, retention, or the development of critical thinking skills necessary for an advanced practice examination. It also demonstrates a lack of professional foresight and commitment to thorough preparation. Professional Reasoning: Professionals facing this situation should employ a structured, goal-oriented approach. First, thoroughly understand the examination’s objectives and scope. Second, identify and prioritize learning resources that are directly relevant and of high quality. Third, develop a realistic study schedule that integrates learning with practice and self-assessment. Finally, seek guidance from mentors or colleagues who have successfully navigated similar examinations. This systematic process ensures that preparation is effective, efficient, and aligned with professional standards.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the rapid advancements in precision oncology with the ethical imperative to ensure patient understanding and informed consent, especially when dealing with novel diagnostic and therapeutic approaches. The clinician must navigate complex genomic data, potential off-label use of therapies, and the inherent uncertainties of experimental treatments within the Sub-Saharan African context, where resource limitations and varying levels of health literacy can further complicate decision-making. Careful judgment is required to avoid both premature adoption of unproven interventions and undue delay in offering potentially life-saving treatments. Correct Approach Analysis: The best professional approach involves a thorough, multi-disciplinary discussion with the patient and their family, clearly outlining the genomic findings, their implications for treatment selection, the evidence base (or lack thereof) for proposed targeted therapies, potential benefits, risks, and uncertainties. This discussion must be tailored to the patient’s understanding, using clear language and visual aids if necessary, and ensuring ample opportunity for questions. This approach is correct because it upholds the fundamental ethical principle of patient autonomy and informed consent. In the context of precision oncology, where treatments are often highly specific and may involve novel or off-label agents, comprehensive disclosure of all relevant information, including the limitations of current knowledge and the experimental nature of some interventions, is paramount. This aligns with general ethical guidelines for medical practice and the principles of responsible innovation in healthcare. Incorrect Approaches Analysis: One incorrect approach involves proceeding with a targeted therapy based solely on a genomic alteration without a detailed discussion of the evidence supporting its efficacy in this specific cancer type and patient population, or without fully exploring the patient’s understanding of the treatment’s experimental nature. This fails to adequately inform the patient, potentially violating their right to make an autonomous decision based on complete information. It also risks offering treatment that may not be supported by robust clinical data, leading to potential harm without commensurate benefit. Another incorrect approach is to dismiss the genomic findings entirely due to the novelty of the targeted therapy or the perceived complexity of the data, opting instead for standard-of-care treatments that may be less effective. This approach fails to leverage the potential benefits of precision medicine and may deprive the patient of a potentially superior treatment option, thereby not acting in the patient’s best interest. It also represents a failure to stay abreast of evolving medical knowledge and its application. A third incorrect approach is to present the genomic findings and potential targeted therapies as definitive solutions without acknowledging the inherent uncertainties and the possibility of treatment failure or unexpected side effects. This misrepresents the current state of precision oncology, which, while promising, still involves significant unknowns. Such an approach can lead to unrealistic patient expectations and profound disappointment, undermining trust and the therapeutic relationship. Professional Reasoning: Professionals should adopt a patient-centered decision-making framework that prioritizes clear communication, shared decision-making, and ethical considerations. This involves: 1) Thoroughly understanding the patient’s clinical situation, including their cancer diagnosis, stage, and prior treatments. 2) Interpreting complex genomic data in the context of established and emerging scientific literature. 3) Engaging in open and honest dialogue with the patient, explaining the rationale for precision medicine, the specific genomic findings, and the potential treatment options, including their benefits, risks, and uncertainties. 4) Collaborating with a multidisciplinary team (e.g., oncologists, geneticists, pathologists, bioinformaticians) to ensure comprehensive evaluation and management. 5) Continuously assessing and adapting the treatment plan based on patient response and evolving scientific evidence, always with the patient’s well-being and autonomy as the guiding principles.

This scenario is professionally challenging due to the inherent complexities of precision oncology, including the rapid evolution of genomic data, the need for patient-centric decision-making, and the potential for misinterpretation or over-reliance on limited data. Careful judgment is required to balance scientific evidence with individual patient needs and ethical considerations, particularly in a resource-constrained environment. The best approach involves a comprehensive, multi-disciplinary discussion that prioritizes informed consent and shared decision-making. This entails clearly communicating the limitations of the genomic findings, discussing potential treatment options based on the evidence, and actively involving the patient and their family in the decision-making process. This aligns with ethical principles of patient autonomy and beneficence, ensuring that treatment decisions are tailored to the individual’s values, preferences, and understanding of the risks and benefits. It also reflects best practices in precision medicine, which emphasize a holistic view of the patient beyond just their genetic profile. An approach that focuses solely on the genomic finding without thoroughly discussing its clinical relevance, alternative treatments, or the patient’s wishes is ethically flawed. It risks violating the principle of informed consent by not providing the patient with a complete picture necessary for a truly autonomous decision. Furthermore, it may lead to inappropriate treatment choices if the genomic finding is not definitively actionable or if other viable therapeutic avenues are overlooked. Another unacceptable approach is to defer the decision entirely to the patient without providing adequate guidance or context. While patient autonomy is paramount, professionals have a duty to educate and inform. Failing to offer expert interpretation of the genomic data and potential treatment pathways can leave the patient overwhelmed and unable to make a truly informed choice, potentially leading to suboptimal outcomes. Finally, an approach that prioritizes a novel, unproven therapy solely based on a single genomic alteration, without considering the broader clinical picture, patient comorbidities, or established treatment guidelines, is professionally irresponsible. This could lead to unnecessary toxicity, financial burden, and false hope, violating the principle of non-maleficence. Professionals should employ a decision-making framework that begins with a thorough understanding of the patient’s clinical presentation and history. This is followed by a careful interpretation of genomic data within the context of available evidence and clinical guidelines. Crucially, open and honest communication with the patient and their family is essential, facilitating shared decision-making that respects patient autonomy while ensuring the provision of expert guidance. Regular re-evaluation of treatment plans based on evolving data and patient response is also a critical component.

This scenario presents a significant professional and ethical challenge due to the inherent complexities of precision oncology, the vulnerability of patients, and the critical importance of informed consent within the South African healthcare system. The challenge lies in balancing the potential benefits of cutting-edge genomic testing and targeted therapies with the patient’s right to autonomy, understanding of risks and benefits, and the equitable access to such advanced treatments within the existing health system constraints. Careful judgment is required to ensure that the patient’s best interests are paramount, and that all decisions are made with full transparency and respect for their values and preferences. The best approach involves a comprehensive, multi-disciplinary discussion with the patient and their family, facilitated by the oncologist. This discussion should thoroughly explain the rationale for genomic testing, the potential implications of the results (both positive and negative, including incidental findings), the available targeted therapy options, their associated efficacy, side effects, and the uncertainties involved. Crucially, it must also address the practicalities of accessing these therapies within the South African context, including potential costs, insurance coverage, and availability of clinical trials or compassionate use programs. This approach aligns with the ethical principles of beneficence, non-maleficence, and respect for autonomy, as well as the South African National Health Act and the Health Professions Council of South Africa (HPCSA) guidelines on informed consent, which mandate that patients receive sufficient information in an understandable manner to make voluntary decisions about their care. An approach that proceeds with genomic testing without a detailed discussion of potential outcomes and access to treatment fails to uphold the principle of informed consent. Patients have a right to understand not just what is being done, but why, and what the potential consequences are, including the possibility of discovering mutations for which no effective treatment is currently available or accessible in South Africa. This omission constitutes a significant ethical failure and a breach of regulatory requirements for informed consent. Another unacceptable approach would be to present genomic testing as a guaranteed solution without acknowledging the inherent uncertainties and potential for negative findings or lack of actionable targets. This misrepresents the current state of precision oncology and can lead to false hope and subsequent disappointment, violating the principle of honesty and potentially causing psychological harm. It also fails to provide the patient with the balanced information necessary for true informed consent. Furthermore, an approach that prioritizes the availability of a new therapy over the patient’s understanding and consent, or that makes assumptions about their willingness to undergo extensive and potentially costly testing without their explicit agreement, is ethically unsound. It undermines patient autonomy and treats the patient as a passive recipient of care rather than an active participant in decision-making. Professionals should employ a decision-making process that begins with a thorough assessment of the patient’s understanding and values. This should be followed by a clear, jargon-free explanation of the proposed intervention, including its purpose, potential benefits, risks, alternatives, and uncertainties. The discussion should be iterative, allowing ample time for questions and clarification. Professionals must also be aware of and transparent about the resource limitations and access issues within the South African health system, ensuring that proposed interventions are realistic and achievable for the patient. Documentation of the informed consent process is also a critical component.