Center of Interdisciplinary Researches in Human and Social Sciences (CRISES, EA 4424), Paul Valéry University, Rue du Professeur Henri Serre, 34090, Montpellier, France.
University College Maastricht, Zwingelput 4, 6211KH, Maastricht, Netherlands.
Philos Ethics Humanit Med. 2020 Nov 18;15(1):11. doi: 10.1186/s13010-020-00095-2.
Over the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.
In this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.
We first explore the gap between the ideal of personalized healthcare and the reality of today's personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.
Finally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides.
在过去的十年中，致力于个性化医学的文献呈指数级增长，与此同时，对其认识论和伦理的批评声也越来越大。尽管存在分歧，但倡导者和批评者都对人格概念有着过时的哲学理解，因此往往对医疗保健中的个性化持过于简单的理解。
在本文中，我们质疑这种人格和个性化的哲学理解，因为这些概念塑造了个性化医学领域。我们与现象学和解释学（特别是与 E.胡塞尔、M.梅洛-庞蒂和 P.利科）展开对话，以更深入地理解这些概念的含义。我们特别关注个人主观性和客观数据之间的关系。
我们首先探讨了个性化医疗保健的理想与当今个性化医学的现实之间的差距。我们表明，个性化医学几乎完全关注人格的客观部分，导致了有缺陷的伦理辩论，需要重新构建。其次，我们通过借鉴哲学中的现象学-解释学运动来尝试对此进行重新构建。第三，我们表明，这些公认的理论分析为解决个性化医学所面临的非常实际的伦理挑战开辟了新的概念可能性。
最后，我们提出了一种反转：如果个性化是一个人重新赋予各种客观数据意义并由此塑造自己的人类存在方式的连续过程，那么个性化医学本身并不是个性化的，而是可以通过提供数据来促进其服务对象的个性化。
