In this Perspective, owing to an error in the HTML, the surname of author Alejandro López-Tobón of the LifeTime Community Working Groups consortium was indexed as ‘Tobon’ rather than ‘López-Tobón’ and the accents were missing. The HTML version of the original Perspective has been corrected; the PDF and print versions were always correct.@en

Here we describe the LifeTime Initiative, which aims to track, understand and target human cells during the onset and progression of complex diseases, and to analyse their response to therapy at single-cell resolution. This mission will be implemented through the development, integration and application of single-cell multi-omics and imaging, artificial intelligence and patient-derived experimental disease models during the progression from health to disease. The analysis of large molecular and clinical datasets will identify molecular mechanisms, create predictive computational models of disease progression, and reveal new drug targets and therapies. The timely detection and interception of disease embedded in an ethical and patient-centred vision will be achieved through interactions across academia, hospitals, patient associations, health data management systems and industry. The application of this strategy to key medical challenges in cancer, neurological and neuropsychiatric disorders, and infectious, chronic inflammatory and cardiovascular diseases at the single-cell level will usher in cell-based interceptive medicine in Europe over the next decade.@en

The world has been startled by the irresponsible experiment of He Jiankui, who used CRISPR to genetically modify human embryos. In this viewpoint, we explore the phenomenon of moral luck in medicine and its bearing on the limits of simple judgements of the kind “everything that ends well is well” or “someone broke the rules, and is therefore blameworthy”. The risks involved in scientific and medical experiments are often brushed aside, when they turn out well. The clinical application of CRISPR in the human germline is presently too risky to be used without more preclinical research and unacceptable without broader societal support, which justifies the call for a moratorium by the scientific community. However, such policies do not determine how to assess cases, where someone was willing to take such risks beyond all rules, guidelines and regulation and succeeds. The policies including the proposed moratorium are as unanimous about the undesirability of current applications of clinical germline editing as they are about the potential importance of this research. What if this potential is achieved by breaking the rules? The paradox of moral luck impinges on this debate. In our analysis, we rebut simplified judgments and advocate a more balanced view on the relation between moral responsibility and the societal consequences of medicine.@en