- BIOETHICS FORUM ESSAY
P3-4 and the Coming Revolution
There is a medical revolution being planned by Leroy Hood and the Institute for Systems Biology. The ISB recently held the 5th Annual International Symposium on Systems Biology and Medicine, at which scientists discussed “developing the knowledge, approaches and tools which will usher in the new era of predictive, preventive and personalized medicine” – so-called “P3 medicine.” With its catchy acronym, P3 medicine describes what some argue is the future of biomedical research and health care delivery. However, the ethical issues of today’s medicine remain.
Consider this, for example: How will P3 medicine affect personal choice? Today, people who chose not to have a cochlear implant to “cure” them of their deafness may face scorn at their decision. P3 medicine would create problems of this kind in many new areas. Perhaps that’s why recent discussions of the P3 revolution include a fourth “P,” for participatory.
Should we prioritize P3/4 medicine over other methods of improving health? Money spent on P3/4 research could also be spent on public health efforts like improved clean water availability, malaria prevention, and smoking cessation aids. ISB says that “Improved personal measurements and personalized treatments are the keys to improving health care.” Surely they are important, but they aren’t the only factors.
Who will have access to P3/4 medicine? Given that we’ve not figured out how to ethically distribute food or today’s medical care, there is no indication that P3/4 medicine will be available to everyone, though some at ISB may suggest otherwise.
These are just a few of the many questions P3/4 medicine raises and re-emphasizes. Even if we address these and other concerns and fully develop P3/4 medicine, we won’t be in perfect health. Domestic violence, food and advertising redlining, environmental injustice, and other problems continue to present health concerns that P3/4 revolution will not be able to eliminate or even reduce.
This doesn’t mean we shouldn’t pursue P3/4 medicine, as least in principle. But we cannot allow the excitement and promise of P3/4 medicine to let us to neglect the important ethical issues with which we still struggle.
Disclosure: Karama C. Neal is an employee of Emory University, which was one of the sponsors of the ISB 5th Annual International Symposium on Systems Biology and Medicine.