Me Medicine vs. We Medicine

Me Medicine vs. We Medicine: Reclaiming Biotechnology for the Common Good

DONNA DICKENSON
Copyright Date: 2013
Pages: 296
https://www.jstor.org/stable/10.7312/dick15974
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  • Book Info
    Me Medicine vs. We Medicine
    Book Description:

    Personalized healthcare -- or what the award-winning author Donna Dickenson calls "Me Medicine" -- is radically transforming our longstanding "one-size-fits-all" model. Technologies such as direct-to-consumer genetic testing, pharmacogenetically developed therapies in cancer care, private umbilical cord blood banking, and neurocognitive enhancement claim to cater to an individual's specific biological character, and, in some cases, these technologies have shown powerful potential. Yet in others they have produced negligible or even negative results. Whatever is behind the rise of Me Medicine, it isn't just science. So why is Me Medicine rapidly edging out We Medicine, and how has our commitment to our collective health suffered as a result?

    In her cogent, provocative analysis, Dickenson examines the economic and political factors fueling the Me Medicine phenomenon and explores how, over time, this paradigm shift in how we approach our health might damage our individual and collective well-being. Historically, the measures of "We Medicine," such as vaccination and investment in public-health infrastructure, have radically extended our life spans, and Dickenson argues we've lost sight of that truth in our enthusiasm for "Me Medicine."

    Dickenson explores how personalized medicine illustrates capitalism's protean capacity for creating new products and markets where none existed before -- and how this, rather than scientific plausibility, goes a long way toward explaining private umbilical cord blood banks and retail genetics. Drawing on the latest findings from leading scientists, social scientists, and political analysts, she critically examines four possible hypotheses driving our Me Medicine moment: a growing sense of threat; a wave of patient narcissism; corporate interests driving new niche markets; and the dominance of personal choice as a cultural value. She concludes with insights from political theory that emphasize a conception of the commons and the steps we can take to restore its value to modern biotechnology.

    eISBN: 978-0-231-53441-3
    Subjects: Health Sciences, General Science

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. PREFACE
    (pp. vii-xiv)
    Donna Dickenson
  4. 1 A REALITY CHECK FOR PERSONALIZED MEDICINE
    (pp. 1-29)

    The soaring promises made by advocates of personalized medicine are probably loftier than those in any other medical or scientific realm today. In addition, the range of therapies covered by personalized medicine is even greater than then-Senator Obama realized. Direct-to-consumer genetic testing, personal tailored drug regimes, private umbilical cord blood banking, and “enhancement” technologies all come under that rubric. Part of this book’s own promise is to introduce you to personalized medicine’s lesser-known variants, illustrating how they all chime together in their hymns and psalms in praise of what I call “Me Medicine.”

    Sometimes, the clarion calls for these new...

  5. 2 ʺYOUR GENETIC INFORMATION SHOULD BE CONTROLLED BY YOUʺ: Personalized Genetic Testing
    (pp. 30-61)

    In June 2011, at the third annual Consumer Genetics Show, the biotechnology company Illumina Incorporated unveiled its MiGenome application for the iPad tablet computer. (That’s a double dose of the first-person singular: the possessive “my” added to the “I” in iPad.) Once you’d had your entire genome sequenced by Illumina—at a price of $9,500, reduced from the previous $19,500—MiGenome would ostensibly allow you to check your susceptibility to genetically based disorders. You could also find out how, given your genetic makeup, you would probably respond to particular drugs. MiGenome would display your entire genome, but if even the...

  6. 3 PHARMACOGENETICS: ONE PATIENT, ONE DRUG?
    (pp. 62-88)

    In 2004, at the age of seventy-one, the author Susan Sontag died of cancer—the disease that she had identified as the emblem of modernity in her book Illness as Metaphor. Poignantly and presciently, Sontag had called cancer “obscene—in the original meaning of that word: ill-omened, abominable, repugnant to the senses.”¹

    Cancer is modern both in a symbolic sense—“a disease of overproduction, of fulminant growth”²—and in the factual medical sense. Now that the epidemics of the early industrial age—cholera, typhus, smallpox, diphtheria, typhoid—have been decimated by effective We Medicine programs such as sanitation and vaccination,...

  7. 4 ʺYOUR BIRTH DAY GIFTʺ: Banking Cord Blood
    (pp. 89-112)

    The promise of “one patient, one drug” turned out to be a logical and logistical impossibility in the case of pharmacogenetics, but there is another kind of personalized medicine that claims that such a treatment is perfectly feasible. What’s more, the “drug” is a form of stem cells in the patient’s own blood. Yet it wasn’t manufactured by the patient’s body but by another person altogether, who gave it to the patient as “your birth day gift.” (Yes, “birth day,” not “birthday.”)

    What’s the answer to this riddle? For over twenty years, it’s been known that umbilical cord blood, taken...

  8. 5 ENHANCEMENT TECHNOLOGIES: Feeling More Like Myself
    (pp. 113-142)

    The enhancement debate epitomizes Me Medicine at its most controversial. Speculative technologies in cognitive and physical enhancement are premised on the idea that I have a duty to create the best Me I can possibly be. Some of their proponents also argue that we have an obligation to produce the best children we can.¹ While banking your baby’s umbilical cord blood is promoted—albeit misleadingly—as a way to guard against future illness, those who argue for creating the best possible children are concerned not just with negatively preventing disease but with positively engineering the ideal child.

    Even some opponents...

  9. 6 ʺTHE ANCIENT, USELESS, DANGEROUS, AND FILTHY RITE OF VACCINATIONʺ: Public Health, Public Enemy?
    (pp. 143-179)

    It’s certainly tempting to dismiss comments like this as “crackpot conspiracy views,”¹ but that risks becoming counterproductive. Vaccination has plausibly been called “medicine’s greatest lifesaver”:² it’s emphatically not a means for population control. The first and only contagious disease to have been completely eradicated, smallpox, was defeated through vaccination. But in the opinion of Arthur Allen, a leading historian of vaccines, “while vaccination seems to be more efficient and safer than ever before, public ambivalence about the practice has rarely been higher.”³

    Worldwide, popular reactions against vaccines for influenza, childhood diseases, and cervical cancer threaten immunization programs that public health...

  10. 7 RECLAIMING BIOTECHNOLOGY FOR THE COMMON GOOD
    (pp. 180-202)

    Giving personalized medicine an objective reality check has revealed that the evidence base is uneven. In pharmacogenomics, there have been some genuine advances, but in enhancement and retail genetics evidence for the supposed revolution is largely lacking, while in private umbilical cord blood banking the medical consensus is that the procedure may actually be dangerous. Whatever explains the rise of Me Medicine, it isn’t just the science behind it. Likewise, the causes for popular revulsion against vaccines as the most prominent form of We Medicine aren’t rooted primarily in medical evidence, most of which is rejected by many vaccine denialists....

  11. NOTES
    (pp. 203-226)
  12. REFERENCES
    (pp. 227-262)
  13. INDEX
    (pp. 263-278)