The Precision Medicine Nation
Open accessAbstract
The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population‐based, precision medicine research programs.
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There are concerns about the representativeness of the Precision Medicine Initiative (the "All of Us" Study).
“For similar reasons, there are concerns about the representativeness of the Precision Medicine Initiative (the “All of Us” Study28).”
From Predictably unequal: understanding and addressing concerns that algorithmic clinical prediction may increase health disparities (2020) · cites this paper as [28]
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Self-citation
- Authors
- Sabatello, M., & Appelbaum, P. S.
- Affiliations
- Columbia University (US)
- Venue
- Hastings Center Report
- Publisher
- Wiley
- Published
- 2017-07
- Volume
- 47
- Issue
- 4
- Pages
- 19-29
- ISSN
- 0093-0334 (ISSN-L)
- 1552-146X
- PMC
- PMC5568692
- OpenAlex
- W2741035068
- Cited by
- 79
- References
- 76
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 26 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 21 · 2017: 2
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Hastings Center Report (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Human Genome Research Institute (K01HG008653, U01HG008680, P50HG007257, RM1HG007257)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Physiology › Biomedical Ethics and Regulation
- Keywords
- Precision Medicine Initiative, precision medicine, nationalism, democracy, health policy, patient empowerment, research ethics, social equity
- MeSH terms
- Humans, Patient Participation, Politics, United States, Genomics, Patient Rights, Biomedical Research, Precision Medicine
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