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Personalized medicine, digital technology and trust: a Kantian account

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease a...

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Autores principales: Myskja, Bjørn K., Steinsbekk, Kristin S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538445/
https://www.ncbi.nlm.nih.gov/pubmed/32888101
http://dx.doi.org/10.1007/s11019-020-09974-z
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author Myskja, Bjørn K.
Steinsbekk, Kristin S.
author_facet Myskja, Bjørn K.
Steinsbekk, Kristin S.
author_sort Myskja, Bjørn K.
collection PubMed
description Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust.
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spelling pubmed-75384452020-10-19 Personalized medicine, digital technology and trust: a Kantian account Myskja, Bjørn K. Steinsbekk, Kristin S. Med Health Care Philos Scientific Contribution Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. Springer Netherlands 2020-09-04 2020 /pmc/articles/PMC7538445/ /pubmed/32888101 http://dx.doi.org/10.1007/s11019-020-09974-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Scientific Contribution
Myskja, Bjørn K.
Steinsbekk, Kristin S.
Personalized medicine, digital technology and trust: a Kantian account
title Personalized medicine, digital technology and trust: a Kantian account
title_full Personalized medicine, digital technology and trust: a Kantian account
title_fullStr Personalized medicine, digital technology and trust: a Kantian account
title_full_unstemmed Personalized medicine, digital technology and trust: a Kantian account
title_short Personalized medicine, digital technology and trust: a Kantian account
title_sort personalized medicine, digital technology and trust: a kantian account
topic Scientific Contribution
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538445/
https://www.ncbi.nlm.nih.gov/pubmed/32888101
http://dx.doi.org/10.1007/s11019-020-09974-z
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