Personalized Medicine: Promises, Problems and Perils of a New Paradigm for Healthcare

A new paradigm for medical care is emerging which terms itself “personalized medicine”. Advocates claim that medical treatment can now be targeted on the specific characteristics of each individual, using genetic profiling to identify the particular nature of the condition, and to tailor treatments for each person. Further, they argue, the focus of medicine will move from treatment to prevention. It is claimed that genetic tests based on recent genomic research will enable doctors to identify susceptibilities for such common conditions before the onset of illness, and to target preventive intervention to reduce the individual and social burdens of ill health. Further, it is argued that genetic information will allow precision in the choice of drugs and doses, avoiding adverse reactions, minimising waste, reducing costs and increasing efficacy. Coupled with other advances, it is argued that the future of medicine should and will be “personalised, predictive and preventive.” Drawing on such developments, we have seen the growth of personal genomics companies marketing tests “direct to consumers” that claim to identify individual disease susceptibilities and to “empower” individuals by giving them the information—and the personal responsibility—to manage their own health. This paper critically assesses the promises made for personalized medicine, discusses some of the challenges for health policy, and considers the social and ethical implications of moving medical care towards such a personalized and individualized model.