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Tyranny of the Gene
Tyranny of the Gene: Personalized Medicine and Its Threat to Public Health | James Tabery
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A revelatory account of how power, politics, and greed have placed the unfulfilled promise of personalized medicine at the center of American medicine The United States is embarking on a medical revolution. Supporters of personalized, or precision, medicinethe tailoring of health care to our genomeshave promised to usher in a new era of miracle cures. Advocates of this gene-guided health-care practice foresee a future where skyrocketing costs can be curbed by customization and unjust disparities are vanquished by biomedical breakthroughs. Progress, however, has come slowly, and with a price too high for the average citizen. In Tyranny of the Gene, James Tabery exposes the origin story of personalized medicineessentially a marketing idea dreamed up by pharmaceutical executivesand traces its path from the Human Genome Project to the present, revealing how politicians, influential federal scientists, biotech companies, and drug giants all rallied behind the genetic hype. The result is a medical revolution that privileges the few at the expense of health care that benefits us all. Now American health care, driven by the commercialization of biomedical research, is shifting focus away from the study of the social and environmental determinants of health, such as access to fresh and nutritious food, exposure to toxic chemicals, and stress caused by financial insecurity. Instead, it is increasingly investing in miracle pills for leukemia that would bankrupt most users, genetic studies of minoritized populations that ignore structural racism and walk dangerously close to eugenic conclusions, and oncology centers that advertise the perfect gene-drug match, igniting a patients hope, and often dashing it later.Tyranny of the Gene sounds a warning cry about the current trajectory of health care and charts a path to a more equitable alternative.
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#NerdStatus activated 🤓, but this is an important read. I never gave a second thought to the development of medicine that targets people with certain genetic codes. If you‘re American, you‘ve probably seen ads on TV. But Tabery made me rethink on two fronts. First, cost of taking these drug versus outcome is often not favorable. Second, the study of genetics in populations has come at the cost of environmental studies that may help a larger ⬇️

Megabooks population of people and could create bigger impacts on marginalized folks. He definitely gave me a lot to consider! 1y
KathyWheeler I‘m really interested in reading this as it seems like having a medicine that is specifically targeted to work for you could be beneficial, but I can see the other side of the argument as well. 1y
Megabooks @KathyWheeler yes, I thought all these cancer medicines that target certain genotypes automatically were better drugs than traditional chemo. But that isn‘t always the case. Often survival time is only a few more months and costs balloon to tens or hundreds of thousands of dollars, at least for us in the US. They often augment traditional chemo so you don‘t necessarily get fewer side effects or a better quality of life for those months. 🤷🏻‍♀️ 1y
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Megabooks @KathyWheeler I think it‘s a more complicated situation than I initially thought. And that‘s just on the use side. The other half is whether the resources allocated by the public sector to make these large gains in the private sector are worth it in what is being defunded. 1y
KathyWheeler @Megabooks It sounds like it. I‘m moving this up on my list. (edited) 1y
willaful This reminds me of whenever there's big excitement over a new invention that helps disabled people walk up stairs and invariably its a huge complicated expensive thing that no disabled people ever asked for and almost certainly wouldn't be able to get instead of something that would generally help a lot of disabled people. 1y
Megabooks @willaful lol. There‘s a simple machine that‘s really helpful: an inclined plane. 😂 physics joke! My mom had polio as a child and walked with crutches until her late 50s and has since used a scooter, so I heard a lot of balderdash over the years, too. 🙄 1y
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