Paper short abstract:

The relatively recent concept of personalized medicine (PM) is already getting renamed as precision medicine (also PM). I will argue that this implies shifts in normativity that borrow from practices of both technical precision (as in tailoring) and precision warfare (as in 'magic bullets').

Paper long abstract:

In previous decades (say, from the 1950s), medical science has focused on inventing generalizable diagnostics and treatments ('blockbusters'). Evidence-based guidelines were intended to establish 'the best for the most'. More recently however (from the 1990s), personalised medicine looks for care that is maximally adapted to the bodies and the lives of singular persons - 'tailoring' being the dominant technological metaphor. Still more recently (from 2012 onwards), the P of PM has come to stand for Precision, not Personalised. Specification and individualisation thus no longer concern different persons / bodies, but different organs and cells. For instance, PM drugs are designed to act as true magic bullets finding their way through the body only to hit the diseased body part. No more side effects because of maximum target orientation.

By comparing practices of precision in medicine and health care with other practices that value precision, I will describe the normative shifts (related, among others, to inclusion and exclusion from therapies) embedded in the transition from 'blockbuster medicine' to personalised medicine to precision medicine. Normative shifts that borrow from the norms of both technical precision (as in tailoring) and precision warfare (as in magic bullets). I will also show which type of values may disappear from care practices when they become precision practices: anti-individualistic values of solidarity and cohesion, that stress what persons and bodies have in common.