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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 healthcare, 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.
"While Scherz’s book would be well received by bioethicists and moral philosophers focused on questions at the intersection of technology, economics, and clinical decision-making, the project’s compactness and accessibility renders it the rare bioethics work that might serve as a clarion call for clinicians themselves—and one especially germane in the current AI-driven and healthcare debt-obsessed cultural moment." —Theoretical Medicine and Bioethics
"[A] well-researched, deep, and probing exploration of an area of medicine that often escapes critique in mainstream medical and bioethical discourse." —The Review of Metaphysics
"The Ethics of Precision Medicine is an insightful book and a healthy corrective for folks like myself who were almost entirely blind to the risks of precision medicine. There are great risks in trying to minimize all risks." —Word on Fire
"Interesting and provocative . . . Scherz makes similar claims about preventive medicine: the focus on risk moves the anxiety and alienation of illness—the sense that one’s body has betrayed one, and that more betrayal is in store—to the realm of experienced health." —Public Discourse
“The Ethics of Precision Medicine offers a way of distinguishing high risk that medicine can reduce without undue adverse consequences from the much broader category of risk that is part of being human.” —Farr Curlin, co-author of The Way of Medicine
Paul Scherz is the Our Lady of Guadalupe Professor of Theology at the University of Notre Dame. He is the author and editor of several books, including The Evening of Life: The Challenges of Aging and Dying Well.
Preface
Acknowledgements
Part 1. The Shift to Prevention
1. Suspicion of the Body
2. Sicken to Shun Sickness
3. Genetics and Risk
4. Individuals and Populations
5. Public Health Ethics and Clinical Ethics
Part 2. Ethical Problems of Prevention
6. The Limitless Demand for Health
7. Managing Populations
8. The Obligation of Health
9. Exclusion and Elimination
10. Caring for the Statistical Other
Part 3. Addressing the Problems of Prevention
11. Prevention and the Social Determinants of Health
12. Regimen
13. Genomics in the Identification and Treatment of Disease
14. Institutions for Slow Medicine
Notes
Bibliography
Index