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Kathryn Tabb, Can Precision Medicine Care for the Polis?
A recent vogue in medicine has been for “precision”. This new paradigm for medicine, also referred to as “personalized” medicine, promises to particularize patient care to the sensitivities of each of our bodies, which we ourselves may or may not be aware of, by identifying rare genetic variants and other biomarkers of disease. While advocates of precision medicine often characterize it in opposition to traditional practices and methods that are vague, careless or nonspecific, I argue that the true opponent of precision medicine — that is, the sort of medicine that stands to lose the most by its ascendency — is general medicine. And this, I believe, should concern us. General medicine is the application of public health knowledge to individual people, and it relies not on new discoveries of biomechanisms and genotypes, but on traditional methods for tracking epidemiological trends and characterizing large-scale social and environmental determinants of health. General medicine is, in other words, a medicine for the polis. Yet the funding of public medicine is increasingly channeled towards precision. In 2015, President Obama introduced an initiative in precision medicine — called the “All of Us” Initiative — to gather a one-million person cohort that could supply the “big data" required for this revolution in medical knowledge. This rhetorical choice captures the complexity of the precision medicine movement, which simultaneously promises a new kind of individualized care even as it appeals to our collective impulses in order to use our personal information for discoveries that likely won’t benefit us personally. Even before the pandemic, there were clear ethical costs of favoring precise over general medicine; I explore some that have manifested in mental healthcare, before turning to the tragic evidence that the abandonment of general medicine has exacerbated the current crisis.
Joy Knoblauch, When is Social Distance? Simmel, Park, Bogardus, Hall, or After
In the United States, the term social distancing was suddenly everywhere in early March of 2020. In a piece for the architecture and urbanism community, Stephen Legg called social distancing “the breakout vocabulary of the 'outbreak narrative'.” But what does the term mean and what strategies or ideologies does it reflect? Rather than ask how far social distance goes, I will consider a few historical moments when social distance has been and is used to think anew and redeploy social tactics. Historians have started to contextualize COVID-19 within the history of spatial practices to prevent infection. These are important histories of epidemic. But there is something ugly about the term social distance, as pointed out by a recent article by Lily Scherlis covering the racial and class history of the term. As a historian of architecture, I will situate what Scherlis lays out in light of spatial and urban practices. Rather than ask where the term comes from, I will trace moments in the history of the term that are applicable as we think about caring for the cities of the near future. I will particualrly draw insights from Georg Simmel circa 1908, the Chicago School of Sociology and Robert Ezra Park of the 1920s, Edward T. Hall's distinction between “social distance” and intimate distance in the 1960s, and from the use of the term circa 2004-2009 for pandemic planning. In so doing, I'll ask when the term has refered to the elites keeping themselves apart from society and whenit has signaled a spatial practice that threatened to rupture public social bonds.