Personalized Medicine and Its Threat to Public Health
by James Tabery
A revelatory account of how power, politics, and greed have placed the unfulfilled promise of personalized medicine at the center of American medicine.
The United States is embarking on a medical revolution. Supporters of personalized, or precision, medicine—the tailoring of health care to our genomes—have promised to usher in a new era of miracle cures. Advocates of this gene-guided health-care practice foresee a future where skyrocketing costs can be curbed by customization and unjust disparities are vanquished by biomedical breakthroughs. Progress, however, has come slowly, and with a price too high for the average citizen.
In Tyranny of the Gene, James Tabery exposes the origin story of personalized medicine—essentially a marketing idea dreamed up by pharmaceutical executives—and traces its path from the Human Genome Project to the present, revealing how politicians, influential federal scientists, biotech companies, and drug giants all rallied behind the genetic hype. The result is a medical revolution that privileges the few at the expense of health care that benefits us all.
Now American health care, driven by the commercialization of biomedical research, is shifting focus away from the study of the social and environmental determinants of health, such as access to fresh and nutritious food, exposure to toxic chemicals, and stress caused by financial insecurity. Instead, it is increasingly investing in "miracle pills" for leukemia that would bankrupt most users, genetic studies of minoritized populations that ignore structural racism and walk dangerously close to eugenic conclusions, and oncology centers that advertise the perfect gene-drug match, igniting a patient's hope, and often dashing it later. Tyranny of the Gene sounds a warning cry about the current trajectory of health care and charts a path to a more equitable alternative.
"The quest for medical treatments tailored to patients' genomes distracts from more effective means of addressing health problems, according to this incisive polemic...Tabery is a penetrating critic...This damning take on scientific bias is not to be missed." —Publishers Weekly (starred review)
"An accessible narrative bolstered by prodigious research...An engaging, provocative study of a much-hyped aspect of American health care...Tabery succeeds in raising a compelling alarm about where things stand and making clear that the current situation could have been much different, all while laying the groundwork for an alternative future." —Kirkus Reviews
"The majority of the common diseases that take a large toll on health in America are caused by lifestyle and environmental factors, or those factors combined with genetics. Yet biomedical research today is focused on genes and exorbitantly expensive gene-based therapies—to the detriment of our health and our pocketbooks. In this powerful book, James Tabery explains how and why the promise of 'personalized' and 'precision' medicine has failed us. A must-read for doctors, patients, scientists, and anyone who cares about the future of health in America." —Naomi Oreskes, co-author of Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming
"James Tabery's book makes the case for why the revolutionary promise of precision medicine has been, at best, elusive and, at worst, a distraction from the revolution we truly need: a radical reimagining of how we prevent disease in our society." —Sandro Galea, author of Well: What We Need to Talk About When We Talk About Health
"Tyranny of the Gene is an extraordinary and invaluable investigation into the prevailing fashions of twenty-first-century medical research, and the price we may be paying for the very questionable promise of personalized medicine." —Gary Taubes, author of Why We Get Fat
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James Tabery is a professor at the University of Utah in the Department of Philosophy and a member of the Center for Health Ethics, Arts, & Humanities. His research has been reported in the New York Times, National Geographic, Time, and on National Public Radio. He lives in Salt Lake City with his wife and their three children.
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