Genomic and biological risk profiling: from medicalization to empowerment

Genomic risk profiling is developing rapidly in many disease areas as part of a growing concern to stratify medical intervention and prevention in accordance with individual characteristics. Within the Mind the Risk project we have studied perceptions of risk and predictive testing both for patients and individuals at risk of developing RA in the future.

We discuss some of the results here in relation to the pros and cons of risk prediction. On the one hand, providing information about personal risk may be seen as an aspect of medicalization where healthy individuals are labelled as ‘at risk’ and therefore responsible for taking preventive actions. On the other hand, it may provide helpful information that will enable autonomous health related decision-making. Moreover, there is a risk that preventive testing and treatment may be requested and used more by some groups in society than others. Such a development risks increasing differences in health between different groups.

For RA, early intervention is associated with improved outcomes, but predictive approaches need to be accompanied by appropriate educational and psychological support. Based on work by McAllister et al. we will suggest a framework of empowerment to support the development of personalized medicine and predictive testing in order to evade the pitfalls of medicalization and loss of autonomous control.