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James Tabery (Department of Philosophy, Utah), “Personalized Medicine” Wasn’t Personal; “Precision Medicine” Isn’t Precise
15 December 2020 | 18 h 00 min - 19 h 30 min
The talk will be given by Zoom at 6pm, Paris time zone (GMT+1)
James Tabery is an Associate Professor at the University of Utah (USA), with appointments in the Department of Philosophy, the Department of Pediatrics, and the Department of Internal Medicine (Program in Medical Ethics and Humanities). His research areas are history and philosophy of science, as well as bioethics. In particular, he examines the history and modern day implementation of genetics–how debates surrounding that science have evolved over the last century, what impact genetic results are having in the criminal justice system, what impact genetics is having in the clinical domain, and who has benefited and who has been harmed historically be genetic research. His research has been reported on in The New York Times, National Geographic, Time Magazine, and National Public Radio. He is the author of Beyond Versus: The Struggle to Understand the Interaction of Nature and Nurture, Cambridge, Mass, The MIT Press (2014), and many papers.
In the late 1990’s, pharmaceutical company executives who were committed to integrating genomics into the pharmaceutical industry introduced a series of phrases to capture and market this pharmacogenomic turn in their businesses: (1) pharmacogenomics was in contrast to “one pill fits all” medicine, (2) pharmacogenomics was about getting “the right drug, to the right patient, at the right time”, and (3) pharmacogenomics paved the way for “personalized medicine”. This concept of personalized medicine quickly expanded to capture any notion of genomic medicine. Soon, clinicians and researchers became worried about the language of personalized medicine. First, doctors had been personalizing medicine for centuries (if not millennia), so the idea that genomics somehow uniquely ushered in an era of personalization was misleading. Second, what geneticists were calling personalized medicine didn’t really personalize medicine; it grouped patient populations into groups based on their genomic profiles. And third, personalized medicine became surrounded by heady promises of miracle cures and breakthrough treatments which were recognized largely as hype. As a result, starting around 2009-2011, a number of communities abandoned talk of “personalized medicine” and replaced it with “precision medicine”, where the revised idea was that adding genomic information about patients to clinical care would get at the underlying causes of health/illness (vs. just treating the symptoms) and so make healthcare more precise. I will argue that all the faults identified with regards to personalized medicine apply equally to precision medicine. First, doctors have been identifying and treating underlying causes of illness for centuries (if not millennia), so the idea that genomics somehow uniquely ushered in an era of treating causes (vs. symptoms) is misleading. Second, genomics is often imprecise; information about the pathogenicity of genetic variants changes frequently and it is fraught with clinical ambiguity. And third, precision medicine has continued to be surrounded by heady promises of miracle cures and breakthrough treatments which remain largely hype.
The talk will be given by Zoom at 6pm (Paris time zone, GMT+1):
Zoom link for the talk; everyone is welcome to join.