Tyranny of the Gene: Personalized Medicine and Its Threat to Public Health

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 herald a new era of miracle cures. Advocates of this gene-guided health-care practice foresee a future where skyrocketing costs may also be curbed by customization and unjust disparities are vanquished by biomedical breakthroughs. Progress, on the other hand, 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 in the back of 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. As an alternative, it is more and more making an investment 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 put it on the market the very best gene-drug match, igniting a patient’s hope, and regularly dashing it later.