  One area where such questions are particularly fraught is “precision” medicine; Obama’s Reinvestment act budgeted a significant component toward cancer genomics, with the idea that a more fine grained analysis of the molecular and genomic features of cancer would promote more effective prediction and control of cancer risk, enable detection of cancers at much earlier stages, and less debilitating, more targeted treatments. With better technologies and more fine-tuned risk information, the practice of medicine has been shifting from diagnosis (and treatment) of disease, to constant surveillance and intervention on disease risk, as well as higher rates of overdiagnosis and overtreatment (diagnosis and treatment for a proto-disease state that may never have progressed in the lifetime of a patient) (Welch, et al. 2011; Esserman, et al. 2014). Moreover, one concern some have raised about precision oncology is that it has been less successful than hoped or advertised (Prasad &amp; Gale 2016, Prasad, et al. 2016).  Such skepticism should raise genuine concerns—especially given the hopes of patients and families hanging upon the promises of such treatments, and the overall costs of both cancer care, and precision medicine research. In sum, current practices of cancer research, screening and treatment raise a number of questions: How ought we to allocate research funds in cancer research? How is investment in precision medicine likely to yield the benefits promised? When is medical intervention on disease risk (rather than disease itself) unduly excessive? What exactly does it mean to speak of effective medical intervention? Is overdiagnosis and overtreatment a serious harm, or is it simply an inevitable byproduct of an otherwise effective strategy—treating disease risk? How ought clinicians to communicate about risk and benefit of novel targeted interventions to patients, especially where there are gray areas of benefit and harm?  Are the (frequently) excessive costs of, and inequitable access to, cancer care, matters of justice?