Assessing the Future: Past and Present Visions of Nanomedicine

Keywords::

• interdisciplinarity
• nanomedicine
• sociology
• technology assessment
• visions

The workshop that led to this special issue of Nanomedicine was titled ‘Quo vadis nanomedicine?’. It aimed to discuss the past, present and future of nanomedicine. Clinical translation certainly is one of the main topics today. It is essential to transform groundbreaking innovations into applications [1]. But to grasp where nanomedicine is going in the future, it is not only necessary to have a look at what scientists and engineers are capable of today. It is also imperative to assess past and present visions. As shown in the following, the social sciences can play a crucial role in this respect [2].

Nanotechnologies: starting from a vision

The retrospective founding moment of nanotechnology – the famous talk of physicist Richard Feynman – is a pre-eminent example of how visions impacted the field of nanotechnologies. In his speech‚ ‘there is plenty of room at the bottom’ which he held in 1959, Feynman described a future where the content of the whole Encyclopedia Britannica would fit on the head of a pin. He also envisioned machines that would build subsequently smaller machines until they reach the nanoscale. From Feynman’s perspective, the laws of physics would allow to manipulate the world atom by atom [3].

About 40 years later, this essential part of his speech resonated with authors of the National Science Foundation. In 1999, the National Science and Technology Council published a paper that would be the starting signal for a huge funding campaign for nanotechnology in the USA, the National Nanotechnology Initiative (NNI). The title of the article: ‘Nanotechnology: shaping the world atom by atom’ [4]. Earlier in 1986, another theme of Feynman’s talk was picked up. Eric K Drexler’s book ‘Engines of Creation’ outlined in detail his idea of a future where nanorobots (molecular assemblers) would be able to replicate and perform different tasks by manipulating single atoms to build all kinds of structures. Drexler called this process ‘molecular manufacturing’ [5]. Drexler’s ideas were soon disputed by Richard Smalley. The Drexler–Smalley debate ensued [6], in which Smalley claimed that the robots would never be able to perform their envisioned work, because their ‘fingers’ would be ‘too fat’ and ‘too sticky’ [7]. But criticism on the viability of the concept was just one sort of reaction to the bold visions of Drexler and others. Another kind of reaction dealt with the possibility that these concepts might indeed be viable, and that their implementation would have devastating consequences for humanity. Bill Joy, co-founder of Sun Microsystems claimed that artificial intelligence in combination with self-replicating nanorobots would give rise to a swarm of robots that would turn all matter into gray goo [8]. Suddenly nanotechnology came under scrutiny.

Hopes & fears: ambivalence & the ‘metaphorical turn’

At this point one of the major characteristics of technological visions comes into view: their ambivalence. Positive visions can easily be turned into negative ones. Yet, bold visions found their way into strategy papers and research programs. Nanotechnology, as an ‘enabling technology’, is applicable in many different fields of research like medicine, where some of the boldest visions were formulated. Visions of nanorobots or nanosubmarines patrolling the human body in search for cancer cells were common pictures in scientific publications and mass media alike. Authors in the field were quite aware of the fact, that many of the promises made in these visions seemed like ‘science-fiction’, as for example a paper from the European Platform for Nanomedicine notes:

“Future techniques in medical diagnosis and treatment have often been the subject of science fiction literature and cinema. What was once the stuff of science fiction is now closer to becoming reality.” [9].

However, pictures of nanorobots and nanosubmarines soon disappeared from scientific literature and the semantics in research programs and strategy papers changed. These pictures now seemed to be unrealistic and it was considered to be unprofessional or even a risk to use ‘science-fiction’ to illustrate research and development [10]. But interestingly enough some of the basic ideas behind these pictures were persistent. For example the concept of ‘theranostics’ comprises the diagnosis of a disease and the targeted delivery of a medication implemented on a single nanoparticle [11]. In this case, the pictures of nanorobots or nanosubmarines are now more of a metaphor for complex systems on the nanoscale [12]. Some of today’s prominent visions of nanomedicine are covering broader concepts, that comprise more than just a technological solution, as in the case of ‘personalized medicine’ [13]. Not any less visionary but not so prone to evoking fears of rampaging nanobots, these visions are still ambivalent in character. As in the case of other visions also the concept of personalized medicine draws criticism (see, for example, [14]).

Technological visions & the social sciences

One reason why visions gain so much controversial attention is that they are intermediaries between the public, scientists and the research policy community. Because of their widespread use they have also drawn interest from the social sciences. For technology assessment visions were of key interest as they allow for a potential glimpse into the future. One of the reasons for the broad use of visions lies in a shift in the research landscape beginning in the 1980s. Governments were now funding promising fields of science and technology somewhere in between basic and applied research [15]. This new form of ‘strategic science’ gave rise to technological visions that were able to transport the promises and expectations of the new technology. Visions in this sense are rhetorical instruments to mobilize resources like funding and a potential tool to recruit and motivate scientists [15]. Visions and their accompanying expectations also form the rather loose field of nanomedicine itself. Consisting of various kinds of disciplines, nanomedicine is what van Lente and Rip call a ‘rhetorical entity’ [15]. What makes nanomedicine a field in itself are the visions and expectations that allow actors from various disciplines to position themselves in respect to others by having a common frame of reference. However for all stakeholders alike there is a hope that visions allow for a look into the future or even providing a tool to steer it.

This potential glimpse into the future is especially of interest for technology assessment, because it has always struggled with the so-called Collingridge dilemma. Collingridge noted that in the early stages of technology development there is not enough information to control or steer the development process [16]. Yet, when enough information is available it is too late as important design decisions have already been made. The social sciences and technology assessment alike have hoped that by analyzing the underlying future concepts, for example, visions of the technologies being developed that there would be a way to circumvent this dilemma. However visions are not exact blueprints of what will happen in the future. They are often vague and speculative and reach into the far future. Nevertheless, some authors argue that they allow for an understanding of what scientists and engineers in the field of interest think [17,18]. Thereby it would at least be possible to deal with uncertainties and enable a dialog with the public on what is desirable for the future and what is not. Newer approaches propose that technology assessment should not start with analyzing the visions but begin even before that. Some authors argue that it is the institutions, the different actors and the processes that lead to imagining the future that should be examined carefully [19]. This is especially important in the light of the professional imagining of visions in order to steer technological development, a process that has been called ‘visioneering’ by the historian McCray [20].

In the social sciences it is contested to what degree visions impact technological development, as they are often vague and ambivalent. Nevertheless, visions tend to fascinate and inspire the public and scientists alike. Visions cover hopes and fears of modern societies. Interdisciplinary cooperation between scientists in the field of nanomedicine and the social sciences can facilitate a public dialogue on not only what is deemed possible but on what should be realized and what should not be. It is essential to develop visions that cover more than just new technologies. As societies and technologies are interdependent, there is a need for holistic approaches that also cover the social aspects of technologies.

Shaping the visions of today might not necessarily lead to their exact implementation, but it might help to structure the way into the future in a positive way. In order to shape these visions there is a need for technical expertise as well as for an understanding of the social aspects of technologies. For this reason it is necessary that natural sciences and social sciences overcome artificial boundaries and join their expertise.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.