Medical Ethics, Prediction, and Prognosis Interdisciplinary Perspectives

Recent scientific developments, in particular advances in pharmacogenetics and molecular genetics, have given rise to numerous predictive procedures for detecting predispositions to diseases in patients. This knowledge, however, does not necessarily promise benign results for either patients or health care professionals. The aim of this volume is to analyse issues related to prediction and prognosis as a burgeoning field of medicine, which is revolutionizing the way we understand and approach diagnosis and treatment. Combining epistemic and ethical reflection with medical expertise on contemporary practice and research, an interdisciplinary group of international experts critically examine anticipatory medicine from various perspectives, including history of medicine, bioethics, theories of science, and health economics. The highly complex issues involved in medical prediction call for a far-reaching debate on the value and scope of foreknowledge. For example, which responsibilities and burdens arise when still healthy people learn of their predisposition to diseases? How should health care insurance reflect risky life styles? Is the increasing medicalization of life connected with prevention ethically sustainable and financially possible in the developing world? These and other related issues are the subject of this timely and important book, which not only serves as an introduction to the area, but also proposes many feasible solutions to the problems outlined.

Introduction: Predictive Medicine – An Interdisciplinary Approach Mariacarla Gadebusch Bondio, Francesco Spöring, and John-Stewart Gordon Part I. Individual Challenges 1. Beyond the Causes of Disease: Prediction and the Need for a New Philosophy of Medicine Mariacarla Gadebusch Bondio 2. Comprehending and Communicating Statistics in Breast Cancer Screening. Ethical Implications and Potential Solutions Giulia Ferretti, Alma Linkeviciute, and Giovanni Boniolo 3. On the Nature of the Right Not to Know John-Stewart Gordon 4. Predictive Diagnostic Testing for Late-Onset Neurological Diseases in Asymptomatic Minors: ‘Do No Harm’ and the Value of Knowledge Heiner Fangerau, Florian Braune, and Christian Lenk 5. Incidental Findings in Genetic Testing Elke Holinski-Feder and Verena Steinke-Lange Part II. Social Challenges 6. Risk and Solidarity within Individualized Medicine Konrad Ott 7. Anticipatory Medicalization: Predisposition, Prediction, and Proto-Disease, Expanding Medicalized Conditions Peter Conrad and Miranda Waggoner 8. Predicting the Cost of Diseases in Resource-Poor Countries Steffen Flessa 9. Genetic Disorders in Chinese Patients and Their Families: A Call for Action on Predictive Medicine Xian-Ning Zhang and Ji Zuo Part III. Research Challenges 10. Personalized Antidepressant Prescription: A Historical Perspective on Risks and Opportunities Francesco Spöring 11. Predicting, Preventing, and Treating Alzheimer’s Disease: Current State and Future Challenges Stefan F. Lichtenthaler 12. Early Detection, Prediction, and Prognosis of Alzheimer’s Disease Simone Lista, Francesco Garaci, Nicola Toschi, and Harald Hampel 13. Immunoscore, Circulating Tumor Cells and Human-Derived Organoids as Potential Predictive Tools in Personalized Cancer Medicine Agnieszka Pastula

Mariacarla Gadebusch Bondio is Professor in the Institute for History and Ethics of Medicine at Technical University of Munich, Germany Francesco Spöring is Research Assistant in the Institute for History and Ethics of Medicine at Technical University of Munich, Germany John-Stewart Gordon is Professor of Philosophy and Head of the Applied Ethics Research Group at Vytautas Magnus University, Lithuania