Fig. 2

Ethical, legal and social issues (ELSI) and challenges associated with the use of epigenetic-based biomarkers in the management of human diseases. Specific ELSI considerations on patient autonomy, personal data privacy and confidentiality and personal responsibility are derived from the intrinsic epigenetic characteristics (upper panel). To tackle these ELSI concerns and to favor the implementation of epigenetic-based approaches in medical care some challenges have been identified. On one side, and given the complexity of epigenetic mechanisms, future communication strategies aimed to ensure the understanding of the epigenetic information during medical decision making are strongly recommended (down, left). On the other hand, public policies such as the definition of general laws on data protection, the promotion of equal access to healthy environments and biomedical services to all citizens or the development of educational scientific programs for public but also healthcare professionals are strongly encouraged (down, right). The engagement of the scientific community and health-care professional with policy-decision makers and general public would definitively lead to new biomedical practices and transformative change in health promotion and medical care