Bespoke Health Care

Patrick Wilson
Original Article:

In President Obama’s State of the Union address last month, he announced that he was launching a new precision medicine initiative, noting that this initiative will “give all of us access to the personalized information we need to keep ourselves and our families healthier.” In essence, precision medicine can help doctors deliver tailored medical care that is matched to our genotypes and personal histories. Precision medicine is also known as personalized medicine; it is an approach to medical care that allows doctors to provide customized, “bespoke” medical treatments.

As a society we value products and goods that are tailored to our personal preferences. But we cannot precisely (or personally) connect to our prevention needs, our treatment options, and our basic health concerns if our doctors don’t ask us questions. I’m talking about tough questions. Questions on topics that we don’t discuss with most people. Questions about things that even our genes can’t reveal, but that nonetheless affect our health. Call them “precision questions.”

For example, to effectively prevent and treat HIV and AIDS, precision medicine will do nothing unless doctors can handle broaching precision questions about sexuality.

When I was growing up as a gay kid in the 1990s, HIV was a health problem that elicited a lot of panic (both rational and irrational). In the early years of the epidemic, it felt as though being gay—a personal attribute that may have a genetic component—was the reason you got HIV and eventually died of AIDS. We now know that being gay doesn’t mean you get AIDS; high-risk sexual and drug use practices make one most susceptible to HIV and AIDS.

As Obama remarked in a White House event to launch his precision medicine initiative, understanding genes may help us treat HIV more effectively, identifying those individuals for whom new antiretroviral drugs will work best, or those who may experience negative side effects from particular treatments.

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