Omics and AI in precision medicine: Maintaining socio-technical imaginaries by transforming technological assemblages

Robert Meunier; Christian Herzog

doi:10.14512/tatup.32.3.48

Authors

Robert Meunier Institut für Medizingeschichte und Wissenschaftsforschung, Universität zu Lübeck, Lübeck (DE) https://orcid.org/0000-0002-4026-6167 robert.meunier@uni-luebeck.de
Christian Herzog Ethical Innovation Hub, Universität zu Lübeck, Lübeck (DE) https://orcid.org/0000-0003-2513-2563 christian.herzog@uni-luebeck.de

DOI:

https://doi.org/10.14512/tatup.32.3.48

Keywords:

precision medicine, big data, artificial intelligence, imaginary, assemblage

Abstract

We understand precision medicine as a socio-technical imaginary according to Jasanoff. After briefly outlining how the imaginary of precision medicine emerged from the Human Genome Project and spread across national contexts, we raise the question of why the imaginary and the expectations and promises associated with it persist despite regular disappointment among practitioners about the failure of personalized healthcare. We argue that short-term technological hypes enable stakeholders to renew and maintain the promises of precision medicine. In our view, these hypes are around transformations of a technological assemblage. We discuss this in detail for omics and AI technologies and evaluate the recent transformations in light of the long-term imaginary of precision medicine.

References

Anonymous (2012): What happened to personalized medicine? Editorial. In: Nature Biotechnology 30 (1), p. 1. https://doi.org/10.1038/nbt.2096 DOI: https://doi.org/10.1038/nbt.2096

Au, Larry (2021): Recent scientific/intellectual movements in biomedicine. In: Social Science & Medicine 278, p. 113950. https://doi.org/10.1016/j.socscimed.2021.113950 DOI: https://doi.org/10.1016/j.socscimed.2021.113950

Au, Larry; Da Silva, Renan (2021): Globalizing the scientific bandwagon. Trajectories of precision medicine in China and Brazil. In: Science, Technology, & Human Values 46 (1), pp. 192–225. https://doi.org/10.1177/0162243920930282 DOI: https://doi.org/10.1177/0162243920930282

Bando, Hideaki (2017): The current status and problems confronted in delivering precision medicine in Japan and Europe. In: Current Problems in Cancer 41 (3), pp. 166–175. https://doi.org/10.1016/j.currproblcancer.2017.02.003 DOI: https://doi.org/10.1016/j.currproblcancer.2017.02.003

Blasimme, Alessandro; Vayena, Effy (2016): “Tailored-to-You”. Public engagement and the political legitimation of precision medicine. In: Perspectives in Biology and Medicine 59 (2), pp. 172–188. https://doi.org/10.1353/pbm.2017.0002 DOI: https://doi.org/10.1353/pbm.2017.0002

Borup, Mads; Brown, Nik; Konrad, Kornelia; Van Lente, Harro (2006): The sociology of expectations in science and technology. In: Technology Analysis & Strategic Management 18 (3–4), pp. 285–298. https://doi.org/10.1080/09537320600777002 DOI: https://doi.org/10.1080/09537320600777002

Bösl, Elsbeth; Samida, Stefanie (2021): New sequencing methods. New data and new challenges. In: TATuP – Journal for Technology Assessment in Theory and Practice 30 (2), pp. 11–17. https://doi.org/10.14512/tatup.30.2.11 DOI: https://doi.org/10.14512/tatup.30.2.11

Buchanan, Ian (2020): Assemblage theory and method. An introduction and guide. London: Bloomsbury Academic.

Deleuze, Gilles; Guattari, Félix (1980): Mille plateaux. Paris: Éditions de minuit.

Erikainen, Sonja; Chan, Sarah (2019): Contested futures. Envisioning “personalized”, “stratified”, and “precision” medicine. In: New Genetics and Society 38 (3), pp. 308–330. https://doi.org/10.1080/14636778.2019.1637720 DOI: https://doi.org/10.1080/14636778.2019.1637720

Etchings, Jay (2017): Strategies in biomedical data science. Driving force for innovation. Hoboken, NJ: Wiley.

Fröhlich, Holger et al. (2018): From hype to reality. Data science enabling personalized medicine. In: BMC Medicine 16 (1), p. 150. https://doi.org/10.1186/s12916-018-1122-7 DOI: https://doi.org/10.1186/s12916-018-1122-7

Geneviève, Lester; Martani, Andrea; Shaw, David; Elger, Bernice; Wangmo, Tenzin (2020): Structural racism in precision medicine. Leaving no one behind. In: BMC Medical Ethics 21 (1), p. 17. https://doi.org/10.1186/s12910-020-0457-8 DOI: https://doi.org/10.1186/s12910-020-0457-8

Ginsburg, Geoffrey; McCarthy, Jeanette (2001): Personalized medicine. Revolutionizing drug discovery and patient care. In: Trends in Biotechnology 19 (12), pp. 491–496. https://doi.org/10.1016/S0167-7799(01)01814-5 DOI: https://doi.org/10.1016/S0167-7799(01)01814-5

Heil, Reinhard et al. (2021): Artificial intelligence in human genomics and biomedicine. Dynamics, potentials and challenges. In: TATuP – Journal for Technology Assessment in Theory and Practice 30 (3), pp. 30–36. https://doi.org/10.14512/tatup.30.3.30 DOI: https://doi.org/10.14512/tatup.30.3.30

Hilgartner, Stephen (2017): Reordering life. Knowledge and control in the genomics revolution. Cambridge, MA: MIT Press. DOI: https://doi.org/10.7551/mitpress/10481.001.0001

Jasanoff, Sheila; Kim, Sang-Hyun (2009): Containing the Atom. Sociotechnical imaginaries and nuclear power in the United States and South Korea. In: Minerva 47 (2), pp. 119–146. https://doi.org/10.1007/s11024-009-9124-4 DOI: https://doi.org/10.1007/s11024-009-9124-4

Jasanoff, Sheila (2015): Future imperfect. Science, technology, and the imaginations of modernity. In: Sheila Jasanoff and Sang-Hyun Kim (eds.): Dreamscapes of Modernity. Sociotechnical imaginaries and the fabrication of power. Chicago, IL: University of Chicago Press. DOI: https://doi.org/10.7208/chicago/9780226276663.001.0001

Juengst, Eric; McGowan, Michelle; Fishman, Jennifer; Settersten, Richard (2016): From “personalized” to “precision” medicine. The ethical and social implications of rhetorical reform in genomic medicine. In: The Hastings Center Report 46 (5), pp. 21–33. https://doi.org/10.1002/hast.614 DOI: https://doi.org/10.1002/hast.614

Lamb, John; Jennings, Lori; Gudmundsdottir, Valborg; Gudnason, Vilmundur; Emilsson, Valur (2021): It’s in our blood. A glimpse of personalized medicine. In: Trends in Molecular Medicine 27 (1), pp. 20–30. https://doi.org/10.1016/j.molmed.2020.09.003 DOI: https://doi.org/10.1016/j.molmed.2020.09.003

Lee, Sandra (2021): Obligations of the “gift”. Reciprocity and responsibility in precision medicine. In: The American Journal of Bioethics 21 (4), pp. 57–66. https://doi.org/10.1080/15265161.2020.1851813 DOI: https://doi.org/10.1080/15265161.2020.1851813

MacEachern, Sarah; Forkert, Nils (2021): Machine learning for precision medicine. In: Genome 64 (4), pp. 416–425. https://doi.org/10.1139/gen-2020-0131 DOI: https://doi.org/10.1139/gen-2020-0131

Maughan, Tim (2017): The promise and the hype of ‘personalised medicine’. In: The New Bioethics 23 (1), pp. 13–20. https://doi.org/10.1080/20502877.2017.1314886 DOI: https://doi.org/10.1080/20502877.2017.1314886

Nail, Thomas (2017): What is an Assemblage? In: SubStance 46 (1), pp. 21–37. https://doi.org/10.1353/sub.2017.0001 DOI: https://doi.org/10.1353/sub.2017.0001

NRC – National Research Council Committee on A Framework for Developing a New Taxonomy of Disease (2011): Toward precision medicine. Building a knowledge network for biomedical research and a new taxonomy of disease. Washington, DC: National Academies Press. https://doi.org/10.17226/13284 DOI: https://doi.org/10.17226/13284

Pokorska-Bocci, Anna; Stewart, Alison; Sagoo, Gurdeep; Hall, Alison; Kroese, Mark; Burton, Hilary (2014): “Personalized medicine”. What’s in a name? In: Personalized Medicine 11 (2), pp. 197–210. https://doi.org/10.2217/pme.13.107 DOI: https://doi.org/10.2217/pme.13.107

Rajpurkar, Pranav; Chen, Emma; Banerjee, Oishi; Topol, Eric (2022): AI in health and medicine. In: Nature Medicine 28 (1), pp. 31–38. https://doi.org/10.1038/s41591-021-01614-0 DOI: https://doi.org/10.1038/s41591-021-01614-0

Schneider, Christoph; Lösch, Andreas (2019): Visions in assemblages. Future-making and governance in FabLabs. In: Futures 109, pp. 203–212. https://doi.org/10.1016/j.futures.2018.08.003 DOI: https://doi.org/10.1016/j.futures.2018.08.003

Strand, Roger (2022): The impact of a fantasy. In: Chiara Beneduce and Marta Bertolaso (eds.): Personalized medicine in the making. Philosophical perspectives from biology to healthcare. Cham: Springer, pp. 311–324. https://doi.org/10.1007/978-3-030-74804-3_16 DOI: https://doi.org/10.1007/978-3-030-74804-3_16

Strickland, Eliza (2019): IBM watson, heal thyself. How IBM overpromised and underdelivered on AI health care. In: IEEE Spectrum 56 (4), pp. 24–31. https://doi.org/10.1109/MSPEC.2019.8678513 DOI: https://doi.org/10.1109/MSPEC.2019.8678513

Tabery, James (2023): Tyranny of the gene. Personalized medicine and its threat to public health. New York, NY: Knopf.

Wang, Pei (2019): On defining artificial intelligence. In: Journal of Artificial General Intelligence 10 (2), pp. 1–37. https://doi.org/10.2478/jagi-2019-0002 DOI: https://doi.org/10.2478/jagi-2019-0002