Molecular medicine and concepts of disease: the ethical value of a conceptual analysis of emerging biomedical technologies

Abstract

Although it is now generally acknowledged that new biomedical technologies often produce new definitions and sometimes even new concepts of disease, this observation is rarely used in research that anticipates potential ethical issues in emerging technologies. This article argues that it is useful to start with an analysis of implied concepts of disease when anticipating ethical issues of biomedical technologies. It shows, moreover, that it is possible to do so at an early stage, i.e. when a technology is only just emerging. The specific case analysed here is that of ‘molecular medicine’. This group of emerging technologies combines a ‘cascade model’ of disease processes with a ‘personal pattern’ model of bodily functioning. Whereas the ethical implications of the first are partly familiar from earlier—albeit controversial—forms of preventive and predictive medicine, those of the second are quite novel and potentially far-reaching.

Rethinking Human Enhancement

“…These concepts are rarely included in ethical analyses of emergent technologies when used for biomedical or human enhancement applications. However, as Marianne Boenink and others have argued, these concepts are relevant to ethical debates on emergent technologies (Boenink, 2009;McKenny, 1997;Sandler, 2009). In particular, there are two main reasons for holding such a claim: 1.…”

The role of PET quantification in neurological imaging: FDG and amyloid imaging in dementia

“…Further improvement of statistical methods and multimodal image processing techniques are expected to provide more accurate prediction of disease progression [72,73] and a better understanding of the multifactorial pathophysiology of dementia [74]. Ultimately, these techniques should contribute to an emerging new concept of neurodegenerative diseases that is no longer restricted to categorical diagnostic classification but identifies a cascade of interacting molecular processes [75], which might be treated by personalised and targeted intervention at an early stage before onset of dementia.…”

Freitas on Disease in Nanomedicine: Implications for Ethics

“…Given the possibility of nanotechnologic cytosurgery, therapy is feasible by matching precise genotypes and phenotypes through the intermediary specification of proteins. 9 We now turn to the volitional normative model of disease made possible by nanotechnologic medicine. The model draws on both an idealist view of health and disease and a functional failure view of disease in order to produce its own disease definition.…”

“…However, to be biologically (and linguistically) accurate, the body is also comprised of other important parts, i.e., lipids, carbohydrates, nucleoproteins and other molecules, which Freitas only mentions in passing earlier in the paper [18]8 The referent of 'molecular reference structures' is never clarified in Freitas's paper, yet the context makes it safe to infer that the term applies to the catalogued protein molecules of the human body 9. The genotype-phenotype relationship is thus crucial in deciding health and disease on the volitional normative model, but only on this abstract, theoretical level.…”