“The growth of personalised medicine threatens the communal approach that has
brought our biggest health gains”, Dickenson (2013b).^13 Namely, the focal point of
ME medicine is an individual as a user of the health care system, expressing his/her
right to (informed) choice of the most optimal form of health care, based on the
bioethical principle of autonomy. On the other hand, WE medicine is viewed as a
public health approach that focuses on the individual as a member of the (narrower
or wider) community, sum of which builds up society at national, regional,
European...global level. Hence, bioethical framework shifts toward principles
ofjustice(i.e. social equity in front of the health care system) andbeneficence,
which in the context of public health becomes redefined into the concept ofsocial
wellbeing, Callahan ( 2002 ).^14
Precisely through the philosophy of personalised medicine, which is in diamet-
rical opposition to the philosophy and vision of public health, Dickenson articulates
the key problem or concern:reallocation of resourcesat the expense of funding
preventive public health interventions on a global level. At the same time, the
question arises regarding the (pre)conditions of applications of existing, current
technologies and the legitimacy of the need for investment in new ones. Namely,
the public sector is asked to sponsor the growth of ME medicine initiatives in order
to minimise or even remove the risks for the private biotechnology sector,
Dickenson ( 2014 ).^15 Dickenson illustrates this concern with two examples:
- In July 2013, the UK government announced that it would offer private compa-
nies a subsidy from a £300 million to encourage investment in its personalised
medicine initiative, Genomics England. - In 2012, the US administration increased the National Institutes of Health budget
for personalised medicine while cutting the budget for the Centres for Disease
Control and Prevention’s Office of Public Health Genomics by 90 %, Dickenson
(2013b).^16
Dickenson believes a special attention should be given to the attempt to under-
stand thewider context: “As well as unpicking and unpacking the science, we need
to consider the social and economic context behind ME medicine”, by posing one of
the key questions—“How can we balance the role of the individual and the
communal in health-care?” Dickenson (2013b).^17
Namely, the context of personalised medicine is a space wheretechno-optimism
andtechno-pessimismgo hand in hand. We are faced with as big faith in techno-
logical advances and possibilities as we are with the fear of their misuse. Medical
history reminds us of similar moments, from the “artificial kidney” to the Human
Genome Project. In both cases, medicine was faced with the question: should we do
(^13) Ibid., 11.
(^14) See Callahan ( 2002 ), pp. 169–176.
(^15) Ibid., 12.
(^16) Ibid., 11.
(^17) Ibid., 11.
84 V. Mic ́ovic ́et al.