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Shifting Solidarities: Personalisation in Insurance and Medicine

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Shifting Solidarities

Abstract

Medicine and healthcare have been affected by the pervasive ideal of personalisation based on behavioural, genomic and other data. Visions of personalised and precision medicine bear the promise of making healthcare cheaper and more effective. At the same time, social science scholarship has criticised these trends for increasing the risk of discrimination, and warned of a decline of solidarity. We analyse two practices, namely personalisation in insurance and in medicine, to illustrate the workings and effects of data-driven personalisation for the (un-)shaping of solidarity. We discuss how relationships between processes and phenomena that are often presented as oppositional, namely singularisation v. generalisation, the individual v. the population, and self-interested v. other-directed practices, play-off and align in surprising ways. They also open opportunities for new forms of solidarity in Europe.

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References

  • Ausiello, D., & Shaw, S. (2014). Quantitative human phenotyping: The next frontier in medicine. Transactions of the American Clinical and Climatological Association, 125, 219.

    Google Scholar 

  • Batten, J. N. (2018). How stratification unites ethical issues in precision health. AMA Journal of Ethics, 20(9), 798–803.

    Article  Google Scholar 

  • BBC News. (2018). John Hancock adds fitness tracking to all policies. https://www.bbc.com/news/technology-45590293.

  • Bennett, W. L., & Segerberg, A. (2012). The logic of connective action: Digital media and the personalization of contentious politics. Information, Communication & Society, 15(5), 739–768.

    Article  Google Scholar 

  • Blassime, A., Vayena, E., & Van Hoyweghen, I. (2019). Big data, precision medicine and private insurance: A delicate balancing act. Big Data & Society. https://doi.org/10.1177/2053951719830111.

    Article  Google Scholar 

  • Çalişkan, K., & Callon, M. (2009). Economization, part 1: Shifting attention from the economy towards processes of economization. Economy and Society, 38(3), 369–398.

    Article  Google Scholar 

  • Callon, M. (2007). An essay on the growing contribution of economic markets to the proliferation of the social. Theory, Culture & Society, 24(7–8), 139–163.

    Article  Google Scholar 

  • Collins, F. S., Green, E. D., Guttmacher, A. E., & Guyer, M. S. (2003). A vision for the future of genomics research. Nature, 422(6934), 835–847.

    Article  Google Scholar 

  • Council of Europe (CoE). (1997). Convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine: Convention on human rights and biomedicine (CETS No. 164), Oviedo.

    Google Scholar 

  • Dixon, P., & Gellman, R. (2014, April). The scoring of America. In World Privacy Forum. https://www.worldprivacyforum.org/category/report-the-scoring-of-america/.

  • Drechsler, L., & Benito Sánchez, J. C. (2018). The price is (not) right: Data protection and discrimination in the age of pricing algorithms. European Journal of Law and Technology, 9(3). Available at SSRN: https://ssrn.com/abstract=3401907.

  • Ernst & Young. (2016). Introducing ‘Pay As You Live’ (PAYL) insurance. Insurance that rewards a healthier lifestyle. https://www.ey.com/Publication/vwLUAssets/EY-introducing-pay-as-you-live-payl-insurance/$FILE/EY-introducing-pay-as-you-live-payl-insurance.pdf.

  • European Science Foundation (ESF). (2012). Personalised medicine for the European Citizen—Towards more precise medicine for the diagnosis, treatment and prevention of disease. Strasbourg: ESF.

    Google Scholar 

  • Ewald, F. (1986). L’Etat-providence. Paris: Bernard Grasset.

    Google Scholar 

  • Ewald, F. (2012). Assurance, prevention, prediction… dans l’univers du big data. Paris: l’Institut Montparnasse.

    Google Scholar 

  • Forkan, A. R. M., Khalil, I., Ibaida, A., & Tari, Z. (2015). BDCaM: Big data for context-aware monitoring—A personalized knowledge discovery framework for assisted healthcare. IEEE Transactions on Cloud Computing, 5(4), 628–641.

    Article  Google Scholar 

  • Fourcade, M., & Healy, K. (2013). Classification situations: Life-chances in the neoliberal era. Accounting, Organisations and Society, 38(8), 559–572.

    Article  Google Scholar 

  • Gellert, R., De Vries, K., de Hert, P., & Gutwirth, S. (2013). A comparative analysis of anti-discrimination and data protection legislations. In B. Custers, T. Calders, & T. Zarsky (Eds.), Discrimination and privacy in the information society (pp. 61–90). Berlin: Springer.

    Google Scholar 

  • Gurwitz, D. (2013). Expression profiling: A cost-effective biomarker discovery tool for the personal genome era. Genome Medicine, 5(5), 41.

    Article  Google Scholar 

  • Hacker, P. (2018). Teaching fairness to artificial intelligence: Existing and novel strategies against algorithmic discrimination in EU law. Common Market Law Review, 55, 1184.

    Google Scholar 

  • Hedgecoe, A. (2004). The politics of personalised medicine: Pharmacogenetics in the clinic. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Hendrickx, K., & Van Hoyweghen, I. (2018). Solidarity after nature: From biopolitics to cosmopolitics. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. https://doi.org/10.1177/1363459318800149.

  • Hilgartner, S. (2017). Reordering life: Knowledge and control in the genomics revolution. Cambridge, MA: MIT Press.

    Book  Google Scholar 

  • Hinrichs, K. (1995). The impact of German health insurance reforms on redistribution and the culture of solidarity. Journal of Health Politics, Policy and Law, 20(3), 653–687. https://doi.org/10.1215/03616878-20-3-653.

    Article  Google Scholar 

  • Hood, L., & Flores, M. (2012). A personal view on systems medicine and the emergence of proactive P4 medicine: Predictive, preventive, personalized and participatory. New Biotechnology, 29(6), 613–624.

    Article  Google Scholar 

  • Juengst, E., McGowan, M. L., Fishman, J. R., & Settersten, R. A., Jr. (2016). From “personalized” to “precision” medicine: The ethical and social implications of rhetorical reform in genomic medicine. Hastings Center Report, 46(5), 21–33.

    Article  Google Scholar 

  • Keller, E. F. (2010). The mirage of a space: Between nature and nurture. Durham and London: Duke University Press.

    Google Scholar 

  • Krittanawong, C., Zhang, H., Wang, Z., Aydar, M., & Kitai, T. (2017). Artificial intelligence in precision cardiovascular medicine. Journal of the American College of Cardiology, 69(21), 2657–2664.

    Article  Google Scholar 

  • Lee, J. H., & Song, J. H. (Guest Eds.). (2019). Recent trends in advertising and required research in emerging markets—An Asian perspective. International Journal of Advertising: The Review of Marketing Communications, 38(4). Contemporary Advertising Studies in Asia.

    Google Scholar 

  • Lehtonen, T.-K., & Liukko, J. (2015). Producing solidarity, inequality and exclusion through insurance. Res Publica, 21, 1–15.

    Google Scholar 

  • Lury, C., & Day, S. E. (2019). Algorithmic personalization as a mode of individuation. Theory, Culture and Society, 36(2), 17–37. ISSN 0263-2764.

    Google Scholar 

  • Matthew, D. B. (2018). Just medicine: A cure for racial inequality in American health care. New York: New York University Press.

    Google Scholar 

  • McFall, L. (2019). Personalizing solidarity? The role of self-tracking in health insurance pricing. Economy and Society, 48(1), 52–76.

    Article  Google Scholar 

  • McFall, L., & Moor, L. (2018). Who, or what, is insurtech personalizing? Persons, prices and the historical classifications of risk. Distinktion: Journal of Social Theory, 19(2), 193–213. https://doi.org/10.1080/1600910x.2018.1503609.

  • Meyers, G., & Van Hoyweghen, I. (2018). Enacting actuarial fairness in insurance: From fair discrimination to behaviour-based fairness. Science as Culture, 27, 413–438.

    Article  Google Scholar 

  • Moor, L., & Lury, C. (2018). Price and the person: Markets, discrimination, and personhood. Journal of Cultural Economy, 11, 501–513.

    Article  Google Scholar 

  • Pestieau, P. (2006). The welfare state in the European Union: Economic and social perspectives. Oxford: Oxford University Press.

    Google Scholar 

  • Prainsack, B. (2015). Is personalized medicine different? (Reinscription: the sequel): A response to Troy Duster. The British Journal of Sociology, 66, 28–35.

    Article  Google Scholar 

  • Prainsack, B. (2017a). Personalized medicine: Empowered patients in the 21st century? New York: New York University Press.

    Google Scholar 

  • Prainsack B. (2017b). The ‘we’ in the ‘me’: Solidarity and health care in the era of personalized medicine. Science, Technology & Human Values, 43(1), 21–44.

    Google Scholar 

  • Prainsack, B. (2018). Power asymmetries, participation, and the idea of personalised medicine. In S. Gibbon, B. Prainsack, S. Hilgartner, & J. Lamoreaux (Eds.), Handbook of genomics, health & society (pp. 212–220). London: Routledge.

    Google Scholar 

  • Prainsack, B. (2019). Precision medicine needs a cure for inequality. Current History, 118(804), 11–15.

    Article  Google Scholar 

  • Prainsack, B., & Buyx, A. (2017). Solidarity in biomedicine and beyond. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Quinn, G., de Paor, A., & Blanck, P. (Eds.). (2014). Genetic discrimination: Transatlantic perspectives on the case for a european level legal response. New York: Routledge.

    Google Scholar 

  • Rebert, L., & Van Hoyweghen, I. (2015). The right to underwrite gender: The goods & services directive and the politics of insurance pricing. Tijdschrift voor Genderstudies, 18(4), 413–431.

    Google Scholar 

  • Rosanvallon, P. (2013). The society of equals. Cambridge: Harvard University Press.

    Book  Google Scholar 

  • Stengers, I. (2014). In catastrophic times: Resisting the coming barbarism. London: Open Humanities Press.

    Google Scholar 

  • Straßheim, H., & Beck, S. (Eds.). (2019). Handbook of behavioural change and public policy. Cheltenham: Edward Elgar.

    Google Scholar 

  • Swiss Re. (2017). Personalised genetic testing and its impact to insurance. Zurich: Swiss Re.

    Google Scholar 

  • Ter Meulen, R., Arts, W., & Muffels, R. (2001). Solidarity in health and social care in Europe. Dordrecht: Springer Science & Business Media.

    Book  Google Scholar 

  • Thaler, R. H., & Sunstein, C. R. (2008). Nudge: Improving decisions about health, wealth and happiness. London: Penguin Books.

    Google Scholar 

  • Tutton, R. (2014). Genomics and the reimagining of personalized medicine. Farnham: Ashgate.

    Google Scholar 

  • [US] National Academy of Sciences (NAS). (2011). Toward precision medicine: Building a knowledge network for biomedical research and a new taxonomy of disease. Washington, DC: NAS.

    Google Scholar 

  • Van Hoyweghen, I. (2014). On the politics of calculative devices: Performing life insurance markets. Journal of Cultural Economy, 7(3), 334–352.

    Article  Google Scholar 

  • Van Hoyweghen, I. (2018). Genomics and insurance. The lock-in effects of a politics of genetic solidarity. In S. Gibbon, B. Prainsack, S. Hilgartner & J. Lamoreaux (Eds.), Handbook of genomics, health & society (pp. 203–211). London: Routledge.

    Google Scholar 

  • Vogt, H., Hofmann, B., & Getz, L. (2016). The new holism: P4 systems medicine and the medicalization of health and life itself. Medicine, Health Care and Philosophy, 19(2), 307–323.

    Article  Google Scholar 

  • Wachter, S., Mittelstadt, B., & Floridi, L. (2017). Why a right to explanation of automated decision-making does not exist in the general data protection regulation. International Data Privacy Law, 7(2), 76–99.

    Article  Google Scholar 

  • Walls, T. A., Forkus, S., & Coria, A. (2019). Citizen health science. International Journal of Population Data Science, 4(1).

    Google Scholar 

  • Weber, G. M., Mandl, K. D., & Kohane, I. S. (2014). Finding the missing link for big biomedical data. The Journal of the American Medical Association, 331(24), 2479–2480.

    Google Scholar 

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Author information

Authors and Affiliations

  1. University of Vienna, Vienna, Austria

    Barbara Prainsack

  2. KU Leuven, Leuven, Belgium

    Ine Van Hoyweghen

Authors
  1. Barbara Prainsack
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  2. Ine Van Hoyweghen
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Correspondence to Barbara Prainsack .

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Editors and Affiliations

  1. KU Leuven, Leuven, Belgium

    Ine Van Hoyweghen

  2. KU Leuven, Leuven, Belgium

    Valeria Pulignano

  3. KU Leuven, Leuven, Belgium

    Gert Meyers

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Prainsack, B., Van Hoyweghen, I. (2020). Shifting Solidarities: Personalisation in Insurance and Medicine. In: Van Hoyweghen, I., Pulignano, V., Meyers, G. (eds) Shifting Solidarities . Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-44062-6_7

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  • DOI: https://doi.org/10.1007/978-3-030-44062-6_7

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  • Publisher Name: Palgrave Macmillan, Cham

  • Print ISBN: 978-3-030-44061-9

  • Online ISBN: 978-3-030-44062-6

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