Precision medicine and the problem of structural injustice.
Equity
Healthcare model
Medical Matthew effects
Personalized medicine
Precision medicine
Structural Injustice
Journal
Medicine, health care, and philosophy
ISSN: 1572-8633
Titre abrégé: Med Health Care Philos
Pays: Netherlands
ID NLM: 9815900
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
accepted:
24
04
2023
medline:
18
8
2023
pubmed:
26
5
2023
entrez:
25
5
2023
Statut:
ppublish
Résumé
Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the perspective needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on-and simultaneously affects-access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects.
Identifiants
pubmed: 37231234
doi: 10.1007/s11019-023-10158-8
pii: 10.1007/s11019-023-10158-8
pmc: PMC10212228
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-450Subventions
Organisme : NHGRI NIH HHS
ID : R01 HG010868
Pays : United States
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s).
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