Sharrer G Terry
Retired Surator of Health Sciences - Smithsonian Institution, Washington, DC, USA.
Methods Mol Biol. 2017;1606:37-50. doi: 10.1007/978-1-4939-6990-6_3.
In our time of genome-based personalized medicine, clinical research and clinical medicine are accelerating at a quick pace. Faster and cheaper DNA sequencing and protein profiling, microfluidic devices for capturing blood biomarkers, nanoparticles for precise drug delivery and enhanced imaging, rapid computational analysis of massive data inputs, and other technological wonders coalesce to create a kind of Moore's Law for medicine. Needs are obvious, knowledge grows, capital becomes available, but these factors are not entirely sufficient to make health more achievable. Personalized medicine also requires social acceptability, not only for accuracy and efficacy but also because medicine is a moral domain. This chapter deals with medical ethics that determine the choices a society makes regarding healthcare; and it has not always been a steady, morally correct course of progress. Indeed, medical ethics has largely derived from socio-scientific calamities in the past. Personalized medicine, with its enhanced capacity to access the individuality of illness, must have a continuously evolving feedback mechanism-the most important element being the physician-patient relationship-which is its ethical footing.
在我们这个基于基因组的个性化医疗时代，临床研究和临床医学正迅速加速发展。更快、更廉价的DNA测序和蛋白质分析、用于捕获血液生物标志物的微流控设备、用于精准药物递送和增强成像的纳米颗粒、对海量数据输入的快速计算分析，以及其他技术奇迹汇聚在一起，创造了一种医学领域的摩尔定律。需求显而易见，知识不断增长，资金也已到位，但这些因素并不足以完全让健康变得更易实现。个性化医疗还需要社会可接受性，这不仅关乎准确性和有效性，还因为医学是一个道德领域。本章探讨的是决定社会在医疗保健方面所做选择的医学伦理；而且这并非一直是一条稳定、道德正确的发展道路。事实上，医学伦理很大程度上源于过去的社会科学灾难。个性化医疗因其更强的了解疾病个体性的能力，必须拥有一个不断演变的反馈机制——其中最重要的要素是医患关系——这是其伦理基础。
