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Tyranny of the Gene

Personalized Medicine and Its Threat to Public Health.


A revelatory account of how power, politics, and greed have placed the unfulfilled promise of “personalized medicine” at the center of American medicine

The United States is embarking on a medical revolution. Supporters of personalized or precision medicine—the tailoring of health care to our genomes—have promised to usher in a new era of miracle cures. Advocates of this gene-guided health-care practice foresee a future where skyrocketing costs can be curbed by customization and unjust disparities are vanquished by biomedical breakthroughs. Progress, however, has come slowly, and with a price too high for the average citizen.

In Tyranny of the Gene, James Tabery exposes the origin story of personalized medicine--essentially a marketing idea dreamed up by pharmaceutical executives--and traces its path from the Human Genome Project to the present, revealing how politicians, influential federal scientists, biotech companies, and drug giants all rallied behind the genetic hype. The result is a medical revolution that privileges the few at the expense of health care that benefits us all.

Now American health care, driven by the commercialization of biomedical research, is shifting focus away from the study of the social and environmental determinants of health, such as access to fresh and nutritious food, exposure to toxic chemicals, and stress caused by financial insecurity. Instead, it is increasingly investing in “miracle pills” for leukemia that would bankrupt most users, genetic studies of minoritized populations that ignore structural racism and walk dangerously close to eugenic conclusions, and oncology centers that advertise the perfect gene-drug match, igniting a patient’s hope, and often dashing it later. Tyranny of the Gene sounds a warning cry about the current trajectory of health care and charts a path to a more equitable alternative.

Chapter adaptations of Tyranny of the Gene in the media

"The False Promises of Personalized Medicine", The New York Times, 6 August 2023. A condensed version of the Introduction, which uses a family member's experience with cancer to explain the dangerous hype surrounding personalized medicine. 

"Geneticists Want to Close Racial Health Gaps. Why Can't They?", Los Angeles Times, 13 August 2023. An adaptation of chapter 8, which highlights the dangers of geneticists recruiting communities of color into massive genetic studies under the promise of combating unjust racial health disparities.

"The Aftermath of a 'Miracle Cure' for a Rare Cancer", WIRED, 4 September 2023. An excerpt from chapter 9, which uses the story of Gleevec--personalized medicine's poster child for success--to reveal the economic challenges associated with genomic medicine.

Book reviews of Tyranny of the Gene

Times Literary Supplement, by Gregory Radick, "Not All in the Genes"

Science, by Henry Greely, "Public Health Versus Personalized Medicine"


The Hastings Center Report, by Kellie Owens and Arthur Caplan, "Why the Gene Was (Mis)Placed at the Center of American Health Policy"

Makroskop, by Rainer Fischbach, "Die Tyrannei der Gene"

GEN Biotechnology, by Kevin Davies, "Drug Pricing Versus Precision Medicine"

Publishers Weekly, Tyranny of the Gene: Personalized Medicine and Its Threat to Public Health

Kirkus Reviews, Tyranny of the Gene: Personalized Medicine and Its Threat to Public Health

“We have long known that the best way to improve the nation’s health is to clean up the environment and enhance social equality. Instead, as Tyranny of the Gene brilliantly shows, we are investing in gene-based personalized medicine, catering to the most privileged patients and enriching pharmaceutical companies. By unraveling the financial, political, and scientific history of hyping genetics’ failed promises, Tabery makes a compelling case for changing course toward a healthier future for all.”

DOROTHY ROBERTS, author of Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-First Century

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