Paul N, Labisch A
Heinrich-Heine-Universität, Düsseldorf, Germany.
Gesundheitswesen. 2002 Nov;64(11):614-22. doi: 10.1055/s-2002-35539.
Any person actively engaged in the sphere of Public Health who refers to "molecular medicine" is bound to arouse suspicion. Nevertheless, neither Public Health nor public health protection or the health sciences in general can afford to ignore medicine and biology. This fundamental fact is explored in a historical and subsequently in an anthropological context. The connections between molecular medicine and public health are discussed at length. Accordingly, health on an individual as well as on a social level is essentially bound to the knowledge of genetically determined dispositions. We may expect that this molecular-genetic reality will become as "true" in future as the hygienic-bacteriological reality has become "true" today. The medicalisation of all human realities will be continued by their "molecularisation". It is important to fundamentally understand the actual effects of this transformation, which is the subject of a wider public discussion. This is the only way to rationally estimate both the opportunities offered by molecular medicine and the involved risks. It is essential for a debate of this kind within public health care institutions that the public health movement addresses the current developments of molecular medicine in a critical but constructive manner. "Nature", and with it the medicine and biology of public health, is an essential aspect of protecting public health. This is the only way to clarify the sphere of activity of public health protection in general, to appreciate its dynamics and to develop adequate measures: "Health is a crossroad" according to Julio Frenk: "It is where biological and social factors, the individual and the community, and social economic policy all converge".
任何积极投身于公共卫生领域且提及“分子医学”的人必然会引发怀疑。然而，无论是公共卫生、公共卫生保护还是一般意义上的健康科学，都不能忽视医学和生物学。本文将在历史背景以及随后的人类学背景中探讨这一基本事实。文中还将详细讨论分子医学与公共卫生之间的联系。因此，个体层面以及社会层面的健康本质上都与对基因决定的特质的了解息息相关。我们可以预期，这种分子遗传学的现实在未来将如同如今卫生细菌学的现实一样“真实”。所有人类现实的医学化将通过其“分子化”得以延续。从根本上理解这一转变的实际影响至关重要，这也是更广泛公众讨论的主题。这是合理评估分子医学带来的机遇和相关风险的唯一途径。对于公共卫生保健机构内部的此类辩论而言，公共卫生运动以批判性但建设性的方式关注分子医学的当前发展至关重要。“自然”以及与之相关的公共卫生医学和生物学，是保护公众健康的一个重要方面。这是明确公共卫生保护总体活动范围、认识其动态并制定适当措施的唯一途径：正如胡利奥·弗伦克所说：“健康是一个十字路口：它是生物和社会因素、个体与社区以及社会经济政策交汇的地方”。
