Download Me Medicine and Genetic Testing

Me Medicine and Genetic Testing
Professor Donna Dickenson
University of London
Author, Body Shopping and Me
Medicine: Reclaiming Biotechnology
for the Common Good
Personalized medicine has
friends in high places…
• We are in a new era of the life sciences,
but in no area of research is the
promise greater than in personalized
medicine.— Barack Obama, as a
Senator, introducing the bill that
became the Genomics and
Personalized Medicine Act 2007
And it covers more than DTC
genetic testing…
• The range of therapies covered by
personalized medicine—what I call “me”
medicine-- is even greater than Obama
realized.
• Direct-to-consumer genetic testing, tailored
drug regimes, private umbilical cord blood
banking and enhancement technologies all
come under that rubric.
What do these technologies
have in common?
• Essentially, they’re linked by two largely
unchallenged assumptions:
• 1. That “individual” is better than “social”
• 2. That we’re on the cusp of a ‘true
revolution in medicine’ to make it more
individualized.
• But are these assumptions justified?
We need to ask…
• …why so many multinational firms,
researchers, and—yes-- Presidents of the
United States have all bought into
personalized medicine.
• We urgently need a disinterested and
balanced critique of personalized medicine’s
origins, the commercial interests that lie
behind it and the dynamics of its marketing as
what I term “retail therapy”—medical
treatment and diagnostic regimes conceived
as consumer goods.
Commodification of body and
medicine
• Just as the body itself has been commodified,
so medicine is increasingly seen as a
commodity, in both insurance-based or
socialized healthcare systems and those in
which the patient really is the customer.
• Like drunk looking for keys under streetlight,
biomedicine is at risk of concentrating where
halogen glare is brightest: not necessarily on
most effective health interventions, but on
most personalized and profitable.
Wider social and cultural context
behind DTC genetic testing
Threat and contamination
Narcissism and “Bowling Alone”
Neo-liberalism and corporate
interests
• 4. The sacredness of personal
choice
• 1.
• 2.
• 3.
So are you “ready to embrace”
personalized medicine?
• We are on the leading edge of a true revolution in
medicine, one that promises to transform the
traditional 'one size fits all' approach into a much
more powerful strategy that considers each
individual as unique and as having special
characteristics that should guide an approach to
staying healthy. Although the scientific details to
back up these broad claims are still evolving, the
outline of a dramatic paradigm shift is coming
into focus…[Y]ou have to be ready to embrace
this new world. (Francis Collins)
Or would that embrace turn out
to be like the Dementor’s kiss?
• In the Harry Potter books, the Dementors
suck out the soul of those they embrace
• All right, it’s a bit melodramatic, but I think
there is a risk that “Me” Medicine may suck
the soul out of more communal forms of
health care—”We” Medicine: public health
programmes, vaccination, screening—
which have lengthened our life spans
Wider political context
• There’ s a pattern here—not only among all the
apparently disparate forms of personalized
medicine, but a familiar neo-liberal political
shape to the way in which we’re all being
encouraged to rejoice at prospect of Me Medicine.
• As second-wave feminists insisted, the personal
really is political. Personalized medicine can only
be understood in the political context of the
“promissory technologies” of the biotechnology
industry, the rolling back of the “post-Keynesian”
state and the decline of the social contract.
Where do we go from here?
• Personalized medicine pushes all the right
buttons in our psyches: the ones marked
individualism, autonomy and choice
• It’s not just a question of whether DTC
genetic testing is accurate: we know it’s
probably not—but its appeal is the deeper
appeal of all forms of Me Medicine.
Two questions for progressives
• How can we get across the message that Me
Medicine isn’t necessarily better medicine?
• How can we improve the image of We
Medicine?