对精准医学批评的辨析

An Analysis of the Critiques to Precision Medicine

首先澄清我国网站上发表的两篇有关精准医学博文中事实上的错误和概念上的混淆。接着讨论了对精准医学提出的批评及对这些批评的分析。指出精准医学术语本身容易引起误解和引起人们过高的期望;对精准医学的论述和实施中存在基因决定论倾向,即过分夸大基因在健康和疾病中的作用,而忽视环境、生活方式、社会因素的作用,这在政策上就会导致在发展高端医学与发展大众医学上不能保持平衡的问题;将巨大的资源投入精准医学研究未进行认真的成本-效果分析,也未考虑到精准医学研究成果的公平可及,以避免加深社会不公正问题;最后,在吸引商家参与精准医学研究计划时未考虑如何力求避免可能引起的利益冲突问题。

bThis article first clarifies the factual mistakes and conceptual confusions existed in blog articles published in Chinese websites.Then it focuses on the critiques to precision medicine and the analysis of these critiques.The author points out that the term precision medicine per se easily causes misunderstanding and the over-expectation in the public;gene determinism is existed in the discourses and projects,that is,the role of genes in health and disease is over-estimated,but the roles of environment,life-style and social factors are under-estimated,and it in turn will cause imbalance between high-tech medicine and conventional medicine in policy;for the enormous resources allocated to precision medicine,it seems that the cost-effectiveness analysis has not been conducted,and the equitable access to the results of precision medicine in order to avoid deepening already existed social injustice has not been taken into account;and in attracting enterprises to participate in precision medicine project,it seems that the avoiding of conflicts of interest is not considered.