256363 Personalized Medicine and Public Health: Must One be Rationed?

Monday, October 29, 2012 : 10:30 AM - 10:50 AM

George Annas, JD, MPH , Department of Health Law, Bioethics & Human Rights, Boston University School of Public Health, Boston, MA
"Personalized medicine" aka applying genomic knowledge of individual patients to guide their medical care and life styles, has the potential to bankrupt the medical care system--but also has the potential to improve the quality of life of populations. Before personalized medicine becomes a reality by default, we should seriously consider the fairness, justice, and sustainability of following our current market model to its logical conclusion--by, for example, providing more and more costly treatments to fewer and fewer people.

The advent of personalized medicine presents a perhaps unique opportunity to seriously considerthe ends of medicine and the ends of public health to determine whether we must adopt formal rationing of medical care if we make personalized medicine available to all. Alternatively,is it plausible to integrate personalized medicine into public health in a way that improves population quality of life at an sustainable cost?

A theoretical model will be proposed that could permit societies, including the US, to use the new genomics to focus on population-based prevention strategies that have at least a reasonable prospect of beinefiting entire societies, and thus help fulfill the WHO's aspiration of providing communities with "the highest standard of health possible."

Learning Areas:
Basic medical science applied in public health
Clinical medicine applied in public health
Ethics, professional and legal requirements
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Compare the goals of "personalized medicine" with the goals of public health. Describe how personalized medicine can be incorporated into public health without requiring rationing.

Keywords: Rationing, Genetics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Expert in genetic medicine and its relationship to public health, as well as the ethics of rationing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.