"Me Medicine vs. We Medicine: reclaiming biotechnology for the common good".
Donna Dickenson. Columbia University Press, New York. 2013.
The key premise of this seductive book by Donna Dickenson is that 'we medicine' - medicine aimed at maximizing the health of the nation, and 'me medicine' - medicine customised for individual patients, are mutually exclusive. The author, an Emeritus Professor of Medical Ethics and Humanities at the University of London, chooses to focus on new molecular diagnostics, including pharmacogenetics and pharmacogenomics, as the major relevant examples of personalised medicines. The author bases much of her argument on her perception of the polarity that 'genetics and genomics reveal more profound truths than other sciences'. However there is no clinical consensus that these are disciplines that operate in isolation. Genetics and genomics complement other medical sciences.
Good therapeutic practice concerns applying a wide range of clinical and laboratory tools to select the right drug(s) for the right disease and the right patient, at the right time, at the right dose, by the right route of administration, and for the right duration. Personal biomarkers of treatment response which should be used as a regular part of good medical practice include age, gender, ethnicity, lifestyle, co-morbidity, concomitant prescribed and non-prescribed regular and occasional medicines, and key lab phenotypes, such as renal and liver function, in addition to emerging pharmacogenetic and pharmacogenomic tests. By using these tools to apply a personal approach to patient management, prescribers are more able to select effective treatment options, and less likely to select treatments that may cause serious adverse effects ..
For more, see my review in Pharmacology Matters, a publication of the British Pharmacological Society.
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