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药物基因组学与健康差异挑战

Pharmacogenomics and the challenge of health disparities.

作者信息

Lee S S

机构信息

Stanford Center for Biomedical Ethics, Stanford University Medical School, Palo Alto, California 94304-1703, USA.

出版信息

Public Health Genomics. 2009;12(3):170-9. doi: 10.1159/000189630. Epub 2009 Feb 10.

Abstract

This paper examines emerging technologies and recent research on population differences in pharmacogenomics and the perspectives of scientists, community advocates, policymakers, and social critics on the use of race as a proxy for genetic variation. The discussion focuses on how recent developments in genomic science impact social understandings of racial difference and the public health goal to eliminate ongoing health disparities among racially identified groups. This paper examines how factors such as governmental policies--requiring the use of racial and ethnic categories in genetic research and increasing interest in identifying untapped racial market niches by the pharmaceutical and biotechnology industries--and weak governmental oversight of race-based therapeutics converge to create an 'infrastructure of racialization' that may alter the vision of personalized medicine that has been so highly anticipated. This paper argues that significant public investment in pharmacogenomics requires careful consideration of the emerging discourse that tethers racial justice to notions of racial biology and discusses the social and ethical implications for the pendulum shift towards a geneticization of race in drug development.

摘要

本文探讨了药物基因组学中群体差异方面的新兴技术和最新研究,以及科学家、社区倡导者、政策制定者和社会批评家对将种族作为基因变异替代指标的使用的看法。讨论聚焦于基因组科学的最新发展如何影响对种族差异的社会认知,以及消除不同种族群体间持续存在的健康差距这一公共卫生目标。本文研究了诸如政府政策(要求在基因研究中使用种族和族裔类别,制药和生物技术行业对识别未开发的种族市场细分领域的兴趣日益增加)以及政府对基于种族的治疗方法监管不力等因素如何相互交织,形成一种“种族化基础设施”,这可能会改变人们对备受期待的个性化医疗的设想。本文认为,对药物基因组学进行大量公共投资需要仔细考虑将种族正义与种族生物学概念联系起来的新兴话语,并讨论药物开发中种族基因化这一钟摆式转变的社会和伦理影响。

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