The ageing population, the high expectations for better quality of life and the changing lifestyle of European society call for improved, more efficient and affordable health care.
Nanotechnology can offer impressive resolutions, when applied to medical challenges like cancer, diabetes, Parkinson's or Alzheimer's disease, cardiovascular problems, inflammatory or infectious diseases.
Experts of the highest level from industry, research centers and academia convened to prepare the present vision regarding future research priorities in NanoMedicine. A key conclusion was the recommendation to set up a European Technology Platform on NanoMedicine designed to strengthen Europe's competitive position and improve the quality of life and health care of its citizens. This article has been extracted from the vision paper “European Technology Platform on NanoMedicine - Nanotechnology for Health” produced by the European Commission.
Nanotechnology offers great promise for medicine, but much of this lies in the future. This future orientation has made nanotechnologies vulnerable to the current zeitgeist of over claiming in science, either the potential benefit or harm. There is a need to be careful about placing premature weight on speculative hopes or concerns about nanotechnologies raised ahead of evidence. Foresighting of breakthrough technologies is notoriously difficult, and carries the risk that early public engagement may promote either public assurance or public panic over the wrong issues.
Nanotechnology as an enabling technology for many future medical applications touches on issues such as sensitivity of genetic information, the gap between diagnosis and therapy, health care resources and tensions between holistic and functional medicine. On the other hand nanotechnology will add a new dimension to the bio (human) and non-bio (machine) interface such as brain chips or implants, which eventually might raise new ethical issues specific to NanoMedicine. This requires careful analysis of ethical aspects in view of existing standards and regulations by ethics committees at the European scale.
At the same time new nanomedical inventions have to be evaluated for new ethical aspects by ethical, legal and social aspects - specialists. The most crucial point in this regard is an early proactive analysis of new technological developments to identify and discuss possible issues as soon as possible. This requires a close collaboration and co-learning of technology developers and ethics specialists assisted by communication experts to ensure open and efficient information of the public about ethical aspects related to nanomedicine. This co-evolution will ensure a socially and ethically accepted development of innovative diagnostic and therapeutic tools in NanoMedicine.
From the above it is clear that an in-depth ethical analysis is necessary in this field. Such an analysis should be based on the following principles.
Human Dignity and the derived ethical principles of:
• Non-instrumentalisation: The ethical requirement of not using individuals merely as a means but always as an end of their own.
• Privacy: The ethical principle of not invading a person’s right to privacy.
• Non-discrimination: People deserve equal treatment, unless there are reasons that justify difference in treatment. It is a widely accepted principle and in this context it primarily relates to the distribution of health care resources.
• Informed Consent: The ethical principle that patients are not exposed to treatment or research without their free and informed consent.
• Equity: The ethical principle that everybody should have fair access to the benefits under consideration.
• The Precautionary Principle: This principle entails the moral duty of continuous risk assessment with regard to the not fully foreseeable impact of new technologies as in the case of ICT implants in the human body.
The last of these principles (the Precautionary Principle) is particularly important in this particular context.
The ethical analysis should also examine value conflicts. There could be conflict between the personal freedom to use one’s economic resources to obtain advanced treatment such as NanoMedicine and what society at large considers desirable or ethically acceptable. Freedom of researchers may conflict with the obligation to safeguard the health of research subjects. Concern for economic competitiveness and other economic values (economic growth) may come into conflict with respect for human dignity. The unrestricted freedom of some may endanger the health and safety of others. Therefore a balance has to be struck between values that are all legitimate in our culture.