Georgetown University Medical Center

Jonathan Keith Killian, M.D., Ph.D.

Section: Edmund D. Pellegrino Fellows

Dr. Killian is currently in residency training in anatomic pathology at NIH. He received his medical and doctoral degrees from Duke University School of Medicine.

Research Proposal

In its most basic definition, biomarker profiling is predictive analysis of the biologic fate of an individual. One of the goals of such profiling is to intervene in the natural course of biology should an adverse prognosis be discovered, and even to tailor the intervention to the individual patient's particular pathobiological profile. While such predictive clinical molecular profiling is relatively new to medicine and is one of the most fascinating technological pursuits of medical research currently, biomarker profiling as a phenomenon is not new to doctors....

....Human biomarker research has led me to ask several general questions about the emergence of biopredictive technologies within medicine, and these question comprise the basis for my interest in a formal fellowship experience in bioethics:
How has biomarker technology contributed to our concepts of doctors, patients, and the doctor-patient relationship?

  • What happens when predictive biomarker analysis outpaces clinical interventional capabilities?
  • Should biomarker analysis/testing be limited to disease entities with a definitive cure, in contrast with the historical precedent of prognosis predating cure for the gravest conditions?
  • Is it general human nature to want to know what lies ahead, regardless of ability to intervene, or is such an attitude more reflective of prevailing social norms in which medicine is practiced?