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      P is not for Person: The Ethical Paradox of P Medicine

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      RExPO24 Conference
      REPO4EU
      RExPO24
      3-5 July 2024
      Ethics, Person-centred care, Personalised medicine, Precision medicine, Stratified medicine, Systems medicine, P4 medicine
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            Abstract

            This research aims to delve into a paradoxical trend within certain knowledge domains. Specifically, it explores how the pursuit of stratification and the rejection of reductionism can inadvertently lead to a reductionist view of the human person. We argue that contemporary conceptualisations of "P medicine" fail to achieve their intended ethical goals.

            In the field of medicine, there is a notable paradigm shift towards individualised approaches. Advances in genomics and data science have fuelled the promise of tailoring medical treatments to each patient's specific needs. This concept, often referred to as "personalised medicine", "precision medicine", "stratified medicine"," systems medicine", or "P4 medicine", leverages vast datasets of genetic, molecular, and clinical data to identify patient subgroups with differential treatment responses. However, these terms, while emphasising individualisation, often neglect subtle ethical distinctions (Ginsburg & Vogelstein, 2002; Gorini & Pravettoni, G. 2010; Hood & Flores, 2012; Schneider, 2013; Pokorska-Bocci et al., 2014; Juengst, et al., 2016; Maier, 2017; Juengst & McGowan, 2018; Jørgensen, 2019).

            While all P medicines offer the potential to move beyond disease-centric treatment by analysing individual susceptibilities and therapeutic targets, a sole focus on the disease remains insufficient (Delpierre & Lefèvre, 2023; Stratton & Olson, 2023). William Osler's ideal physician "treats the patient who has the disease," acknowledging the importance of person-centred care (Tomaselli et al., 2020). Person-centred care and P´s medicine appear to represent seemingly divergent philosophies in modern healthcare. The first, emphasises patient autonomy, values, and preferences, while the second leverages individual genetic and biological data for tailored diagnoses and treatments.

            This research explores the critical need to reconcile these approaches to achieve optimal healthcare delivery. Reconciling these approaches is not about diminishing the importance of either approach (Cornetta & Brown, 2013; El-Alti et al., 2019). Instead, it's about creating a synergy that leverages the strengths of each. A holistic understanding by integrating the patient's biology, social context, and patient values and goals is crucial for optimising treatment strategies, empowering patients, and achieving better health outcomes. Into the framework of P´s medicine, healthcare professionals can deliver more holistic, patient-centred, and ultimately, more effective care.

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            Author and article information

            Conference
            RExPO24 Conference
            REPO4EU
            3 May 2024
            Affiliations
            [1 ] University of Porto ( https://ror.org/043pwc612)
            Author notes
            Author information
            https://orcid.org/0000-0003-3032-8851
            https://orcid.org/0000-0003-1132-8880
            https://orcid.org/0000-0001-7817-9889
            Article
            10.58647/REXPO.24000049.v1
            6829b25e-f3cd-41de-bc80-a7ea4e25c592

            This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

            RExPO24
            3
            Munich, Germany
            3-5 July 2024
            History
            : 3 May 2024
            Product

            REPO4EU

            Categories

            Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
            Life sciences
            Ethics,Person-centred care,Personalised medicine,Precision medicine,Stratified medicine,Systems medicine,P4 medicine

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