理解新的疾病类别:基因组医学中的命名、空间化和序列化

Laura Emdal Navne
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摘要

遗传学家认为新的基因命名缺乏意义,这引起了我的兴趣,我开始探索患者和家属如何理解基因组医学领域的命名实践。为了更加精确地对疾病进行分类,医疗条件的名称更类似于汽车牌照,如DPF2和G246A。在丹麦进行实地考察时,我追随了个体化医疗的引入——它的目标是根据基因组和其他数据为罕见疾病和糖尿病领域的个人量身定制预防、诊断和治疗。通过研究命名理论、空间化理论和序列化理论,我认为,正是由于这些基因名称的含义尚未确定,而且人们认为它们缺乏历史,新的基因名称才为患者提供了额外的创造性身份识别工作空间。我认为,一些患者和家庭使用新的遗传疾病标签来逃避不想要的道德制度,将疾病病因学从道德化的领域转移到“分子化”的遗传领域。我讨论了序列化的做法如何使患者感到被认可为独特的人。总之,我认为,虽然新的基因名称可能不会使患者感到耻辱,但它们确实以令人惊讶的方式改变了患者对自己的看法,其中一些是遗传学家没有预料到的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Making Sense of New Disease Categories: Naming, Spatialising, and Serialising in Genomic Medicine
Intrigued by geneticists’ framing of new gene names as somehow devoid of meaning, I set out to explore how patients and families make sense of naming practices in the field of genomic medicine. The aim for ever-more precise disease categorisation has resulted in names for medical conditions that are more akin to car-licence plates, such as DPF2 and G246A. Conducting fieldwork in Denmark, I followed the introduction of personalised medicine—that is the aim to tailor prevention, diagnosis, and treatment to the individual based on genomic and other data—in the field of rare diseases and diabetes. Engaging with theories of naming, spatialisation and serialisation, I suggest that it is exactly because of their unsettled meaning and presupposed lack of history that new gene names provide patients extra room for creative identity work. I argue that some patients and families use the new genetic disease labels to escape unwanted moral regimes, relocating disease aetiology from a moralised landscape to a ‘molecularised’ genetic one. I discuss how practices of serialisation enable patients to feel recognised as unique persons. In conclusion, I suggest that while the new genetic names may not stigmatise, they do change the patients’ idea of who they are in surprising ways, some of which the geneticists had not anticipated.
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