Donna Dickenson

• BA, MSc, PhD Professor
• University of London

There is an urgent need for reconstructing models of property to make them more women-friendly. However, we need not start from scratch: both 'canonical' and feminist authors can sometimes provide concepts which we can refine and apply towards women's propertylessness. This paper looks in particular at women's alienation from their reproductive lab...

Most opponents of somatic cell nuclear transfer and embryonic stem cell technologies base their arguments on the twin assertions that the embryo is either a human being or a potential human being, and that it is wrong to destroy a human being or potential human being in order to produce stem cell lines. Proponents’ justifications of stem cell resea...

After the development of induced pluripotent stem cells (IPSCs) in 2007, the pressure to commercialize women's eggs for stem cell research could have been expected to lessen. However, the pressure to harvest human eggs in large quantities for research has not diminished; rather, it has taken different directions, for example in germline mitochondri...

Personalized healthcare—or what this book calls “Me Medicine”—is radically transforming the US’s longstanding “one-size-fits-all” model. Technologies such as direct-to-consumer genetic testing, pharmacogenetically developed therapies in cancer care, private umbilical cord blood banking, and neurocognitive enhancement claim to cater to an individual...

We live in an era when all bodies are potentially ‘feminised’ by being rendered ‘open-access’ for biomedical research and clinical practice. Adopting a theoretically sophisticated and practical approach, Property in the Body: Feminist Perspectives rejects the notion that the sale of bodily tissue enhances the freedom of the individual through an in...

Surrogacy: new challenges to law and ethics It is often said that complex and fast-moving new biotechnologies always outstrip legal regulation and ethical scrutiny. This lecture examines this conventional view critically in relation to the international surrogacy market, comparing the unregulated situation in Sri Lanka with recent moves to regulat...

This presentation covers recent international issues about the commodification of human tissue.

Given the established success of newborn screening programmes around the world, promoters of personalized medicine envision the possibility of extending genetic analysis to bloodspots routinely collected for newborn screening. Since most of the diseases already screened for are genetic, diagnosis would be more precise. Moreover, data thus collected...

In the medicine of the fifty years, the prevailing paradigms were the ‘biopsychosocial model’ and ‘evidence-based medicine’. The currently emerging vision is ‘personalized/precision medicine’. The two interchangeable names—personalized medicine and precision medicine—raise fundamental questions. Is increased precision an improvement in the personal...

https://www.geneticsandsociety.org/biopolitical-times/surrogacy-new-challenges-law-and-ethics Everyone knows, or thinks they know, that complex and fast-moving new biotechnologies inevitably outstrip legal regulation and ethical scrutiny. Surrogacy—the subject of a special issue of The New Bioethics edited by myself and Britta van Beers—challenges...

It is often said that law and ethics always lag behind new biotechnologies. In the case of surrogacy, however, it is not new biotechnologies themselves that have challenged well-established principles in law and ethics, but rather political and social phenomena such as commodification of women’s reproductive tissue and labour, demands to allow new...

Review of Sheela Saravanan's 2018 book https://www.tandfonline.com/eprint/NSY62TGXR2EYMEJCQTRF/full?target=10.1080/20502877.2020.1826096

In 2013 I published my book Me Medicine vs. We Medicine, in which I argued that personalised medicine (what I called ‘Me Medicine’) risked diverting attention and resources from public health medicine (as part of the community-focused outlook that I termed ‘We Medicine’). In 2020 the coronavirus epidemic has cast a harsh light on the disastrous eff...

Article for Project Syndicate: https://www.project-syndicate.org/commentary/challenging-heritable-human-genome-editing-by-donna-dickenson-et-al-2020-03 In recent years, the consensus barring genetic changes that would be passed down to a person’s every descendant has collapsed, and scientists and bioethicists now focus largely on creating a detail...

Review of Francoise Baylis, Altered Inheritance: CRISPR and the Ethics of Human Genome Editing: By Francoise Baylis. Pp. 268. Cambridge, Massachusetts: Harvard University Press. 2019. £19.95. ISBN: 978-0-674-97671-9

As public interest advocates, policy experts, bioethicists, and scientists, we call for a course correction in public discussions about heritable human genome editing. Clarifying misrepresentations, centering societal consequences and concerns, and fostering public empowerment will support robust, global public engagement and meaningful deliberatio...

As public interest advocates, policy experts, bioethicists, and scientists, we call for a course correction in public discussions about heritable human genome editing. Clarifying misrepresentations, centering societal consequences and concerns, and fostering public empowerment will support robust, global public engagement and meaningful deliberatio...

Direct-to-consumer genetic testing is often seen as a first stage in promoting personalised medicine-- what I call .Me Medicine', because it relies on an individualistic framework in which the patient is encouraged to 'take control of her own health'. However, this outlook risks diverting attention from the social determinants of health and taking...

In common law, the traditional rule has been that there is no property in excised human tissue. In an era of widespread commodification of tissue, however, the practical reasons behind this position are increasingly outdated, while the philosophical grounds are paradoxical. This no-property rule has been construed so as to deprive tissue providers...

Is hereditable gene editing a positive or negative biomedical technology? The claim that it will disrupt the inheritance of debilitating or deadly genetic disease is medically misleading. In social terms, it raises serious concerns about what we owe to each other (issues of inequality) and what we owe to future generations (issues of exclusion).

Slides to accompany keynote speech on hereditable gene editing, Erasmus University Rotterdam

Debate at annual meeting of Royal College of General Practitioners, Liverpool, 2018

Genomic studies often rely on individual-based approaches for tribal members residing outside of their communities. This consent model fails to acknowledge the risks to small groups such as tribes, which can implicate the community as a whole. Guidelines for engaging indigenous people in genomics 1 are based on community-based participatory researc...

This is the final YouTube version of the TEDx talk given in February 2019 at the New Theatre, Oxford.

In this critical examination of whether personalized medicine really is a revolution, I examine the need to retain the importance of the common good.

We review the Nuffield Council on Bioethics 2018 report on germline gene editing and show how its shortcomings are part of an increasingly permissive climate among elite scientists that may well have emboldened the Chinese 'CRISPR babies' experiment. Without a robust and meaningful airing of the perils of human germline modification, these views ar...

This is a draft of my talk at the TEDx Oxford event at the New Theatre, Oxford, on 10 February 2019. The title is 'In Me We Trust: The Rights and Wrongs of Personalised Medicine'.

Hippocrates famously advised doctors, 'it is far more important to know what person the disease has than what disease the person has'. Yet 2500 years later, 'personalised medicine', based on individual genetic profiling and the achievements of genomic research, claims to be revolutionary. In this book, experts from a wide range of disciplines criti...

Publisher's entry for van Beers, Sterckx and Dickenson (eds), Personalised Medicine, Individual Choice and the Common Good, as part of Cambridge University Press Bioethics and Law series

On July 17 2018, the UK's influential Nuffield Council on Bioethics implicitly endorsed 'heritable genome editing', declaring the practice of altering the DNA of a human embryo 'morally permissible' under certain circumstances. But although the report nods in the direction of international co-operation, it breaches a global consensus in a way that...

This article for the Italian journal Ingenere examines the commodification of women's labour and tissue in modern biotechnologies.

This is a summary of my speech for the opposition to the motion 'This house believes genetic engineering undermines the nature of humanity', debated at the Oxford Union on 3 May 2018. I argue that while we have many good reasons to be sceptical about genetic engineering, the so-called 'nature of humanity' is not one of them. Instead, it diverts us...

[For some years, advocates of personalized genetic medicine—also known as “precision medicine—have been making lofty claims about imminent breakthroughs in the very nature of medical care.] Francis Collins, Director of the US’s National Institutes of Health, guides us through the [antici-pated] upheaval in his [2011] book The Language of Life—DNA a...

Biobank donors need protection to prevent abuses of their rights and to ensure that their altruism is respected. Using case examples such as PXE International and the Havasupai settlement, this paper argues that a limited number of rights in the property bundle can enhance community benefit from biobanks and correct market failures.

The term commodification is sometimes thought to be rhetorical, but it can never be overused in relation to property in the body because the phenomena it describes are still a threat.

On one view, limb transplants cross technological frontiers but not ethical ones; the only issues to be resolved concern professional competence, under the assumption of patient autonomy. Given that the benefits of limb transplant do not outweigh the risks, however, the autonomy and rationality of the patient are not necessarily self-evident. In ad...

Guidelines on embryo storage, as analysed by Jenni Millbank in her article 'Reflecting the "human nature" of IVF embryos,' prioritise 'respect for the embryo' above the wishes of the women whose labour and tissue have gone into creating the embryo in the first place. Millbank views this phenomenon as involving a complex process of making the female...

In conventional thinking, the promise of scientific progress gives automatic and unquestioned legitimacy to any new development in biotechnology. It is the nearest thing we have in a morally relativistic society to the concept of the common good. This chapter begins by examining a recent case study, so-called ‘mitochondrial transfer’ or three-perso...

Although the term commodification is sometimes criticised as imprecise or overused, in fact it has a complex philosophical ancestry and can never be used too much, because the phenomena that it describes are still gaining ground. The issues that commodification raises in relation to reproductive technologies include whether it is wrong to commodify...

Interview on themes of bioethics and the commodified body, including the key theme of 'the lady vanishes'

New technologies are transforming and reconfiguring the boundaries between patients, research participants and consumers, between research and clinical practice, and between public and private domains. From personalised medicine to big data and social media, these platforms facilitate new kinds of interactions, challenge longstanding understandings...

Feminism offers three separate but equally important insights about human genetics and the new reproductive technologies. First, feminism is concerned with ways in which these new technologies have the potential to exploit women, particularly in the treatment of their reproductive tissue, while seeming to offer both sexes greater reproductive freed...

Personalised medicine has been widely hailed as revolutionary, but while there have been notable successes in pharmacogenetics, a more balanced approach is in order.

This article documents the reaction against international commercial surrogacy in developing countries.

Personalized healthcare—or what the award-winning author Donna Dickenson calls "Me Medicine"—is radically transforming our longstanding "one-size-fits-all" model. Technologies such as direct-to-consumer genetic testing, pharmacogenetically developed therapies in cancer care, private umbilical cord blood banking, and neurocognitive enhancement claim...

This introductory chapter presents the book’s intention to give accurate, current medical and scientific evidence regarding Me mMdicine and We Medicine, as well as locating the new technologies in their ethical and political context. These new personalized technologies, catered by Me Medicine, imply two assumptions: that mankind is on the edge of a...

This chapter focuses on the components and implications of pharmacogenetics, which refers to the relationship between heritable variations and individual differences in drug response. Pharmacogenetics aims to alter pharmaceutical patterns in cancer treatment and other branches of medicine in accordance to the patient’s individual genome. Some comme...

This chapter looks at the process and consequences of cord blood banking. Cord blood banking involves the use of stem cells from the patient’s own blood, that were manufactured by another person who gave it to the patient as a “birth day gift.” Cord blood banking is generally used for We Medicine purposes, however, it has also become a recommended...

This chapter demonstrates how the enhancement debate embodies Me Medicine at its most questionable. “Enhancement” is defined as any medication designed to improve individual human performance, created through science-based or technology-based interventions. Physical and cognitive enhancement technologies are based on the idea that an individual is...

This chapter explores how We Medicine in the form of vaccination appears to be old news. It briefly recounts the history of resistance to mass vaccination, which includes themes of government intrusion pitted against individual and parental autonomy. It presents three distinct vaccine stories concerning “swine flu,” childhood vaccines, and the HPV...

This chapter initially examines the political landscape in which Me Medicine and We Medicine exist. This landscape is shaped by a strange phenomenon encountered in the vaccine case: communal solidarity in the cause of absolute individualism. Such an event seems to have foretold what would happen later in national politics—people came together as We...

This chapter discusses how consumerized genetic testing has become controversial, since it both involves a direct relationship between consumer, researcher, and industry, and because it is grounded on presumptions not fully supported by genomic research. Retail genetics has generally become a symbol for personalized medicine, as well as a place of...

It is sometimes alleged that the term 'commodification' is vague, overused, or both. I want to argue the opposite: commodification has quite a precise philosophical meaning and can never be used too often in relation to new biotechnologies, because the phenomena that it describes are still gaining ground. This keynote speech analyses three instance...

Audio presentation for Henry Stewart talks, available online at http://hstalks.com/?t=BL1993933-Dickenson), based on previous article (attached)

New developments in biotechnology constitute the nearest thing in our morally relativistic society to the concept of the common good. But why should technological progress be exempt from our general scepticism about whether there can be any such thing as the common good?

Powerpoint version of keynote speech

Genetically personalised medicine has been hailed as a paradigm shift away from the so-called 'one size fits all' approach towards a much more powerful and individualised approach. Yet neither the basic science nor the bench-to-bedside translation of personalised medicine has fully lived up to this claim, despite genuine recent advances. In this pr...

The rapid pace of change in the biosciences makes setting biotechnology policies and regulating the life sciences difficult for governments, but no less necessary. Although government policies around the globe are sometimes classed as ‘pro‐science’ or ‘anti‐science’, that is a misleading oversimplification. Nurturing the ‘bioeconomy’ is a key goal...

France has consciously developed a policy of resistance to commodification of human tissue, based on solidarity and gift (rather than autonomy and choice as in Anglo-American bioethics). But this policy of non-commercialisation fails pregnant women in respect of an important form of their tissue: cord blood. Instead, financial motives rule. Althoug...

Although government policies around the globe are sometimes classed as ‘pro-science’ or ‘anti-science’, that is a misleading oversimplification. Few governments are consistently one or the other, although many governments feel they must promote the bioeconomy with neoliberal policies. Opposition to permissive regulatory policies often comes not onl...

Paper for Project Syndicate on Ebola virus and wider issues of vaccine development

The UK is contemplating breaching an international consensus against germline genetic engineering by allowing the technique of 'mitochondrial transfer', or 'three-parent IVF'. Would this departure make the UK a pioneer or a pariah?

Contrasts communitarian and commercial visions of the human genome.

The rush to change UK law to allow “three-person IVF” is troubling, argue Donna Dickenson and Marcy Darnovsky

Critical evaluation of personalised or 'stratified' medicine for popular science audience

Protection of healthy egg donors has been almost completely ignored in the UK proposals to allow 'mitochondrial replacement' or three-person IVF. Instead, international scientific competitiveness has been very much to the fore in public policy.

The original vision of the human genome was communitarian; it was seen as the common property of humanity. Yet by 2005, nearly one in five human genes had been privatized and removed from the public domain by patenting. Together with personalized medicine, this trend represents an individualization of the vision behind the new biotechnologies. The...

Talk for popular audience on my book Me Medicine vs. We Medicine: Reclaiming Biotechnology for the Common Good, focusing on how public health medicine would respond a future pandemic

Article for Project Syndicate on personalised genetic testing

Conventional bioethics frequently lacks a political dimension, especially in the individualistic Anglo-American context. The continued dominance of utilitarianism, particularly in the United Kingdom, has been built on a simplistic assumption that whatever medical science proposes must be good for the general welfare. Although many of the original b...

Conventional bioethics frequently lacks a political dimension, especially in the individualistic Anglo-American context. The continued dominance of utilitarianism, particularly in the United Kingdom, has been built on a simplistic assumption that whatever medical science proposes must be good for the general welfare. Although many of the original b...

With the highest profile seller of $99 genetic tests under fire, will public trust in personalised medicine suffer, wonders Donna Dickenson

The old common-law concept of the commons can make a major contribution to how we regulate human tissue and genetic information in the 21st century. But if we want to use this concept, we will have to act fast, because private corporate interests have already realised the relevance of the commons for holdings in human tissue and genetic information...

Response to review by Peter MacKay, clarifying my position on the supposed conflict between religion and science

The growth of personalised medicine threatens the communal approach that has brought our biggest health gains.

Interview about publication of my book on personalised medicine, Me Medicine vs. We Medicine

Critical examination of personalised medicine in European context

Introduction: Can't Regulate, Won't Regulate? As the global trade in human eggs continues to expand with logarithmic momentum, it is frequently argued that we could not regulate it even if we wanted to. Not all commentators do want to, of course. Many view regulation as counterproductive: reports have suggested that FDA governance has had the perve...

The gene is a cultural icon, as Dorothy Nelkin and Susan Lindee put itin The DNA Mystique: it's widely seen as the equivalent of the soul. With this weight of belief attached to it, it's not surprising that popular understandings of genetics are particularly resistant to Mark Twain's warning that 'what gets you into trouble is what you think you kn...

Article for Project Syndicate on whether expectations have been realised for discovery of DNA structure 60 years ago

Personalised medicine-- what I call Me Medicine--claims to radically transform the long-standing one-size-fits-all model. Technologies such as direct-to-consumer genetic testing, pharmacogenetic therapies for cancer and neurocognitive enhancement assert that they cater to an individual's specific genetic profile. In some cases these technologies ha...

The soaring promises made by personalized genetic medicine advocates are probably loftier than those in any other medical or scientific realm today. Are they justified?

Speculative enhancement technologies are premised on the notion that I have a duty to be the best Me I can possibly be. This article takes a sceptical look at that claim.

How does the changing agenda in the life sciences – from the first rather deterministic hopes and fears for the genetic revolution to the notions of complexity and gene-gene-environment interaction – affect the gender agenda, and what does it entail for the meaning of ‘property’ and for conceptualizing the power of women and women’s health issues?

Despite the good intentions behind mitochondrial research, concern is mounting about the implications of breaching the current legal barrier against genetic changes that affect future generations. Project Syndicate article

Personalized genetic medicine has received enormous 'hype' from overconfident backers, but the evidence paints a humbler picture. http://www.councilforresponsiblegenetics.org/genewatch/GeneWatchPage.aspx?pageId=448

The idea of the genome as the common heritage of humanity underpinned the international agreement reached by scientists in the “Bermuda statement,” which declares: “All human genome sequence information from a publicly funded project should be freely available in the public domain.” There’s also the 1997 UNESCO Universal Declaration on the Human Ge...

Examines the notions of the 'genetic mystique', genetic determinism and free will

Should we do whatever science lets us do? This short introduction in the 'All That Matters' series shows how developments in biotechnology, such as genetics, stem cell research and artificial reproduction, arouse both our greatest hopes and our greatest fears. Many people invest the new biotechnology with all the aspirations and faith once accorded...

Earlier version of chapter of same title in Goodwin (ed.) The Global Body Market

Personalised medicine and genetic testing are linked by two assumptions: that individualisation is good, and that we are on the cusp of a true revolution in medicine to make it more individualised. But are these assumptions justified?

Creating biobanks—tissue and data repositories which can be sold on to other firms or mined for research—requires capital investment, unless consumers and governments can be persuaded to shoulder the risk. A central National Institute of Health biobank was one of the demands made on government by the private interests in George Bush’s creation, the...

Whilst India has been debating how to regulate 'surrogacy' the UK has undergone a major consultation on increasing the amount of 'expenses'paid to egg 'donors', while France has recently finished debating its entire package of bioethics regulation and the role of its Biomedicine Agency. Although it is often claimed that there is no alternative to t...

Genetic patents have now been taken out on approximately one in five human genes. How is this possible, and how should we respond to it?