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Promising precision medicine: how patients, clinicians and caregivers work to realize the potential of genomics-informed cancer care 前景光明的精准医疗:患者、临床医生和护理人员如何努力实现基因组学信息癌症治疗的潜力
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-12-11 DOI: 10.1080/14636778.2021.1997577
Sara L. Ackerman
This paper examines the emerging field of molecular oncology, in which targeted treatments are sought for patients who have exhausted standard cancer therapies. Drawing on an ethnographic study at a U.S. academic medical center, and building on recent theoretical work examining potentiality as a site where expectations, meaning and value are produced, I describe efforts to translate genetic information into extended life for patients. Clinicians, patients and families performed various types of largely-unrecognized labor that invested precision medicine with potential even when life-prolonging therapies remained elusive. Their future-making work was enabled and constrained by the structural conditions of U.S. health care. In this context potentiality was a generative force that was harnessed to the interests and inequities of a market-driven health system, raising important questions about who is able to participate in, contribute to, and benefit from emerging innovations and narratives of hope.
本文探讨了分子肿瘤学的新兴领域,其中有针对性的治疗寻求患者谁已经用尽标准的癌症治疗。根据美国学术医疗中心的一项人种学研究,并以最近的理论工作为基础,研究潜力作为产生期望、意义和价值的场所,我描述了将遗传信息转化为延长患者寿命的努力。临床医生、患者和家属进行了各种基本上未被认识到的劳动,即使在延长生命的疗法仍然难以捉摸的情况下,这些劳动也为精准医疗带来了潜力。他们创造未来的工作受到美国医疗保健结构条件的支持和限制。在这种情况下,潜力是一种生发力量,被利用于市场驱动的卫生系统的利益和不公平,提出了关于谁能够参与、促进和受益于新出现的创新和希望叙述的重要问题。
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引用次数: 4
Bio-imperialism. Disease, terror and the construction of national fragility Bio-imperialism。疾病、恐怖和国家脆弱性的构建
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-12-11 DOI: 10.1080/14636778.2021.1997579
John Harrington
and on the injustices and asymmetries of global health security. Completed before the onset of pertinent history of the pandemic present, furnishing points against which to understand and judge global and health over acute critique biodefence strategies, both domestic and international, through four nely worked case studies from the twenty years following the terrorist atrocities and the anthrax attacks which followed them soon after, formed the linchpin for new iteration American
以及全球卫生安全的不公正和不对称。在当前流行病的相关历史开始之前完成,通过对恐怖主义暴行和炭疽袭击之后20年的四个新案例研究,提供了理解和判断全球和健康的要点,而不是国内和国际的尖锐批评生物防御战略,形成了新一代美国人的关键
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引用次数: 0
“Donating with eyes shut”: attitudes regarding DNA donation to a large-scale biobank in Israel “闭着眼睛捐献”:对向以色列大型生物银行捐献DNA的态度
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-12-03 DOI: 10.1080/14636778.2021.2007066
Aviad E. Raz, Yael Hashiloni-Dolev
DNA collection raises ethical, legal, and social issues around privacy, consent, participatory science, benefits and risks, biodata governance, and, ultimately, trust. While there is a consensus that DNA biobanks’ success depends on public trust, more evidence is needed regarding the determinants, production, and preservation of such trust. We draw on 14 semi-structured interviews with participants – seven people who donated DNA to an Israeli biobank, and seven who refused to donate; as well as on two focus groups with members of the general public. Our findings call into question the relationship between trust/trustworthiness and donation, suggesting moral strategies termed by respondents as “donating with eyes shut.” We conclude by discussing how DNA donation is built on a mixture of attitudes combining criticism, optimism, resistance, and avoiding responsibility as a pragmatic solution to the unresolved conflicts in sharing one’s DNA.
DNA收集引发了关于隐私、同意、参与性科学、利益和风险、生物数据治理以及最终信任的伦理、法律和社会问题。虽然人们一致认为DNA生物库的成功取决于公众的信任,但需要更多的证据来证明这种信任的决定因素、产生和维护。我们对参与者进行了14次半结构化访谈,其中7人向以色列生物银行捐赠了DNA, 7人拒绝捐赠;以及两个针对公众的焦点小组。我们的研究结果对信任/可信度与捐赠之间的关系提出了质疑,提出了被受访者称为“闭着眼睛捐赠”的道德策略。最后,我们讨论了DNA捐赠是如何建立在批评、乐观、抵制和逃避责任的混合态度之上的,作为一种务实的解决方案,以解决共享DNA时未解决的冲突。
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引用次数: 3
“It didn’t mean anything” – moving within a landscape of knowledge to interpret genetics and genetic test results within familial cancer concerns “这没有任何意义”——在对基因和基因检测结果进行解读的知识背景下,从家族癌症的角度出发
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.1997575
Mavis Machirori, C. Patch, A. Metcalfe
Genetics is increasingly defining how we understand health and disease, affecting for some, their understanding of inherited disease, and the meaning of medical genetic information. When interpretations of hereditary conditions are determined, partly, by one’s familial experience of heritable characteristics and partly by various other lived experiences, the meaning of genetics becomes highly personal. Through descriptions of stocks of knowledge, this paper describes findings from a qualitative study with a cohort of Black and Asian women with family and personal histories of cancer, about their interpretations of their genetic tests. We describe their interpretations as shaped by different experiences of biomedical practice as well as familial experiences of cancer and genetic testing; and we introduce a metaphor of “moving within a landscape,” to show how those interpretations were created and influenced by various sources of knowledge and life experiences.
遗传学越来越多地决定着我们如何理解健康和疾病,对一些人来说,影响着他们对遗传疾病的理解,以及医学遗传信息的含义。当对遗传条件的解释部分取决于一个人对遗传特征的家族经历,部分取决于其他各种生活经历时,遗传学的意义就变得非常个人化了。通过对知识储备的描述,本文描述了一项定性研究的结果,该研究对一群有家庭和个人癌症病史的黑人和亚洲妇女进行了研究,了解她们对基因测试的解释。我们将他们的解释描述为生物医学实践的不同经历以及癌症和基因检测的家庭经历;我们引入了一个“在景观中移动”的比喻,来展示这些解释是如何被各种知识和生活经验所创造和影响的。
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引用次数: 1
Editorial: themed issue: understanding the technical and social landscape of gene editing 社论:主题问题:理解基因编辑的技术和社会景观
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.2004032
R. Dimond, Jamie Lewis, Gareth Thomas
This 2021 themed issue is an acknowledgement of the emergence and significance of gene editing technology, which has already been described as contributing to a new era in human history, that is, as a revolution, a game-changer, and a disruptive technology. Gene editing has proved to be an inexpensive, expeditious, and effective technique that can target and edit (by deleting, adding, or otherwise modifying) genetic material. As such, it has broad applicability in the clinical, agricultural, and industrial arenas, while it has also proven popular in less formal settings such as for “biohacking” techniques (DIY biology). Our focus in this themed issue is the relevance of gene editing for human health. Somatic gene editing has already proved successful and is contributing to the development of therapeutic benefits for some types of childhood blindness, spinal muscular atrophy, and sickle cell disease (Ledford, 2020). Reproductive (germline) gene editing is more controversial, and there has been increasing concern about the rapid pace of development. Concerns about risk include the introduction of unintended genetic changes (known as “off target” effects), which would be irrevocable and irreversible, meaning that there are significant “known unknowns” about the long-term health implications for the child. New Genetics and Society has a long history in documenting the emergence of new technologies and the ensuing debates (see, for example, Parry (2003), Haddow et al. (2010) and Sleeboom-Faulkner et al. (2011), to name a few). Many authors continue to debate the risks and benefits of gene editing, following a familiar path of assessing new technologies in terms of their safety, ethics, and public opinion (Martin et al. 2020, So et al. 2021). The UK, in particular, employs a closely regulated yet liberal approach to supporting new reproductive technologies and, in February 2016, Kathy Niakan (Francis Crick, UK) became the New Genetics and Society, 2021 Vol. 40, No. 4, 361–366, https://doi.org/10.1080/14636778.2021.2004032
这期2021年主题特刊是对基因编辑技术的出现和重要性的认可,基因编辑技术已经被描述为人类历史上一个新时代的贡献,即一场革命,一项改变游戏规则的技术,一项颠覆性技术。基因编辑已被证明是一种廉价、快速和有效的技术,可以针对和编辑(通过删除、添加或以其他方式修改)遗传物质。因此,它在临床,农业和工业领域具有广泛的适用性,同时它也被证明在不太正式的环境中很受欢迎,例如“生物黑客”技术(DIY生物学)。我们在这个主题问题上的重点是基因编辑与人类健康的相关性。体细胞基因编辑已经被证明是成功的,并有助于开发某些类型的儿童失明、脊髓性肌萎缩症和镰状细胞病的治疗益处(Ledford, 2020)。生殖(种系)基因编辑更具争议性,人们对其快速发展的担忧日益增加。对风险的担忧包括引入意想不到的基因变化(称为“脱靶”效应),这将是不可撤销和不可逆转的,这意味着对儿童的长期健康影响存在重大的“已知未知”。《新遗传学与社会》在记录新技术的出现和随之而来的争论方面有着悠久的历史(例如,参见Parry(2003)、Haddow等人(2010)和sleboom - faulkner等人(2011)等)。许多作者继续讨论基因编辑的风险和益处,遵循熟悉的从安全性、伦理和公众舆论方面评估新技术的路径(Martin et al. 2020, So et al. 2021)。特别是英国,采用严格监管但自由的方法来支持新的生殖技术,2016年2月,Kathy Niakan (Francis Crick,英国)成为《新遗传学与社会》,2021年第40卷,第4期,361-366,https://doi.org/10.1080/14636778.2021.2004032
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引用次数: 2
The omics of our lives: practices and policies of direct-to-consumer epigenetic and microbiomic testing companies 我们生活的组学:直接面向消费者的表观遗传和微生物检测公司的实践和政策
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.1997576
Terese Knoppers, Elisabeth Beauchamp, K. Dewar, S. Kimmins, G. Bourque, Y. Joly, C. Dupras
While much attention has gone towards ethical, legal, and social implications of direct-to-consumer genetic testing over the past decades, the rise of new forms of consumer omics has largely escaped scrutiny. In this paper, we analyze the product descriptions, promotional messages, terms of service, and privacy policies of five epigenetic and seven microbiomic testing companies. The advent of such tests online represents a significant shift in consumer omics, from a focus on inherited molecules with genetic tests, to broader interest for information about the lives of individuals, such as chronological and biological age, exposures, and lifestyle. Building on previous literature about direct-to-consumer genetic testing, and taking this shift into account, we identify limitations, gaps and inconsistencies in current practices and policies of the new companies. Best practice standards and regulations applicable across different omic sample and data types is a necessary first step in the promotion of responsible consumer omics.
在过去的几十年里,人们对直接面向消费者的基因检测的伦理、法律和社会影响给予了很多关注,但新形式的消费者组学的兴起却在很大程度上躲过了审查。本文分析了5家表观遗传学检测公司和7家微生物学检测公司的产品描述、促销信息、服务条款和隐私政策。这种在线测试的出现代表了消费者组学的一个重大转变,从关注遗传分子的基因测试,到对个人生活信息的更广泛兴趣,如实际和生物年龄、暴露和生活方式。基于先前关于直接面向消费者的基因检测的文献,并考虑到这一转变,我们确定了新公司当前实践和政策中的局限性、差距和不一致之处。适用于不同组学样本和数据类型的最佳实践标准和法规是促进负责任的消费者组学的必要的第一步。
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引用次数: 4
The rise of the biocyborg: synthetic biology, artificial chimerism and human enhancement 生物半机械人的兴起:合成生物学、人工嵌合和人类增强
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.2007064
L. Pio-Lopez
Applying technologies into the human body makes a hybrid human/machine: a cyborg. We identified four types of cyborgs in the literature: the original cyborg, enhanced temporarily for space exploration, the science-fiction cyborg, the “Haraway cyborg” used to critic the dualisms and the “everyday cyborg” who became one by necessity, and learns to live with the implanted technologies. We propose in this article a fifth version: the biocyborg. Such a cyborg presents a new kind of hybridity that we named artificial chimerism, it leads to a multi-scale non-Darwinian evolution and the willingness to become a biocyborg is not only driven by necessity but also by the desire to be enhanced and to push the physiological boundaries of the human body. Becoming a biocyborg comes with new vulnerabilities as any embodied technologies but the associated risk is multi-level and also concerns the human species.
将技术应用于人体,就会产生一种人与机器的混合体:半机械人。我们在文献中确定了四种类型的电子人:原始的电子人,为了太空探索而暂时增强,科幻小说中的电子人,用来批评二元论的“哈拉威电子人”和“日常电子人”,他们必须成为一个电子人,并学会与植入的技术一起生活。我们在这篇文章中提出了第五个版本:生物半机械人。这样的半机械人呈现出一种新的杂交,我们称之为人工嵌合,它导致了一种多尺度的非达尔文进化,成为一个生物半机械人的意愿不仅是由必要性驱动的,也是由渴望增强和推动人体生理界限的愿望驱动的。与任何具体化的技术一样,成为一个生物半机械人也会带来新的脆弱性,但相关的风险是多层次的,也涉及到人类物种。
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引用次数: 6
Many thanks for New Genetics and Society reviewers 非常感谢新遗传学和社会评论家
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.2009262
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引用次数: 0
The platforming of human embryo editing: prospecting “disease free” futures 人类胚胎编辑平台:展望“无疾病”的未来
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-10-02 DOI: 10.1080/14636778.2021.1997578
Ayo Wahlberg, D. Dong, Priscilla Song, Zhu Jianfeng
In November 2018, a scientific scandal broke when news emerged that the world’s first gene edited babies had been born in China on the eve of the 2nd International Summit on Human Genome Editing in Hong Kong. He Jiankui had recruited a total of seven couples who were in need of fertility treatment to participate in an effort to clinically apply human embryo editing with the promise that, if successful, their future children would be protected from HIV. While He Jiankui has since been jailed for illegal medical practice and much has been written about his unethical and flawed “experiment,” in this article we suggest that the Hong Kong summit nevertheless marked the moment when human embryo editing came to be platformed. Human embryo editing brings together a complete set of new reproductive and genetic technologies into a total bio-reproductive platform shaped by socio-technical “disease free” imaginaries.
2018年11月,在香港举行的第二届人类基因组编辑国际峰会前夕,有消息称世界上第一批基因编辑婴儿在中国出生,这引发了一场科学丑闻。贺建奎总共招募了7对需要生育治疗的夫妇参与临床应用人类胚胎编辑的努力,并承诺如果成功,他们未来的孩子将免受艾滋病毒的侵害。尽管何建奎此后因非法医疗行为被判入狱,关于他不道德和有缺陷的“实验”的报道也很多,但在本文中,我们认为,香港峰会标志着人类胚胎编辑成为平台的时刻。人类胚胎编辑将一整套新的生殖和遗传技术汇集到一个由社会技术“无疾病”想象塑造的整体生物生殖平台中。
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引用次数: 5
The color of creatorship: intellectual property, race, and the making of Americans 创造的色彩:知识产权、种族和美国人的形成
IF 1.8 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2021-07-15 DOI: 10.1080/14636778.2021.1951194
Jinhong Choi
very small issues. Kirkland is a master of the material and her meticulous scholarship has much to commend it. This book should be of great interest to her intended audiences in socio-legal studies and STS. Medical sociologists, anthropologists, historians, and scholars of health policy will also find this book valuable as it generates important insights that usefully inform broader debates about and understandings of vaccine hesitancy and anti-vaccine social movements. “Vaccine Court” was written before the current COVID-19 pandemic, which has arguably given vaccination a new social and political significance and visibility. Though at the time of writing this review, COVID-19 vaccines are not on the list of vaccines eligible for compensation via the National Vaccine Injury Compensation Program (at least whilst a declaration of a public health emergency remains in place), it will be interesting to observe if and how these vaccines and any claims of harm reflect and potentially shape the epistemic politics of vaccine injury more generally.
非常小的问题。柯克兰是材料的大师,她一丝不苟的学术研究有很多值得赞扬的地方。这本书应该对她的社会法律研究和STS的目标受众非常感兴趣。医学社会学家、人类学家、历史学家和卫生政策学者也会发现这本书很有价值,因为它产生了重要的见解,有助于对疫苗犹豫和反疫苗社会运动进行更广泛的辩论和理解。《疫苗法庭》写于当前的COVID-19大流行之前,可以说,这场大流行赋予了疫苗接种新的社会和政治意义和知名度。尽管在撰写这篇综述时,COVID-19疫苗并不在通过国家疫苗伤害赔偿计划获得赔偿的疫苗名单上(至少在宣布公共卫生紧急情况仍然存在的情况下),但观察这些疫苗和任何伤害声称是否以及如何反映并可能更普遍地塑造疫苗伤害的认知政治将是有趣的。
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引用次数: 0
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