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Between evidence, persons, and things: Travelling, affordance and governance of expertise in personalized medicine

Conference paper
Authors Aant Elzinga
Fredrik Bragesjö
Amelie Hoshor
Dick Kasperowski
Morten Sager
Published in Konferensbidrag till the 4S Conference in Cleveland, Ohio, November 2-5, 2011
Pages 10
Publication year 2011
Published at Department of Philosophy, Linguistics and Theory of Science
Pages 10
Language en
Keywords evidence-based medicine; personalized medicine; emerging technologies; travelling; affordance; governance
Subject categories Theory of science


The paper delineates some recent work being developed on pertinent dimensions in a perceived gap between evidence-based medicine and personalized medicine. The approach is mainly conceptual. The approach is informed by investigations of ramifications of a recent movement from patient-based medicine to individualization and personalisation in the management of health care. In addition it takes account of the role of new and emerging technologies in efforts to bridge the cited gap with special reference to three dimensions of expertise: we refer to these as the travelling, governance and affordance of expertise. Expertise then is taken to include inscription of rules and procedures in monitoring devices. Questions asked are: what kinds of technologies typically come into play; what modes of governance are therewith enhanced or, respectively, marginalized; what repertories of “objectivity” are preferred or shaped when expertise is transported and embedded in technologies? Closely related is the question of what types of authority that may be associated with these “epistemologies” ranging from the charismatic to the institutional and technological? Given our analytic tri-focal lens of travelling, affordance and governance of expertise, we expect to elucidate the ways in which evidence-based and personalized medicine interact and construct identities of patients, staff, and next of kin. The purpose of the paper is, first, to invite comments on the conceptual take and, second, to receive viewpoints on future directions of the research program.

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