James Tabery (Department of Philosophy, Utah, USA)“Personalized Medicine”
Wasn’t Personal; “Precision Medicine” Isn’t Precise
Tuesday, December 15th, 2020, 6pm


*The talk will be given by Zoom:*

*Zoom link*
<https://u-bordeaux-fr.zoom.us/j/88497235260?pwd=L0Y4QWtTcXdBUzNzKzlzMUF6RXlwQT09>
for the talk; everyone is welcome to join.

This talk will NOT be recorded.


James Tabery <https://faculty.utah.edu/u0578517-JAMES_TABERY/hm/index.hml>
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 <http://mitpress.mit.edu/books/beyond-versus>,
Cambridge, Mass, The MIT Press (2014), and many papers.


*Abstract: *
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.

Sincerely,
Thomas Pradeu
CNRS Senior Researcher in Philosophy of Science
Immunology Unit ImmunoConcEpT, UMR5164, CNRS & University of Bordeaux
Stanford University CASBS Fellow
<https://casbs.stanford.edu/people/current-fellows> (2020-2021)
Team Leader Conceptual Biology and Medicine Group
<https://www.immuconcept.org/conceptual-biology-medicine/>
PI ERC Starting Grant Immunity, Development, and the Microbiota (IDEM)
<http://erc-idem.cnrs.fr/>
Coordinator of the Institute for Philosophy in Biology and Medicine
<https://www.philinbiomed.org/> (PhilInBioMed)
Associate Editor, Biology & Philosophy
<https://link.springer.com/journal/10539>
146 rue Léo Saignat 33076 Bordeaux, France
& IHPST <https://www.ihpst.cnrs.fr/en> Pantheon-Sorbonne University 13 rue
du Four, 75006 Paris, France

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