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Fundamental Questions in Medicine

A new editorial by Simon Levin in PLoS Biology has the thought provoking title “Fundamental Questions in Biology”. It set me thinking what the fundamental questions in medicine now might be, and, perhaps even more importantly, what’s going on to address them. Medical journals have an opinion (sometimes too many opinions) about what these priorities should be and can attempt to influence the policy agenda by encouraging papers on a particular topic, but we are not the ultimate arbiters.

Off the top of my head, here are some suggestions – feel free to disagree.

How are western countries going to afford to pay to pay for the advanced care that many patients have now come to consider a human right?

Conversely, what will it take to provide the necessary impetus to provide cures for the most neglected diseases of the developing world? (see also the recent blog post by Gavin Yamey)

Why are so many people willing to accept the unproven benefits of some alternative medicines yet are so suspicious of some highly effective interventions, such as vaccination? Have the practitioners of conventional medicine lost the trust of patients?

Why has the huge death toll caused by road traffic accidents worldwide failed to outrage the public and make policy makers take action?

What’s to be done about the pandemic of obesity and its related diseases in the Western world? Surely this is related to our willingness to let children eat poor quality, high-calorie food; in the UK school food has become a hot political topic.

How can the enormous technological advances of basic science such as genome sequencing and stem cell research be harnessed for the good of global health. One new initiative that might be able to coordinate efforts has been annnonced by the US’s National Centre for Biotechnology Information, NCBI. The Whole Genome Association will manage the “submission, storage, and access for clinical phenotype measures and associated whole genome genotype data”.

If you’ve got opinions on these questions, let us know. You never know, we might get to change an agenda or two.

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