Me Medicine vs. We Medicine

Reclaiming Biotechnology for the Common Good

Donna Dickenson

Columbia University Press

Me Medicine vs. We Medicine

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Pub Date: February 2016

ISBN: 9780231159753

296 Pages

Format: Paperback

List Price: $23.00£20.00

Pub Date: June 2013

ISBN: 9780231159746

296 Pages

Format: Hardcover

List Price: $29.95£25.00

Pub Date: June 2013

ISBN: 9780231534413

296 Pages

Format: E-book

List Price: $28.99£25.00

Me Medicine vs. We Medicine

Reclaiming Biotechnology for the Common Good

Donna Dickenson

Columbia University Press

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.

Donna Dickenson's book offers a compelling and overarching framework for interpreting new trends in biomedical science, such as gene biobanks, pharmacogenetics, and the banking of cord blood. It forces the reader to ask whether every new technological advance in medicine truly betters the field—and for whom.

Sheldon Krimsky, Tufts University

Few words have as much ethical clout these days as that of 'choice,' a word that can be construed as the centrality of 'me.' Donna Dickenson's splendid book shows how deeply the 'me' has become embedded in medicine and abetted by the seemingly unchallengeable ethical concept of autonomy. What we have lost is the importance of 'we.' Using personalized medicine as her point of departure, she brilliantly works her way through a range of recent medical developments to show the damage the dominance of 'me' can bring. Her book can help restore the 'us' that has been diminished.

Daniel Callahan, cofounder and president emeritus of The Hastings Center and author of The Roots of Bioethics: Health, Progress, Technology, Death

In this timely book, Dickenson levels trenchant criticism at the poster child of the twenty-first-century biomedical establishment: 'personalized medicine.' Analyzing an impressive array of practices in the new life sciences, she makes a persuasive argument that, as personalized medicine unfolds, market values and individualism are trumping the ideals of public health. This book comes at a critical moment. As we reappraise the social contract of health care, this book helps better direct research and development towards the common good.

David Winickoff, University of California, Berkeley

Donna Dickenson's book is a seminal philosophical examination of the enthusiastic embrace of 'personalized medicine,' questioning easy assumptions about its benefits for patient care and for public health. Dickenson sounds powerful warnings about the extent to which personalized medicine risks confusion with individual self-interest and the devotion of biotechnology for private gain.

Leslie Francis, University of Utah, co-author of The Patient as Victim and Vector: Bioethics and Infectious Disease

Recognizing that there are trade-offs in how we conceptualize medicine as either driven and developed for the common good or specialized for the individual, Dickenson offers an important examination of contemporary medicine and a beautifully written account of what is at stake when the common good is overlooked. Hands down, she is one of the most insightful contributors to law and medicine discourse, and this book is a must-read for everyone concerned about the future of biotechnology.

Michele B. Goodwin, University of Minnesota, and editor of Baby Markets: Money and the New Politics of Creating Families

If you are wondering what to make of personalized medicine's grand claims, let Dickenson be your guide. Turning her keen scientific and political intelligence to biotech visions of individually tailored drugs, consumer gene tests, enhancement technologies, and more, she finds tidbits of hope for improving health care among scads of hype—some of it dangerous. This must-read book makes a powerful case for taming market domination and 'me-centeredness' and for renewing our commitments to public health and the common good.

Marcy Darnovsky, executive director, Center for Genetics and Society

Dickenson's mapping out of this vital fork in the road is valuable.

Publishers Weekly

This book is filled with clearly explained, hard science, giving equal treatment to the benefits and problems of personalized medicine.... I recommend expending the necessary reading effort not only for healthcare workers but for the general public.

New York Journal of Books

Dickenson's greatest achievement in this book is that she largely succeeds in creating a coherent, compelling narrative across the five disparate case studies and that she does so incorporating insights from a range of domains including sociology, ethics, philosophy, law and biomedicine.

Michael Morrison, New Genetics and Society
1. A Reality Check for Personalized Medicine
2. "Your Genetic Information Should Be Controlled by You": Personalized Genetic Testing
3. Pharmacogenetics: One Patient
4. "Your Birth Day Gift": Banking Cord Blood
5. Enhancement Technologies: Feeling More Like Myself
6. "The Ancient, Useless, Dangerous, and Filthy Rite of Vaccination": Public Health
7. Reclaiming Biotechnology for the Common Good

Read an excerpt from the chapter, "A Reality Check for Personalized Medicine":

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About the Author

Donna Dickenson is emeritus professor of medical ethics and humanities at the University of London and research associate at the Centre for Health, Law, and Emerging Technologies at the University of Oxford. She is the author of Body Shopping: Converting Body Parts to Profit, and has won the prestigious International Spinoza Lens award for her contribution to public debate on ethics.