Pharmacogenetics is an emerging biotechnology concerned with understanding the genetic basis of drug response, and promises to transform the development, marketing and prescription of medicines. This paper is concerned with analysing the move towards segmented drug markets, which is implicit in the commercial development of pharmacogenetics. It is claimed that in future who gets a particular drug will be determined by their genetic make up. Drawing on ideas from the sociology of expectations we examine how pharmaceutical and biotechnology companies are (...) constructing, responding to and realising particular ‘visions’ or expectations of pharmacogenetics and market stratification. We argue that the process of market segmentation remains uncertain, but that the outcome will be fashioned according to the convergence and divergence of the interests of key commercial actors. Qualitative data based both on interviews with industry executives and company documentation will be used to explore how different groups of companies are developing pharmacogenetics in distinct ways, and what consequences these different pathways might have for both clinical practice and health policy. In particular, the analysis will show a convergence of interests between biotechnology and pharmaceutical companies for creating segmented markets for new drugs, but a divergence of interest in segmenting established markets. Whilst biotechnology firms have a strong incentive to innovate, the pharmaceutical industry has no commercial interest in segmenting markets for existing products. This has important implications, as many of the claimed public health benefits of pharmacogenetics will derive from changing the prescribing of existing medicines. One significant implication of this is that biotechnology companies who wish to apply pharmacogenetics to existing medicines will have to explore an alternative convergence of interests with healthcare payers and providers . Healthcare providers may have a strong incentive to use pharmacogenetics to make the prescribing of existing medicine more cost-effective. However, we conclude by suggesting that a question mark hangs over their ability to provide the necessary economic and structural resources to bring such a vision to fruition. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, that of the (...) common good as a goal in medicine. (shrink)

ABSTRACT A key selling point of pharmacogenetics is the genetic stratification of either patients or diseases in order to target the prescribing of medicine. The hope is that genetically ‘tailored’ medicines will replace the current ‘one‐size‐fits‐all’ paradigm of drug development and usage. This paper is concerned with the relationship between difference and justice in the use of pharmacogenetics. This new technology, which facilitates the identification and use of difference, has, we shall argue, the potential to lead to injustice either by (...) the inappropriate use of difference or through the inappropriate failure to use difference. We build on empirical data from a detailed study of the range of options for the development of pharmacogenetics to present a consideration of the ethical issues that surround patient and disease stratification. In it we explore the ways in which the use of pharmacogenetics may lead to the creation of new, genetically stratified, forms of difference and new forms of injustice based on these divisions. We also examine the ways in which existing forms of difference and social stratification may interact with the use of pharmacogenetics. In conclusion, we suggest how an understanding of these ethical issues could usefully inform future policy discussions. (shrink)

This article explores the way in which social explanations underpin the names of particular disciplines. Taking the example of pharmacogenomics, it shows how this term has been constructed since it appeared in 1997, the differences and similarities between it and its precursor, pharmacogenetics, and the way in which commercial interests underpin this new term. Drawing on the idea of visions and the sociology of expectation, the article shows how different actors compete to have their preferred definitions of the term accepted (...) by the world at large. (shrink)

Why is science so credible? Usual answers center on scientists' objective methods or their powerful instruments. In his new book, Thomas Gieryn argues that a better explanation for the cultural authority of science lies downstream, when scientific claims leave laboratories and enter courtrooms, boardrooms, and living rooms. On such occasions, we use "maps" to decide who to believe—cultural maps demarcating "science" from pseudoscience, ideology, faith, or nonsense. Gieryn looks at episodes of boundary-work: Was phrenology good science? How about cold fusion? (...) Is social science really scientific? Is organic farming? After centuries of disputes like these, Gieryn finds no stable criteria that absolutely distinguish science from non-science. Science remains a pliable cultural space, flexibly reshaped to claim credibility for some beliefs while denying it to others. In a timely epilogue, Gieryn finds this same controversy at the heart of the raging "science wars.". (shrink)

In _Abductive Analysis_, Iddo Tavory and Stefan Timmermans provide a new navigational map for constructing empirically based generalizations in qualitative research. They outline an accessible way to think about observations, methods, and theories that nurtures theory-formation without locking it into predefined conceptual boxes. The authors view research as continually moving back and forth between a set of observations and theoretical generalizations. To craft theory is to then pitch one’s observations in relation to other potential cases, both within and without one’s (...) field. The book provides novel ways to approach the challenges that plague qualitative researchers across the social sciences—how to think about the relation between methods and theories, how to conceptualize causality, how to construct axes of variation, and how to leverage the researcher’s community of inquiry. _Abductive Analysis_ is a landmark work that shows how a pragmatist approach provides a more productive and fruitful way to conduct qualitative research. (shrink)

Applied ethics, a subdiscipline of philosophy, lends itself to an encyclopedia format because of the many industries and intellectual fields that it encompasses. The Encyclopedia of Applied Ethics is based on twelve major categories, such as Biomedical Ethics and Environmental Ethics. Religious traditions that embody normative beliefs, as well as classical theories of ethics, are explored in a non-judgmental manner. Each of the twelve categories is divided into discrete areas that are covered by 5,000-6,000 word articles. Each of the 281 (...) articles begins with a definition of the subject and includes a table of contents, glossary of key terms, and bibliography. Second- and third- level headings, boxes, sidebars, and the like emphasize the reference-oriented nature of the material. The four volumes are arranged in an A-Z format, with a complete subject index at the end of the last volume. Articles are written by international experts, arranged alphabetically by title, not by subject, and cross-referenced so the reader can locate relevant information in other articles. One of Library Journal's Best Reference Sources for 1997! One of the CHOICE Outstanding Academic Books for 1998! Cross-references appear in each article to refer readers to related information A glossary and bibliography in each article provide readers with tools for learning and creative thinking. (shrink)

Bioethics as politics -- Bioethics and the politics of expectations -- Engendering consent : bioethics and biobanks -- Missing the big picture : bioethics and stem cell research -- Testing times : bioethics and "do-it-yourself" genetics -- Governing uncertainty : the politics of nanoethics -- Beyond bioethics.

The demarcation of science from other intellectual activities-long an analytic problem for philosophers and sociologists-is here examined as a practical problem for scientists. Construction of a boundary between science and varieties of non-science is useful for scientists' pursuit of professional goals: acquisition of intellectual authority and career opportunities; denial of these resources to "pseudoscientists"; and protection of the autonomy of scientific research from political interference. "Boundary-work" describes an ideological style found in scientists' attempts to create a public image for science (...) by contrasting it favorably to non-scientific intellectual or technical activities. Alternative sets of characteristics available for ideological attribution to science reflect ambivalences or strains within the institution: science can be made to look empirical or theoretical, pure or applied. However, selection of one or another description depends on which characteristics best achieve the demarcation in a way that justifies scientists' claims to authority or resources. Thus, "science" is no single thing: its boundaries are drawn and redrawn inflexible, historically changing and sometimes ambiguous ways. (shrink)