Quantifying Wellness: Beyond the Dichotomous Choice Between Health and Disease Lies the Road to P6 Medicine

摘要

Systems medicine is the culmination of the progression of the health/disease dichotomy to a continuum from health to disease allowing for measures of disease accumulation that mark an individual's position, i.e., her wellness, along the continuum. Proponents of systems medicine have promised a scientific (non-normative), value-free, holistic measure of "wellness" that will be the cornerstone of P4 (personalized, predictive, preventive and participatory) medicine. While the focus of this paper is on the quantification of wellness, the authors also consider how this metric drives the rest of the P4 program. The authors trace the history of this development in order to appreciate the promises, problems, pitfalls, and perils that accompany this approach. To the 4Ps already in place, the authors add P5 = promissory and P6 = profitable, and find that the road to P6 medicine is paved with neoliberal theories.