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The Prospects of Personalising Medicine



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Mncube, Zinhle 


Personalised Medicine (PM) is touted as a medical revolution where medical treatment and diagnosis is tailored to the individual patient so that it is optimal, safe, and exactly appropriate. Each chapter in this dissertation deals with the conceptual, methodological, epistemic, or ethical issues of personalising medicine that influence our ability to reliably predict, diagnose, and treat disease for individual patients. I argue that PM in its current form is insufficient in several ways. My dissertation contributes to the literature by providing arguments for why and how we should reconceive of PM.

In Chapter 1, I describe and analyse two conceptions of PM: broad-based and biological. I reject the popular claim that biological conceptions of PM are not truly personalised because they do not capture holistic aspects of personhood. Instead, I argue that the real problem for genome-based conceptions is that genomics is frequently imprecise and explanatorily not robust about underlying causes of disease.

In Chapter 2, I illustrate that some theorists combine their defence of the use of race in medicine with an appeal to the value-free ideal. Against this view, I contend that contextual value judgements are important in assessing the use of race in medicine because evidence on the epistemic usefulness of racial categories in medicine can be transiently underdetermined and inductively risky.

In Chapter 3, I interrogate the controversial use of racial categories in equations to predict kidney function and show that equations that include race in their estimations are inadequate at accurately predicting kidney function. In Chapter 4, I assess the underexplored reliability of what I call the ‘stratification strategy’. This strategy requires that clinicians make therapeutic predictions about individual patients based on evidence of commonly shared molecular biomarker status among patient subgroups. I argue that in many instances of its use, this strategy has low reliability because biomarker evidence lacks credibility.

Lastly, in Chapter 5, I draw attention to African Traditional Medicine as a broad-based form of PM. I consider the rationale to decolonise medicine as it applies to African Traditional Medicine in South Africa. I argue that interpreting this rationale as many do—that African Traditional Medicine is epistemically equivalent to Western mainstream medicine—implies an untenable wholesale medical relativism.





Stegenga, Jacob


Personalised Medicine, Precision Medicine, Philosophy of Medicine, Philosophy of Race, Philosophy of Science


Doctor of Philosophy (PhD)

Awarding Institution

University of Cambridge
The British Society for the Philosophy of Science