Thursday, January 29, 2015

"Precision medicine" – another funding boondoggle?

Obama's decided to spend a pile of money on "precision" medicine. Michael Joyner remarks that we've been down this road before and don't have much to show for it:
The idea behind the “war on cancer” was that a deep understanding of the basic biology of cancer would let us develop targeted therapies and cure the disease. Unfortunately, although we know far more today than we did 40-plus years ago, the statistics on cancer deaths have remained incredibly stubborn. The one bright spot has been tobacco control — again highlighting the dominant role of culture, environment and behavior versus biological destiny in what ails most of us.

Given the general omertà about researchers’ criticizing funding initiatives, you probably won’t hear too many objections from the research community about President Obama’s plan for precision medicine. But I am deeply skeptical. Like most “moonshot” medical research initiatives, precision medicine is likely to fall short of expectations. Medical problems and their underlying biology are not linear engineering exercises, and solving them is more than a matter of vision, money and will.

We would be better off directing more resources to understanding what it takes to solve messy problems about how humans behave as individuals and in groups. Ultimately, we almost certainly have more control over how much we exercise, eat, drink and smoke than we do over our genomes.
Given my current hobbyhorses, this is yet another example of how anxiety about the unknown, and death, leads us to expend great effort in ways that are ineffective in achieving stated objectives. One certainly gets the impression that progress is a crapshoot. Is this one source of the blind variation driving long-term cultural evolution? 

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