Precision

Precision medicine, personalized medicine, P4 medicine, individualized medicine, stratified medicine—broadly speaking, these terms refer to an aspirational set of transformations in biomedical knowledge (see Tutton 2014, 4–6; and Hedgecoe 2004, 16–20). After these transformations, it is imagined, clinicians will use biomarkers (such as genetic signatures, blood products, or neural maps) to categorize patients instead of their superficial features—their signs and symptoms. Therapies will no longer be applied helter-skelter through a process of trial and error but on the basis of causal understanding and predictive power. While in much of the English-speaking world the term personalized medicine has dominated, in the United States, the label “precision” has become increasingly popular. Following the 1990s vogue for precision warfare after the Gulf War, since the early 2000s there has been an enthusiasm for medical interventions that minimize collateral damage, and make efficient and effective use of costly, innovative technologies. Compared to “one-size-fits-all medicine,” its apologist Francis Collins once claimed of precision, “it’s a smart bomb” (Juengst et al. 2016, 24; for more on this metaphor, see Kenney and Mamo 2020).