The new holism P4 systems medicine and the medica

Authors: Henrik Vogt Bjørn Hofmann Linn Getz

Publish Date: 2016/01/28

Volume: 19, Issue: 2, Pages: 307-323

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Abstract

The emerging concept of systems medicine or ‘P4 medicine’—predictive preventive personalized and participatory is at the vanguard of the postgenomic movement towards ‘precision medicine’ It is the medical application of systems biology the biological study of wholes Of particular interest P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist This article analyzes its concept of holism both with regard to methods and conceptualization of health and disease Rather than representing a medical holism associated with basic humanistic ideas we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology We argue that this holism which is aimed at disease prevention and health optimization points towards an expanded form of medicalization which we call ‘holistic medicalization’ Each person’s whole life process is defined in biomedical technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is allencompassing It is directed at all levels of functioning from the molecular to the social continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society which we call ‘the medicalization of health and life itself’ We explicate this holistic medicalization discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine quaternary preventionAt the risk of sounding academic you are a system A system made up of systems to be exact … Our integrative—or systems—approach holistically gathers connects and analyzes your data to create a complete picture of you all 360 degrees of you At Arivale we don’t guess We base our recommendations—your roadmap—on your personal data story that 360degree view of you consisting of millions of data points—The website of the P4 systems medicine company Arivale 2015Research projects The Institute for Systems biology ISB recently launched the first phase ‘The Hundred Person Wellness Project’ of its ‘100 K Wellness Project’ This is the first ‘real life’ clinical trial using P4SM principles It is planned to involve quantification of a large number of parameters in 100000 well people Hood and Price 2014 In Europe the ‘Virtual Physiological Human’ and ‘Digital Patient’ are central research projects Diaz et al 2013 Hunter et al 2013Clinical reality P4SM is associated with concrete changes to clinical reality as highlighted in the quantified selfmovement Here individuals employ new technologies for example genome sequencing and socalled ‘eHealth’ ‘mHealth’ or lifelogging tools notably smartphones to continuously track their bodily functioning Wolf 2009 Lupton 2014 Smarr 2012Institutions and companies P4SM is associated with a range of research institutions in the USA Europe and Asia Systems medicine has gained support from the EU and European Commission which have funded the ‘Coordinating Action Systems Medicine’ CASyM initiative to promote the implementation of systems medicine in Europe as well as the Virtual Physiological Human and Digital Patient projects Kirschner et al 2013 Diaz et al 2013 Hunter et al 2013 In the USA P4SM is strongly linked to the Institute for Systems Biology ISB the P4 medicine Institute P4MI the associated novel company Arivale The latter has started to deliver actual health services Another central US institution is the Harvard Medical School in Boston In Europe examples of central institutions are the European Institute for Systems Biology and Medicine EISBM in France the Luxembourg Centre for Systems Biomedicine LCSB The University of Rostock Germany and University College Dublin Ireland In Asia there are institutions in India Singapore and China notably the Center for Systems Biomedicine in Shanghai

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