From medical gaze to statistical person: Historical reflections on evidence-based and personalised medicine

Background The nineteenth century saw the rise of what historians of medicine have termed the 'medical gaze'. Physicians used instrumentation and trained senses to locate the site of disease within the patient's body. This change in practice went alongside changes in the physician's power and how diseases were understood. In the twenty-first century, the rise of high-throughput biomedical experiments, especially in genomics, is leading to equally dramatic shifts in medicine. Increasingly, clinical decisions may be made on the basis of data and statistical associations rather than the particularities of the case at hand. Objectives The aim of this commentary iso re-evaluate the status of precision and evidence-based medicine in light of the social, political and economic shifts they entail. Discussion Increasingly, the statistical view of diseases and people threatens to take judgment and expertise out of medical decision making. It threatens the centrality of the physician in the relationship between patient and disease.