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Accepted Paper:
Precision Medicine: Speculative Health Care?
Lisa Hoffman
(University of Washington Tacoma)
This paper considers how precision medicine, with a focus on cancer, works through speculation. As a future-oriented, predictive analytics, precision medicine enacts logics and politics of profiling while also creating hope in patients based on statistics (vs. certainty).
Paper long abstract:
This paper considers how precision medicine, with a focus on cancer risk, diagnosis, and treatment, works through speculation. Also known as personalized or stratified medicine, precision medicine divides the population into segments based on genetics, lifestyle, and environment. It then predicts - speculates - about which treatments would be most effective for a particular patient, at a particular time. Massive datasets (big data) are analyzed through computational algorithms to create these predictions. This is a future-oriented, predictive analytics, which in many ways works through logics and politics of profiling. Moreover, rather than certainty, oncology, like precision medicine overall, “relies on statistics,” as Lochlann Jain (2013) argues, to make its claims and hedge its bets about how one may respond to treatment and perhaps even be lucky enough to survive. As health care becomes more personalized, hopes increase for individuals, yet the socio-political logics of knowing seem to be highly steeped in speculative predictions. How does one conduct an ethnographic study of such speculative practices when the stakes are so high for the individuals and their loved ones? What is at stake in such speculation? This paper addresses such questions based on research conducted for a project on how future risk is embedded in present bodies through precision medicine and the increased prominence of understanding ourselves through genetics.