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

爱尔兰共和国(ROI)和联合王国(UK)在生物医学和公共卫生方面处于领先地位。两人都强调了治疗创新对经济和人口健康的重要性。特别是，投资回报率和英国承诺，象征性地和财政上，在医疗保健研究和提供方面采取有针对性的方法。我们所说的这些措施，例如指的是：针对非常特定类型的疾病(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有反应；针对特定类型的人群(例如前武装部队人员)提供的心理治疗服务；以及针对现有的和新出现的疾病形式对公众进行分层和建设的人口一级干预措施(例如，限制被视为极易受新冠肺炎影响的群体的行动)。与此同时，由于ROI和英国之间的相似之处为比较工作提供了基础，干预措施的制定和实施所依据的价值观和规范也存在差异。在对新冠肺炎的不同回应以及英国退欧的背景下，这些分歧可能会变得更加明显。研究它们与“靶向”生物医学和公共卫生的设计、交付和影响有关，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。我们将从现有的工作中吸取线索，例如，个性化和精准(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往往将这些领域分开，但我们的分析将寻求查看它们之间的共同点。我们的网络将从生物伦理学、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)中收集方法，探索生物医学和公共卫生中的“有针对性的”方法和干预的文化和规范层面。通过比较分析，我们将探索不同的文化、历史、法律、科学和医疗保健背景如何在形成和部署“有针对性的”生物医学和公共卫生方面相互作用。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金和开展方式，以及医疗保健的优先顺序和提供方式。反过来，我们将通过有针对性的健康方法来研究法律、道德和文化是如何受到影响和影响的。我们的工作计划旨在促进研究人员(以前从未合作过)、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、患者团体和更广泛的公众)之间和之间的新关系。这些关系将通过五个网络讲习班和相关的公众参与来建立和加强。该网络的成功及其能力建设的核心是将以指导、展示其研究的机会、介绍(非)学术网络等形式向ROI和英国的人文ECR提供智力和财政支持。该网络的输出将包括针对不同人文学科受众的同行评审论文。我们还将寻求让政策制定者参与我们的工作，以及生物医学和公共卫生科学家和医疗保健专业人员(例如，通过邀请参加研讨会、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)与网络讲习班相关的面向公众的博客、公开小组讨论和类似活动。爱丁堡惠康信托支持的生物医学、自我和社会中心的资源将被用于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.