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Development of Personalized Health in Switzerland: Social Sciences Perpectives

Applicant Panese Francesco
Number 180350
Funding scheme Sinergia
Research institution Institut des sciences sociales Faculté des sciences sociales et politiques Université de Lausanne
Institution of higher education University of Lausanne - LA
Main discipline Interdisciplinary
Start/End 01.01.2019 - 31.12.2022
Approved amount 2'764'048.00
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All Disciplines (7)

Discipline
Interdisciplinary
Ethnology
Legal sciences
Economics
Political science
Sociology
Philosophy

Keywords (11)

Precision medicine; Legal foundations; Moral economies; Public Participation; Healthcare costs and insurance; Social epistemology; Personalized health; Self-care practices; Biomedical platforms; Policy implications; Biomedical industry

Lay Summary (French)

Lead
On assiste aujourd’hui au développement de nouvelles approches médicales sous le terme de Médecine 4P (préventive, personnalisée, prédictive et participative). L'objectif du projet « Développement de la santé personnalisée en Suisse. Perspectives de sciences sociales » (DoPHiS) est d’étudier des mises en œuvre concrètes de ces approches aux niveaux technique, clinique, social, économique, juridique, politique et moral.
Lay summary

DoPHiS adopte une perspective interdisciplinaire adaptée aux questions de recherche posées par les mises en œuvre concrètes de la Médecine 4P. Les spécialistes en études sociales de la biomédecine analysent le développement de nouvelles plateformes diagnostiques, thérapeutiques et de prévention. Les spécialistes en économie de la santé et en systèmes d’information analysent les évolutions des coûts, des normes de remboursement et du marché des données. Les spécialistes en politiques sanitaires analysent les évolutions des politiques de la santé liées aux développements différentiés de la Médecine 4P au niveau international. Les spécialistes en droit de la santé étudient la manière dont son institutionnalisation génère des tensions au regard des normes, des règles et des lois aux niveaux local et international. Les spécialistes en éthique et en recherche participative analysent les engagements collectifs et individuels, profanes et professionnels dans ces nouvelles approches médicales en termes de consentement, de participation active et d’évolution de la vie sociale.

La collaboration étroite des quatre équipes de recherche qui composent DoPHiS permettra de mieux comprendre et, cas échéant, d’orienter : 1) l’intégration de la médecine 4P dans les pratiques et les organisations biomédicales existantes ; 2) les transformations des compétences et des pratiques des professionnels de la santé et des usagers ; 3) les évolutions en termes de normes, règles et lois liées à son institutionnalisation aux niveaux local, national et international.

Direct link to Lay Summary Last update: 05.12.2018

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Associated projects

Number Title Start Funding scheme
156509 Knowledge Translation through Tool-Supported Practices in Health Care: Production and Use of Self-Management Tools in Chronic Disease. The case of Diabetes 01.09.2015 Project funding (Div. I-III)
162679 Genetic determinism, human intuitions, and genetics literacy 01.03.2016 Project funding (Div. I-III)
159428 Solvency Levels, Asset Allocation and Risk Management in Swiss Pension Funds 01.08.2015 Project funding (Div. I-III)
169662 Public-private interactions and intergenerational phenomena in long-term care financing 01.09.2017 Project funding (Div. I-III)
157787 The Rise of Citizen Science: Rethinking Public Participation in Science 01.11.2015 Temporary Backup Schemes
162873 PARED - Parental Responsibility, Epigenetics and DOHaD: Emerging sociotechnical imaginaries of reproduction in the age of epigenetics 01.01.2016 Project funding (Div. I-III)

Abstract

1. SummaryThe present project engages with Personalized Health in Switzerland from an interdisciplinary perspective deeply grounded in the social sciences (i.e. Science and Technology Studies, Anthropology of biomedicine, Health Economics, Political Sciences, Health Law, Practical Ethics and Sociology of Public Engagement with Science). The scope and ambitions of Swiss biomedical institutions currently working towards the realization of Personalized Health requires in fact recognizing the potentially profound impact of this endeavour on social categories of biomedicine, on regulatory standards, and on the economic functioning of healthcare. From the reconfiguration of diagnosis, prognosis and treatment of the most common diseases, to the expansion of the role of patients and citizens in the management of their own health, and the transformations of reimbursement standards in health insurance, the categories and objects of Personalized Health require scrutinizing the conditions of possibility under which different versions of personalization can become “social facts”; namely, how the multiple biomedical platforms of Personalized Health can give shape to institutionally stable ways of personalizing medicine and health promotion for the Swiss population.Our general goal is to scrutinize how the implementation of Personalized Health in Switzerland rests upon the alignment of both the techno-scientific and the socio-political components of this initiative. On the one hand, we will study the “alignment” of work at an experimental, technical and practical level. Implementing personalization requires working towards the coexistence under the same “biomedical roof” of different technological, scientific and medical platforms. This point is already the focus of ignited discussions among the concerned actors for it raises the pressing necessities to (i) make compatible diverse theoretical and methodological perspectives, to (ii) render interoperable technological and material tools for knowledge-production, as well as to (iii) adapt epistemic cultures from different communities of biomedical research and clinical practice. On the other hand, we will also consider the “alignment” of Personalized Health as demanding socio-political forms of work, which consist of (i) carving institutional alliances to render interoperable existing biomedical platforms, (ii) formulating regulatory provisions that make Personalized Health operational in healthcare, as well as (iii) ensuring the political accountability of the whole endeavour. The reconfigurations of healthcare possibly produced by Personalized Health generate questions about major shifts in micro- and macro-economic models in healthcare, and require the stabilization of such approach in Swiss medical consultation standards. At the same time, the challenges of implementing *omics-based (e.g. genomics, epigenomics, transcriptomics, proteomics, metabolomics, exposomics) consultation in medical practice also include integrating new professional figures in biomedicine, and dealing with the public availability of knowledge (e.g. direct-to-consumer-DTC *omics tests) that was previously the preserve of biomedical experts.The main deliverable of the project is the production of a series of iterative Policy Briefs on the development of Personalized Health in Switzerland. Our interdisciplinary research on Personalized Health will encourage its wider societal use in that it will (i) provide a multi-dimensional description of policy problems relating to the implementation of Personalized Health in biomedicine and public health, (ii) provide social science evidence to clarify the size and nature of these problems, (iii) describe the likely impacts of Personalized Health on different actors in the Swiss polity, and finally (iv) inform considerations about its effective implementation and social integration. In doing so, our project wants to overcome critical narratives of Personalized Health as necessarily de-socializing medicine, and complement with a socially grounded perspective the ELSI (i.e. Ethical, Legal and Social Issues) work necessary to render scientific collaborations, flows of information, data and biomaterials operational in biomedical and translational research on personalization.
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