Targeting Therapies: Exploring the Cultural and Normative Dimensions of 'Targeted' Approaches to Biomedicine and Public Health

爱尔兰共和国和联合王国在生物医学和公共卫生方面处于领先地位。两者都强调了治疗创新对经济和人口健康的重要性。特别是，投资回报率和英国已经承诺，象征性地和财政上，“有针对性”的方法在医疗保健研究和交付。我们指的是：针对非常特殊的疾病（例如某些癌症）的药物，这些药物可能只对具有特定基因变异的人起作用；针对特定人群（如退役军人）的心理治疗服务；人口层面的干预措施，针对现有和新出现的疾病形式对公众进行分层和构建（例如，限制被认为极易感染COVID-19的群体的流动）。与此同时，RoI和英国之间的相似性为比较工作提供了基础，在干预开发和交付的价值观和规范方面存在差异。在对COVID-19的不同反应以及考虑到英国脱欧之后，这些分歧可能会变得更加明显。将它们与“目标”生物医学和公共卫生的设计、交付和影响联系起来，将有助于我们更好地理解科学、医疗保健和社会之间的动态关系。我们将从现有的工作中获得启示，例如，个性化和精确（生物）医学，并朝着令人兴奋的新方向前进。虽然人文学科对生物医学和公共卫生的研究经常将这些领域分开，但我们的分析将寻求研究它们之间的共性。我们的网络将汇集来自生物伦理学、性别研究、历史、法律、医学人文、政治哲学和科学研究（以及其他）的方法，以探索生物医学和公共卫生领域“有针对性”方法和干预措施的文化和规范层面。通过比较分析，我们将探讨不同的文化、历史、法律、科学和医疗环境如何在“目标”生物医学和公共卫生的塑造和部署中相互作用。换句话说，我们将研究社会历史、传统和法律程序如何影响科学研究的资助和实施方式，以及医疗保健的优先级和交付方式。反过来，我们将研究法律，道德和文化是如何通过有针对性的方法影响和轮廓的健康。我们的工作计划旨在促进研究人员（以前没有一起工作过）、合作者、更广泛的网络成员以及RoI和英国的其他利益相关者（例如其他人文学者、生物医学和公共卫生科学家、生命科学行业、患者群体、更广泛的公众）之间和之间的新关系。这些关系将通过五次网络讲习班和相关的公众参与得到巩固和加强。网络成功及其能力建设的核心是智力和财政支持，这些支持将以指导的形式提供给RoI和英国的人文学科ecr，展示他们的研究机会，介绍给（非）学术网络等等。该网络的产出将包括针对不同人文学科受众的同行评议论文。我们还将设法使政策制定者以及生物医学和公共卫生科学家和卫生保健专业人员参与我们的工作（例如，通过邀请参加讲习班、参与活动和一对一会议）。调查人员致力于与更广泛的公众接触，并将通过（例如）面向公众的博客、公众小组讨论和与网络研讨会相关的类似活动来实现这一目标。爱丁堡惠康信托基金支持的生物医学、自我与社会中心的资源将被用来增加参与活动的价值。

The Republic of Ireland (RoI) and the United Kingdom (UK) are leaders in biomedicine and public health. Both emphasise the importance of therapeutic innovation for economies and the health of populations. In particular, the RoI and UK have committed, symbolically and financially, to 'targeted' approaches in healthcare research and delivery. By these, we mean for instance: drugs aimed at very specific kinds of disease (e.g. certain cancers) which might respond only to people with particular genetic variants; psychological therapy services tailored to specific kinds of populations (e.g. ex-armed forces personnel); and, population-level interventions that stratify and construct publics in response to existing and emerging forms of illness (e.g. restrictions on the movements of groups regarded as highly vulnerable to COVID-19). At the same time as similarities between the RoI and UK provides a substrate for comparative work, differences exist in the values and norms underlying intervention development and delivery. These divergences could become more pronounced following differential responses to COVID-19 and in light of Brexit. Examining them in relation to the design, delivery, and implications of 'targeted' biomedicine and public health will help us to better understand the dynamics between science, healthcare, and society. We will take cues from existing work on, for instance, personalised and precision (bio)medicine and move in exciting new directions. While research from the humanities on biomedicine and public health often keeps these domains apart, our analysis will seek to look at the commonalities between them.Our Network will draw together approaches from bioethics, gender studies, history, law, medical humanities, political philosophy, and science studies (among others) to explore the cultural and normative dimensions of 'targeted' approaches and interventions in biomedicine and public health. Through comparative analysis, we will explore how different cultural, historical, legal, scientific, and healthcare contexts interact in the shaping and deployment of 'targeted' biomedicine and public health. In other words, we will look at how societal histories, traditions, and legal processes affects how scientific research is funded and conducted, and how healthcare is prioritised and delivered. In turn, we will examine how law, ethics, and cultures are impacted and contoured through targeted approaches to health. Our work-plan has been designed to foster new relationships between and across the investigators (who have not previously worked together), collaborators, wider Network members, and other stakeholders in the RoI and UK (e.g. other humanities scholars, biomedical and public health scientists, life sciences industry, patient groups, wider publics). These relationships will be scaffolded by and enhanced through five Network workshops and associated public engagement. Central to the success of the Network and its capacity-building is the intellectual and financial support that will be provided to humanities ECRs in the RoI and UK in the form of mentorship, opportunities to present their research, introductions to (non-)academic networks, and more.Outputs from the Network will include peer-reviewed papers aimed at different humanities audiences. We will also seek to engage policymakers with our work, as well as biomedical and public health scientists and healthcare professionals (e.g. through invitations to workshops, engagement events, and one-to-one meetings). The investigators are committed to engagement with wider publics, and will achieve this through (e.g.) public-facing blogs, and public panel discussions and similar events associated with the Network workshops. The resources of Edinburgh's Wellcome Trust-supported Centre for Biomedicine, Self & Society will be drawn upon to add value to engagement activities.