Abstract
Nanomedicine plays a prominent role among emerging technologies. The spectrum of potential applications is as broad as it is promising. It includes the use of nanoparticles and nanodevices for diagnostics, targeted drug delivery in the human body, the production of new therapeutic materials as well as nanorobots or nanoprotheses. Funding agencies are investing large sums in the development of this area, among them the European Commission, which has launched a large network for life-sciences related nanotechnology. At the same time government agencies as well as the private sector are putting forward reports of working groups that have looked into the promises and risks of these developments. This paper will begin with an introduction to the central ethical themes as identified by selected reports from Europe and beyond. In a next step, it will analyse the most frequently invoked ethical concerns–risk assessment and management, the issues of human identity and enhancement, possible implications for civil liberties (e.g. nanodevices that might be used for covert surveillance), and concerns about equity and fair access. Although it seems that the main ethical issues are not unique to nanotechnologies, the conclusion will argue against shrugging them off as non-specific items that have been considered before in the context of other biomedical technologies, such as gene therapy or xenotransplantation. Rather, the paper will call on ethicists to help foster a rational, fair and participatory discourse on the different potential applications of nanotechnologies in medicine, which can form the basis for informed and responsible societal and political decisions.
Similar content being viewed by others
References
Academy for Technology Assessment Baden-Württemberg (ed.): 2002, Quo vadis homine? Der neue Realismus in den Zukunftstechnologien — Tagungsbericht, Die Zukunft des Menschen: Gentechnologie, Nanotechnologie, Künstliche Intelligenz’, www.z-punkt.de/download/z-tagungsbericht0102.pdf
Allianz Group/OECD: 2005, Opportunities and Risks of Nanotechnologies. London & Ismaning
Anderson W.F. (1985) Human Gene Therapy: Scientific and Ethical Considerations. The Journal of Medicine and Philosophy 10:275–291
Bayertz K. (1994) GenEthics: Technological Intervention in Human Reproduction as a Philosophical Problem. Cambridge University Press, Cambridge
Bharali D.J., Klejbor I., Stachowiak E.K., Dutta P., Roy I., Kaur N., Bergey E.J., Prasad P.N., Stachowiak M.K. (2005) Organically Modified Silica Nanoparticles: A Nonviral Vector for in vivo Gene Delivery and Expression in the Brain. Proceedings of the National Academy of Sciences of the USA 102(32):11539–11544
Bianco A., Kostarelos K., Prato M. (2005) Applications of Carbon Nanotubes in Drug Delivery. Current Opinion in Chemical Biology 9(6):674–679
Birnbacher D. (1991) Ethische Dimensionen bei der Bewertung technischer Risilken. In: Lenk H., Maring M. (eds.), Technikverantwortung. Güterabwägung, RisikobewerLung, Verhaltenskodizes, Campus Verlag, Frankfurt a.M., pp. 136–147
Böhnigk, V.: 2000, Article Risiko/Risikoanalyse/Risikoforschung’, Section 2, Philosophical’, in: Lexikon der Bioethik, Gütersloher Verlagshaus, Gütersloh, pp. 210–216
Bostrom, N.: 2000, The World in 2050’, www.nickbostrom.com/2050/world.html; accessed Jan. 1st, 2006
British Royal Society/Royal Academy of Engineering: 2004, Nanoscience and Nanotechnologies: Opportunities and Uncertainties. London
Davis, K.: 1995, Reshaping the Female Body: The Dilemma of Cosmetic Surgery, New York
Decker M. (2003) Definitions of Nanotechnology — Who needs them?. Newsletter of the European Academy Neuenahr-Ahrweiler 41:1–3
Drexler K.E. (1986) Engines of Creation: The Coming Era of Nanotechnology. Anchor Press/Doubleday, New York
Economic & Social Research Council (ESRC): 2003, The Social and Economic Challenges of Nanotechnology, WWW.esrc.ac.uk/esrccontent/Download Docs/Nanotechnology. pdf
Emerich D.F. (2005) Nanornedicine — Prospective Therapeutic and Diagnostic Applications. Expert Opinion on Biological Therapy 5(1):1–5
Ferber D. (2001) Gene Therapy: Safer and Virus-Free?. Science 294:1638–1642
Freed C.R. (2002) Will Embryonic Stem Cells be a Useful Source of Dopamine Neurons for Transplant into Patients with Parkinson’s Disease?. Proceedings of the National Academy of Sciences of the United States of America 99:1755–1757
Freitas, R.A.: 1999, Nanomedicine, Vol.I: Basic Capabilities’ Landes Biosciences, Georgetown, TX, www.foresight.org/Nanornedicine/
German Parliament’s Office for Technology Assessment: 2003, Nanotechnologie, Working Report #92, Berlin
Gordijn B. (2005) Nanoethics: From Utopian Dreams and Apocalyptic Nightmares Towards a More Balanced View. Science and Engineering Ethics 11(4):521–533
Habermas J. (2001) Die Zukunft der menschlichen Natur. Auf dem Weg zu einer liberalen Eugenik?. Suhrkainp, Frankfurt a.M.
Hoet, P.H.M., I. Brüske-Hohlfeld and O.V. Salata: 2004, ‘Nanoparticles — Known and Unknown Health Risks’, Journal of Nanobiotechnology, 2 (12), www.jnanobiotechnology.com/content/2/ 1/12
Honnefelder, L. (1997) Medizinische Ethik and ärztliche Teleologie. Zu den ethischen Aspekten der Behandlung irreversibel bewusstloser Patienten. In: Honnefelder L., Streffer C. (eds.), Jahrbuch für Wissenschaft and Ethik, Vol. II. de Gruyter, Berlin and New York, pp. 169–180
Jordan A. (2001) Nanotechnologie — ein neues Konzept für Diagnostik und Therapie maligner Tumoren. Der Onkologe 10:1073–1081
Kalitzkus V. (2003) Leben durch den Tod. Die zwei Seiten der Organtransplantation. Eine medizinethnologische Studie. Campus Verlag, Frankfurt am Main
Kramer P.D. (1994) Listening to Prozac. Fourth Estate, London
Lehrman S. (1999) Virus treatment questioned after gene therapy death. Nature 401:517–518
Lenk C. (2002a) Therapie and Enhancement. Ziele and Grenzen der modernen Medizin. Lit Verlag, Münster
Lenk C. (2002b) Health and Enhancement. In: Gimmler A., Lenk C., Aumüller G. (eds.), Health and Quality of Life. Philosophical, Medical, and Cultural Aspects. Lit Verlag, Münster, pp. 37–46
Lenk H. (2002) Erfolg oder Fairness? Leistungssport zwischen Ethik and Technik. Lit Verlag, Münster
Manzei A. (2003) Kritische Anthropologie any Beispiel der Transplantationsmedizin. Lit Verlag, Münster
Mill, J.S.: 2003, On liberty. Haven, C. et al.: Yale University Press. First published in 1859
Mnyusiwalla A., Daar A.S., Singer P.A. (2003) ‘Mind the Gap’: Science and Ethics in Nanotechnology. Nanotechnology 14:R9–R13
Moghimi S.M., Hunter A.C., Murray J.C. (2005) Nanomedicine: Current Status and Future Prospects. FASEB Journal 19(3):311–330
Montemagno C.D., Bachand G.D. (1999) Constructing Nanomechanical Devices Powered by Biomolecular Motors. Nanotechnology 10:225–331
National Bioethics Advisory Commission (NBAC) (ed.): 1998, Research Involving Persons with Mental Disorders That May Affect Decisionmaking Capacity’, Volume I, Report and Recommendations of the National Bioethics Advisory Commission, Chapter IV, The Assessment of Risk and Potential Benefit’, www.georgetown.edu/research/nrcbl/nbac/capacity/Assessment.htm
National Science Foundation (NSF) (ed.) (2002) Converging Technologies for Improving Human Performance: Nanotechnology, Biotechnology, Information Technology and Cognitive Science. Arlington, Virginia
Nedbal D. (2001) Forever Young oder die ewige Jugend. Bayerisches Ärzteblatt 12:650–651
Oberdörster E. (2004) Manufactured Nanomaterials (Fullerenes, C60) Induce Oxidative Stress in the Brain of Juvenile Largemouth Bass. Environmental Health Perspectives 112(10):1058–1062
Paschen H., Coenen C., Fleischer T., Grünwald R., Oertel D., Revermann C. (2003) Nanotechnologie, Endbericht. TAB-Arbeitsbericht 92, Berlin
Quante, M.: 2002, Personales Leben und menschlicher Tod. Personale Identität als Prinzip der biomedizinischen Ethik. Suhrkamp, Frankfurt a.M.
Salem A.K., Searson P.C., Leon K.W., (2003) Multifunctional Nanorods for Gene Delivery. Nature Materials 2:668–671
Savulescu J. (2001) Harm, Ethics Committees and the Gene Therapy Death. Journal of Medical Ethics 27:148–150
Service R.F. (2003) Nanomaterials Shows Signs of Toxicity. Science 300:243
Shrader-Frechette, K.: 1997, Technology and Ethical Issues’, in: Shrader-Frechette, K.; Westra, L. (eds.), Technology and Values, Rowman & Littlefield Publishers, Lanham et al., pp. 25–31
Sloterdijk P. (1999) Regeln füs den Menschenpark. Ein Antwortschreiben zu Heideggers Brief über den Humanismus. Suhrkamp, Frankfurt a.M.
SwissRe (ed.): 2003, Nanotechnology — Small matter, many unknowns, www.swissre.com.
U.S. National Science and Technology Council (1999) Nanotechnology — Shaping the World Atom by Atom. Washington, D.C.
Wehner-v. Segesser, S. 2002, Nanotechnologie in der Medizin. Zukunftshoffnungen für Diagnostik and Krebstherapie’, Neue Zürcher Zeitung Online, 30-01-2002, www.nzz.ch/2002/01 /30/ft/page-article7XBGQ.html
Acknowledgements
We would like to thank Ms Agomoni Ganguli, B.Sc, M.Sc. for linguistic editing of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Notes
Notes
-
1.
For a critical discussion of the term ‘nanotechnology’ see Decker (2003).
-
2.
Paschen et al. (2003), translation by the authors.
-
3.
http://www.nihroadmap. nih.gov/nanomedicine/
-
4.
PubMed search on Jan. 5, 2006.
-
5.
Cf. for example the projects presented on the joint Website of the German Ministry for Education and Research (BMBF) and the Club of German Industry: http://www.nanobio.de/projekte.html
-
6.
Allianz Group/OECD (2005), ESRC (2003), British Royal Society/Royal Academy of Engineering (2004), German Parliament’s Office for Technology Assessment (2003), Swiss Re (2003), U.S. National Science and Technology Council (1999).
-
7.
Shrader-Frechette (1997: 26).
-
8.
Böhnigk (2000: 213).
-
9.
op. cit.: 27.
-
10.
Oberdörster 2004: 1061 f.
-
11.
Ferber (2001).
-
12.
op. cit.; see www. foresight.org/EOC/
- 13.
-
14.
See also Vol. 28 (April 2003) of The Journal of Medicine and Philosophy on ‘Human Nature and its Normativity.’
-
15.
ESRC (2003, esp. p. 22) “focus on improving the human-machine interface”
-
16.
Academy for Technology Assessment Baden-Württemberg (2002).
-
17.
ESRC (2003: 21).
Rights and permissions
About this article
Cite this article
Lenk, C., Biller-Andorno, N. Nanomedicine–emerging or re-emerging ethical issues? A discussion of four ethical themes. Med Health Care Philos 10, 173–184 (2007). https://doi.org/10.1007/s11019-006-9014-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11019-006-9014-6