Re-Defining Disease: Mapping the Contours of Genomic Medicine

Genetic research is expanding the scope for genetic explanations of disease. The application of genetic science in medicine was once concentrated on rare genetic conditions. Increasingly, however, common and complex disorders are being ¿geneticized.¿ These developments promise profound conceptual change, as practitioners and patients come to understand and act on disease with new interpretive frameworks. Further, conceptual developments are being engaged in a clinical domain that is experiencing profound change in procedural and ethical norms. Despite the significance of these anticipated developments, empirical research to illuminate the shape and form of a future ¿geneticized¿ medicine is lacking and hard to acquire. Developments in molecular and population genetics are already having an impact on clinical genetic practices, and on those areas of medicine into which genetic services have begun to expand (e.g., cancer). Comparative analysis of different kinds of clinical genetic services (e.g., predictive, diagnostic, prenatal, etc.), and of genetic services provided by non-genetics clinicians (e.g., oncologists, cardiologists, primary care clinicians, etc.), provides a window into future developments in the practice, guiding concepts and moral philosophy of medicine.