Bioethics and the Politics of Expectations
Predictions about the future benefi ts of medicine are rife in the fi eld of biotechnology. The expressed confi dence in this scenario-that medicine will change in the direction outlined-is common in both recent scientifi c and popular literature. In particular, the expectation that biotechnology will help make medicine more predictive and personalised in the future has been a key theme in both academic literature and policy documents and has arguably provided a major spur to innovations and infl uence on health policy decisions. It is also expected that in the future medicine will be more preventive and participatory; hence Hood’s designation ‘P4 medicine’—predictive, personalised, preventive, and participatory (2009: 50). Many emerging technologies are assumed to enhance individual choice and assist in developing interventions that will be oriented to the prevention of illness. Breakthroughs in human genomics, combined with the convergence of genetic technologies with other technologies, including nanotechnologies and digital technologies, scientists claim, will permit the systematic pre-detection of disease-a scenario depicted above. Despite acknowledged uncertainties about how and to what extent technologies will converge and what opportunities (and dangers) this will present, proponents of new technologies express little doubt that ‘the public’ will in time derive benefi ts of the kind described.