Theses Doctoral

The Global Emergence of a Scientific Field: Precision Medicine in China

Au, Larry

Precision medicine is defined as the use of genomics and big data approaches to health to better tailor the diagnosis and treatment of disease to patients. Precision medicine was conceived in the National Research Council’s 2011 report Towards Precision Medicine and was picked up by the Obama Administration in its 2015 launch of the Precision Medicine Initiative. Central to this is the All of Us Research Program, which seeks to sequence the genomes and conduct a longitudinal study of 1 million individuals to advance knowledge about various health outcomes. Precision medicine has been taken up by governments and organizations around the world, notably in China, where the term was incorporated in national plans in 2016 such as the 13th Five Year Plan and Healthy China 2030. Precision medicine became a “key strategy”, and a large amount of funding was pledged to finance the start of precision medicine projects at a range of research organizations, such as the Chinese Academy of Sciences and BGI.

My dissertation investigates why precision medicine attracted the attention of scientists, policymakers, and clinicians in the 2010s. It also traces how the precision medicine bandwagon gained so many allies globally, and what precision medicine means for stakeholders located at different positions in the emerging field. To answer these questions, I apply the concepts of global field and scientific capital to trace the emergence of precision medicine at the global and national levels. My argument analytically distinguishes between global scientific capital and national scientific capital in order to show how varying combinations of scientific capital orients actors towards different goals and priorities of precision medicine. More generally, I demonstrate how hybrids and “off-label” forms of science appear in the process of scientific globalization.

In the introduction of the dissertation, I look to Bourdieu’s writing on scientific fields to lay out my theoretical framework of fields and capitals as it applies to global science. The dissertation is then organized into three substantive chapters. In Chapter 1, I trace the emergence of the global field of precision medicine drawing on two sources of data: first, a bibliometric analysis of scientific publications in precision medicine, and a further analysis of the key institutions and actors behind its global push. This chapter charts the contours of the global scientific field of precision medicine and the logics of accruing global scientific capital.

In Chapter 2, I examine the differentiation of the national field of precision medicine in China from the global field, and trace the logics of accumulation for a national scientific capital. In this chapter, I draw on documentary analysis to tell the recent history of genomics in China, as well as interviews with scientists and participant observation of scientific conferences. In doing this, I shed light on two hybrid forms of precision medicine in China: Chinese Precision Medicine or the use of genomics to identify “Chinese DNA” and to cure “Chinese diseases”, and Precision Chinese Medicine or the use of genomics to open the “black box” of traditional Chinese medicine.

In Chapter 3, I take the case of genetic talent testing in China to show how precision medicine is understood by the public. Making use of social media data, and a content analysis of news articles and marketing material, I argue against the “deficit model” of science used to paint parents who use genetic talent tests as scientifically illiterate. Instead, I show how this “off-label” use of genomics responds to broader social, political, and economic pressures of parenting in contemporary China, and argue that scientific capital continues to shape the circulation of genetic talent testing as it encounters the public. I conclude with notes on how the imaginary of precision medicine is affecting the practice of precision governance in China and observations of how the ongoing U.S.-China uncoupling may shape global science.

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More About This Work

Academic Units
Thesis Advisors
Eyal, Gil
Whitford, Josh
Ph.D., Columbia University
Published Here
April 20, 2022