Panel Event

5 November, 2018 11:00 – 12:30

Sarah Cunningham-Burley, Sophie Day

Genomics in the clinic: context, care and communication

The complexity of genomic information presents challenges for health care professionals, patients and their families as they make meaning from risk information and negotiate the future. Improving genetic literacy and the effective communication of information only partially addresses the contextual way in which people make sense of information and its relevance for their lives.

This session will draw together current social research in this area, as genomics enters the clinic, through trials as well as standard of care, in order to understand the ways in which genomic knowledge is taken up in different settings. The session will enable attendees to learn: How patients are engaging with genomic information as they confront this during their cancer journey How patients and health care professionals use this information within the range of decisions that are made during care How we can create approaches to communication and genomic literacy that are sensitive to the diverse contexts and needs of patients How social scientific research can enrich understanding of the practice of genomic medicine in relation to cancer.

Sarah Cunningham-Burley


University of Edinburgh, UK

Sophie Day


Goldsmiths, University of London, UK

People Like You: Genomics in a London breast cancer service.

NHS England’s choice of the term, personalisation, in its 2016 vision for improving outcomes raises critical contextual issues for clinic participants. Are you presenting as an individual patient, a member of a wider category or both at the same time? Singular and plural remain intrinsically connected in medical practice despite widespread reports that genomic personalisation constitutes a newme as opposed to one-size-fits-all we medicine (Donna Dickenson 2016). Drawing on interviews, observation and a range of meetings from 2013-14 in a breast cancer service, I suggest that applications of genomics conform to longstanding practices of sorting ambiguities and uncertainties of address to a you that is both singular and plural. Even so, calibration between different aspects of your situation with breast cancer may be especially provisional given the speed of change in cancer, knowledge, techniques and therapies. Me medicine, using precise techniques of genomic individuation (n of 1), will appear with therapeutic failure in these clinics since, by definition, there are no evidence-based treatment options (that is, no We). Paradoxically, participants may also welcome such situations if they then direct clinical attention to a broader range of needs and preferences, that is, to a personalised care.