A sociology of precision‐in‐practice: The affective and temporal complexities of everyday clinical care

Abstract

The idea of 'precision medicine', which has gained increasing traction since the early 2000s, is now ubiquitous in health and medicine. Though varied in its implementation across fields, precision medicine has raised hopes of revolutionary treatments and has spurred the proliferation of novel therapeutics, the alteration of professional trajectories and various reconfigurations of health/care. Nowhere is the promise of precision medicine more apparent, nor further institutionalised, than in the field of oncology. While the transformative potential of precision medicine is widely taken for granted, there remains scant attention to how it is being experienced at the coalface of care. Here, drawing on the perspectives of 54 cancer care professionals gleaned through eight focus group discussions in two hospitals in Australia, we explore clinicians' experiences of the day-to-day dynamics of precision-in-practice. We illustrate some of the affective and temporal complexities, analysed here under the rubrics of enchantment, acceleration and distraction that are emerging alongside the | 2179

Desafios atuais e futuros do uso da medicina de precisão no acesso ao diagnóstico e tratamento de câncer no Brasil

“…Como resultado do estudo, alguns achados mostraram-se interessantes. Em primeiro lugar, observamos que os especialistas médicos -declaradamente bem preparados e informados sobre os avanços nas áreas da medicina de precisão -abraçam a nova medicina molecular com grande otimismo 30 , antecipando e projetando, para antes de 2049, em combinação ainda com a cirurgia e a radioterapia, uma transformação bem-sucedida no tratamento do câncer por meio do diagnóstico, monitoramento e terapias precisas.…”

“…Essa nova forma de tratamento oncológico, ainda em processo de desenvolvimento e maturação de sua aplicação na clínica 24,30,31 , visa determinar a resposta terapêutica ideal por meio da classificação da população e dos tumores em agrupamentos biologicamente apropriados -uma abordagem estratificada que busca substituir os atuais protocolos que são aplicados de forma padronizada em toda a população 23 . Scheuenpflug 32 comenta que a medicina de precisão/personalizada, impulsionada pela evolução da ciência e das tecnologias do século XXI em um contexto de economia global da saúde, procura desenvolver conceitos inovadores e de maior valor terapêutico para pacientes das sociedades industrializadas e envelhecidas.…”

“Doing Good” in U.S. Cancer Genomics? Valuation practices across the boundaries of research and care in rural community oncology

“…Current literature underlines how genomics’ promissory rhetoric is coupled with distinctive affective states, including anticipation, hope and worry, or feelings oriented to the future ( Fortun 2008 ; Adams, Murphy, and Clarke 2009 ). For example, Kenny and colleagues observed that Australian clinicians and patients encountering cancer genomics felt the “problematic pull of survival” regardless of affective or material costs ( Kenny et al . 2021 , 2185).…”

Approaches in Post‐Experimental Science. The Case of Precision Medicine**

“…10 Standardization and automation of the production of data appear to reduce the possibility for unprecedented events emphasized by Rheinberger. 11 Furthermore, it seems that such research is built on the assumption that there is nothing left to discover with respect to, say, constituents of cells (at least for humans or 5 Kenny et al 2021. For a long-term perspective on the promissory nature of biomedicine, see Löwy, this issue.…”