Advancing precision medicine through agile governance: Bridging innovation and regulation for the greater good

Kevin W. Doxzen
Landry Signé
Diana M. Bowman
This piece focuses on the framework of “agile governance” for precision medicine. This framework suggests that governance needs to build its capacity for responding to the pace of innovation, suggesting a reactive, backfooted approach (as opposed, for example, to the more proactive approach of “anticipatory governance” (see, David Guston's 2014 article on the topic, or the related piece by John Nelson and collaborators). Bowman et al. often focus on making policy minimally obtrusive to innovation, expecting that innovation in precision medicine is a promising strategy for addressing public health problems even while acknowledging that it has often underdelivered and faces many remaining hurdles. Where it does recognize social and ethical issues with precision medicine, it focuses on relatively limited questions of data sovereignty and access. It generally favors market-based solutions—including to the problem of access—as efficient means of solving social problems while generally ignoring the role of markets in contributing to inequities of health care and treatment.