We have featured many techno-optimists on this show — healthcare leaders who believe that precision medicine and emerging technologies promise to revolutionize and democratize medicine in the best of ways. But look under the glossy veneer of this optimism and we see a far more complex story, one that touches on questions of power, inequity and the troubling ways in which genetics can be wielded, intentionally or not, to shape society in potentially dangerous ways. 

Our guest on this episode is James Tabery, PhD, a bioethicist, philosopher, and author of the book Tyranny of the Gene” Personalized Medicine and its Threat to Public Health (2024). Tabery gives us a tour of the rise of personalized and precision medicine, a field that promises to tailor treatments to our unique genetic profiles. Importantly, though, he highlights how the blind pursuit of these advances can distract us from larger public health challenges and exacerbate inequality. In our conversation, we explore the historical forces that have shaped modern genetics, ethical dilemmas involving the tension between patient autonomy and societal justice, and necessary guardrails around technological advances. 

We hope this conversation will challenge your assumptions, whether you are a clinician, a patient, or simply someone fascinated by the ways science shapes our world.

In this episode, you’ll hear about: 

3:15 - How Tabery became drawn to his work in philosophy and bioethics 

5:30 - Tabery’s view on the potential perils of the constant march of scientific progress 

9:34 - The ways in which his father’s early experience with precision medicine shaped Tabery’s thinking on the topic  

19:33 - Examining the promises and realities of precision medicine 

30:12 - Navigating the inequities caused by the exorbitant cost of precision medicine

35:29 - The challenges doctors face when approaching “financial toxicity”

40:00 - Tabery’s worries about medical genetics and AI

49:51 - How innovation be controlled in order to better align with ethical concerns

James Tabery can be found on Twitter/X at @jamestabery. 

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