Crossing the Styx: If Precision Medicine Were to Become Exact Science

The term “precision medicine” is used to denote existing practices as well as how medical research and practice are imagined to become in the future. One important element of the imaginaries of precision medicine is the development of systems biology and computational models with the promise of numerical precision and conceptual rigour. If precision medicine were to become an exact science that relies on computational models, it might increase precision in diagnosis and treatment, specifying the right drug to the right patient at the right time. It should be noted, though, that computational models require explicit specification of the properties and boundaries of the system to be modelled, whereas cells, tissues and patients are predominantly open systems in their natural state. Accordingly, such models risk being precisely wrong instead of approximately right. Right and wrong, however, are value judgements that depend upon the aims and scope of the scientific and medical enterprise. In order for medicine to become an exact science, cells, tissues and patients would have to be reconceived and/or reconfigured as relatively closed systems with relatively deterministic behaviour. The realization of precision medicine as an exact science may thus be accompanied by a transition from a world of complex natural life to a world of reduced life or a simple delay of death; a transition to be likened with the crossing of the Styx.