The Ethics of Precision Medicine: The Problems of Prevention in Healthcare

by Paul Scherz

Paul Scherz explores the ethical challenges raised by precision medicine and its focus on medical risk as opposed to current disease.

Genetic technologies and artificial intelligence are rapidly changing the landscape of medical practice and patient care. In the emerging field of precision medicine, a patient’s risk factors—especially genetic risk factors—are incorporated into an all-encompassing plan to prevent future disease. But identifying at-risk individuals through technologies such as wearable devices and direct-to-consumer genetic sequencing can undermine the overall experience of health. The potential for overdiagnosis and overtreatment grows as patients are prescribed medications and receive prophylactic surgeries that carry inherent risks. Also, as the medical industry shifts its attention from individuals to trends in the general population, the one-to-one practitioner-patient relationship becomes strained.

Using the lens of virtue ethics and theological bioethics, The Ethics of Precision Medicine offers suggestions for better implementing precision medicine to treat those currently suffering from or at high risk of disease, while also recognizing that effectively preventing disease depends, ultimately, on addressing the social determinants of health. The book provides a new perspective on the problems of contemporary heathcare, proposing practical steps that individuals and institutions can take to ensure that the advanced technologies of precision medicine can be used to promote human flourishing.

210 pages, Hardcover

First published October 1, 2024

Reviews

[Micah Rojo]

i really liked it. i thought it offer very good critical assessments of risk reduction and population-based/preventive medicine. it was also written in a very succinct and digestible manner.

if i had to be cynical sometimes i wish he spent more time on things, but if he did it would’ve been a completely different book.

[Evan Beacom]

Excellent critique of contemporary medicine, specifically the tendency to subsume medical care - that which takes place between doctors, patients, and families - into population health, which is governed by statistical metrics rather than more pedestrian human concerns, risk reduction rather than care, and treatment of potential illness rather than actual illness. Draws on earlier social and medical criticism from Foucault, Illich, Agamben, Bishop, and Stegegna. Offers a prescription for healthy, caring institutions for medical care in the vein of Victoria Sweet's "slow medicine." Greatly benefits from the author's background as a genetics researcher prior to his switch to moral theology. While the focus is on ethics and proper approaches to risk and public health, it serves as an excellent introduction to notions of biopolitics/bio-power in an accessible format. Would be excellent as a seminar for medical students, shared reading for discussion by health system administrators, and a useful overview for practitioners, scientists, and laity (especially those interested in current health trends) of all stripes. Full disclosure: the author was a teacher of mine while studying at Georgetown University a couple of years back.

[Steven McCorkle]

This is a very intriguing, yet odd mix of materials. It reads 50% like a legitimate and excellent ethical discussion of current trends in medicine, 25% like someone with an agenda, and 25% like someone with limited (and negative) experiences working in medicine. Despite all that, it is definitely a book I would recommend for the medical ethics scholar to read. The good sections of it are very good indeed. It may only be average as a whole, but it brings up excellent critiques and discussions.