Questioning the governance of pharmacogenomics and personalized medicine for global health

摘要: As pharmacogenomics and personalized medicine progressively build knowledge of the genetic and genomic determinants of person-to-person and population differences in drug pharmacokinetics and pharmacodynamics, questions regarding the governance of these emergent postgenomics fields have blossomed [2]. Consider some in the global health context, where many of the challenges and opportunities for innovation reside. What do we mean by public engagement of patients and research participants, or the broader public? How can, or should, national regulatory powers address issues concerning equitable distribution of diagnostics and treatments to stratified populations? How are biological determinants of health to be weighed against social and political determinants? How can public funding be maintained over prolonged periods, past the common hype cycles of new technologies? How can transnationally collaborative researchers share data and samples across jurisdictions in real time ethically or without unjustifiably intrusive and impedimentary national or regional legislation? Are voluntary and informal modes of ordering a more suitable alternative to laws passed by politicians? And so on.These and the myriad other questions require a great deal of deliberation and an even greater deal of transparent analysis because they are contestable and perplexing. Questions of pharmacogenomics and personalized medicine governance in our globally networked society induce an explication of its ontological framing, to discover what actual intentions lay “under the hood”. As Brian Wynne astutely observes, it is incumbent on scientific …