A revelatory account of how power, politics, and greed have placed the unfulfilled promise of personalized medicine at the center of American medicine
The United States is embarking on a medical revolution. Supporters of personalized, or precision, medicine—the tailoring of health care to our genomes—have promised to usher in a new era of miracle cures. Advocates of this gene-guided health-care practice foresee a future where skyrocketing costs can be curbed by customization and unjust disparities are vanquished by biomedical breakthroughs. Progress, however, has come slowly, and with a price too high for the average citizen.
In Tyranny of the Gene, James Tabery exposes the origin story of personalized medicine—essentially a marketing idea dreamed up by pharmaceutical executives—and traces its path from the Human Genome Project to the present, revealing how politicians, influential federal scientists, biotech companies, and drug giants all rallied behind the genetic hype. The result is a medical revolution that privileges the few at the expense of health care that benefits us all.
Now American health care, driven by the commercialization of biomedical research, is shifting focus away from the study of the social and environmental determinants of health, such as access to fresh and nutritious food, exposure to toxic chemicals, and stress caused by financial insecurity. Instead, it is increasingly investing in “miracle pills” for leukemia that would bankrupt most users, genetic studies of minoritized populations that ignore structural racism and walk dangerously close to eugenic conclusions, and oncology centers that advertise the perfect gene-drug match, igniting a patient’s hope, and often dashing it later.Tyranny of the Gene sounds a warning cry about the current trajectory of health care and charts a path to a more equitable alternative.
About the Author
JAMES TABERY is a professor at the University of Utah in the Department of Philosophy and a member of the Center for Health Ethics, Arts, & Humanities. His research has been reported in The New York Times, National Geographic, Time, and on National Public Radio. He lives in Salt Lake City with his wife and their three children.
“Incisive . . . Tabery is a penetrating critic, positing that research on personalized drugs takes up an oversize share of funding because it’s more profitable than investigating environmental determinants of health. . . . This damning take on scientific bias is not to be missed.”—Publishers Weekly (starred review)
“An accessible narrative bolstered by prodigious research . . . An engaging, provocative study of a much-hyped aspect of American health care . . . Tabery succeeds in raising a compelling alarm about where things stand and making clear that the current situation could have been much different, all while laying the groundwork for an alternative future.”—Kirkus Reviews
“The majority of the common diseases that take a large toll on health in America are caused by lifestyle and environmental factors, or those factors combined with genetics. Yet biomedical research today is focused on genes and exorbitantly expensive gene-based therapies—to the detriment of our health and our pocketbooks. In this powerful book, James Tabery explains how and why the promise of ‘personalized’ and ‘precision’ medicine has failed us. A must-read for doctors, patients, scientists, and anyone who cares about the future of health in America.”—Naomi Oreskes, co-author of Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming
"[A] lively history...interweaving tales of environmental and genomic medicine... Tabery’s excellent book argues powerfully for a more balanced approach to human health research." —Henry T. Greely, Science
“James Tabery’s book makes the case for why the revolutionary promise of precision medicine has been, at best, elusive and, at worst, a distraction from the revolution we truly need: a radical reimagining of how we prevent disease in our society.”—Sandro Galea, author of Well: What We Need to Talk About When We Talk About Health
“Tyranny of the Gene is an extraordinary and invaluable investigation into the prevailing fashions of twenty-first-century medical research, and the price we may be paying for the very questionable promise of personalized medicine.”—Gary Taubes, author of Why We Get Fat
“We have long known that the best way to improve the nation’s health is to clean up the environment and enhance social equality. Instead, as Tyranny of the Gene brilliantly shows, we are investing in gene-based personalized medicine, catering to the most privileged patients and enriching pharmaceutical companies. By unraveling the financial, political, and scientific history of hyping genetics’ failed promises, Tabery makes a compelling case for changing course toward a healthier future for all.”—Dorothy Roberts, author of Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century
“Tyranny of the Gene will challenge your thinking about the ‘miracle cures’ of DNA-based personalized medicine. In documenting the rise of genetically-based treatments, Tabery reveals the scientific, financial and political forces that have promoted this technology — much to the detriment of health care equality and public health research. Deeply investigated and fluidly told, this is a book that commands our attention.”—Douglas Starr, author of Blood: An Epic History of Medicine and Commerce
“Tabery’s fascinating and unique book is a much-needed critique of our current obsession with genetics, personalization, and individualism in health. A compelling mix of history of science, political intrigue, and public health policy, the book tells us how we got here – and, more importantly, why this is the wrong place to be. A must read for anyone interested in the massive disconnect between what we invest in to make us healthy and what actually matters.”—Timothy Caulfield, author of Relax, Dammit!: A User's Guide to the Age of Anxiety