Sturdy Steve
a Science, Technology and Innovation Studies, University of Edinburgh , Edinburgh , UK.
New Bioeth. 2017 Apr;23(1):30-37. doi: 10.1080/20502877.2017.1314892.
Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and - partly at least - to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support.
与其试图区分炒作与合理的承诺,将个性化医疗视为一种承诺经济可能更有帮助,这种经济既有助于为研究调动资源,至少部分地也有助于确定该研究的方向。个性化医疗是更大的医疗生物技术承诺经济的一种发展。因此,它系统性地将公共利益与商业利益,尤其是制药利益的追求混为一谈。结果,个性化医疗的研发往往更倾向于生产昂贵的新疗法,而不是无利可图的预防形式或更有效地使用旧疗法。需要重新平衡研究重点,以利于追求公共利益,即使这不会带来私人利润。这反过来将需要公共研究资助者及其支持的科学家持续进行反思、自我批评,而且往往要自我克制。