From Inside Technology
Building Genetic Medicine
Breast Cancer, Technology, and the Comparative Politics of Health Care
A comparative study of genetic testing for breast and ovarian cancer in the United States and Britain that shows the importance of national context in the development and use of science and technology even in an era of globalization.
In Building Genetic Medicine, Shobita Parthasarathy shows how, even in an era of globalization, national context is playing an important role in the development and use of genetic technologies. Focusing on the development and deployment of genetic testing for breast and ovarian cancer (known as BRCA testing) in the United States and Britain, Parthasarathy develops a comparative analysis framework in order to investigate how national “toolkits” shape both regulations and the architectures of technologies and uses this framework to assess the implications of new genetic technologies.
Parthasarathy argues that differences in the American and British approaches to health care and commercialization of research led to the establishment of different BRCA services in the two countries. In Britain, the technology was available through the National Health Service as an integrated program of counseling and laboratory analysis, and was viewed as a potentially cost-effective form of preventive care. In the United States, although BRCA testing was initially offered by a number of providers, one company eventually became the sole provider of a test available to consumers on demand.
Parthasarathy draws lessons for the future of genetic medicine from these cross-national differences, and discusses the ways in which comparative case studies can inform policy-making efforts in science and technology.
HardcoverOut of Print ISBN: 9780262162425 288 pp. | 6 in x 9 in 9 figures, 7 tables
Paperback$24.00 S | £18.99 ISBN: 9780262517478 288 pp. | 6 in x 9 in 9 figures, 7 tables
Building Genetic Medicine is an enlightening overview of one of the first skirmishes of our genetic century.
Combining historical, comparative, and coevolutionary perspectives, this book offers a highly original and informative account of the emergence of BRCA testing as a much debated and controversial new health care technology. It makes the reader vividly aware of the various ways in which technologies and practices of health care mutually shape each other.
Science, Technology, Health & Policy Studies, University of Twente, The Netherlands
The assumption that universally valid generalizations regarding the value of new medical technologies are possible, given good enough clinical evidence, is proving highly resistant to critique from the social sciences. Shobita Parthasarathy shows how and why genetic testing acquired quite different roles in the United States and in Britain, evoking very different responses from patient advocacy groups in the two countries. Her book is not only a valuable addition to the STS literature. I hope that everyone confronting the implications of rapid scientific and technological advance for health care provision will reflect carefully on what it has to say.
Chair, The Innovia Foundation for Medicine, Technology & Society, and Professor of Science Dynamics, University of Amsterdam