by Rania Hashim
As our world slowly adopts and integrates new technology like nanotechnology into the field of healthcare, there raises an ethical concern over its use. As such, there is no “good” and “bad” technology. Beneath black and whites, there lie hues of grey. The same technology that can improve human lives and biological functions can also be an easy way of interfering with someone else’s medical data, thereby invading their privacy. Even with just mobile-based applications, there has been multiple cases relating to breach of privacy. How would this look if we were obtaining data in the cellular scale? Moreover, what other negative cases can arise from the integration of nanomedicine? What is the role of scientists in the ethics of the same? In this essay, we will be exploring the answers to these questions.
Nanotechnology is a form of science, technology and engineering in the nanoscale2. A nanometer is one billionth of a meter, so with nanotechnology, we are dealing on the molecular scale. It comes as no surprise that nanotechnology can revolutionize healthcare. After all, having molecular machines performing tasks like drug delivery, mini-surgery and data collection and so on is bound to have positive effects. Let’s explore some of these first. Integrating nanotechnology into healthcare will see a phase with more precise drug delivery than ever3.&text=This%20technique%20reduces%20damage%20to,for%20earlier%20detection%20of%20disease.). By employing nanoparticles to specific types of cells, we will be able to deliver a multitude of substances like heat, light and drugs. Engineering particles to get attracted to diseased cells (like cancerous cells) will allow for precise treatment of the same. As of present, there are 4 drug delivery routes4. These include inhalation, swallowing, absorption through the skin and intravenous injection. With nano-intervention, drug delivery methods can improve on the facets of accuracy, speed, cost and precision. In addition to drug delivery, nanotechnology can also be used for inexpensive diagnosis. For instance, a test for early detection of kidney damage is currently being developed5. The method utilizes gold nanorods that shift color when a specific protein given out by damaged kidneys accumulate. Similar applications are present within this field for cancers. Another aspect of this technology is treatment, more specifically antibacterial treatment. In this field, it opens many doors for the increasing use cases of nanotech, like treating antibiotic resistant infections, treating staph infections and releasing antibiotics as infections start6. For instance, a research conducted by the University Of Colorado and BioFrontiers Institute found that light-activated nanoparticles, known as quantum dots, can prove effective against antibiotic resistant cells. It successfully killed 92% of drug resistant bacterial cells in a lab grown culture7. With all these applications, it might seem tempting to use it without thinking.
However, as aforementioned, everything can be utilized for both good and bad. This means that this wonderful technology could possibly be used negatively. In this section, we will be exploring some potential negative use cases of the technology while touching on some of the resultant ethical implications. One such case is the breach of privacy that may arise as many technologies intersect and integrate onto the healthcare system. Already, with the small scale introduction of electronic data and records, we have seen major disclosure in protected healthcare information. In fact, a cybersecurity firm, Tenable8 released a report about data breaches in the healthcare industry. It was found that 2020 broke the previous record (2019) with 237 breaches. With nanotechnology, we’d be getting access to much more sensitive data, considering how you are monitoring the inner workings of your body. If accessed by the wrong hands, it could be exploited in many ways. For example, it could be used to tailor advertisements towards you. It could even be that nanoparticles are used for this specific purpose. Another issue concerns the use of nanomaterials for non-medical enhancement(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695932/#:~:text=Another ethical issue,become super-intelligent.). While this may be the case for many technologies and isn’t unique to nanotechnology alone, it is expected to make a significant dent in the area. For instance, nanomedicine therapies helping to replace memory loss could also be used to enhance human memory. These problems all raise the need for rules and regulations. In order to enforce these rules and regulations, we’d need methods and techniques to detect their violation - something that can be difficult to do when we deal with this scale of things. It will also be necessary to take appropriate measures so that nanotechnology-based enhancement doesn’t become the norm. Another implication of this technology lies in the health and safety aspect. This can be a tedious process owing to the uniqueness of the technology. In the nano-world, as I like to call it, shape and size are major determinants of function11. They may also disintegrate or change shape or size within the body as they tend to behave differently in cell cultures and actual organisms. This could cause a shift in properties. Since we are getting extraordinarily good at manipulating substances on the atomic scale, it is possible that someone may deliberately engineer these to have a negative effect. Such possible incidents make it necessary for scientists and those involved in these processes to have a board of ethics oversee their work and procedures to determine what is ethical and what is not. While we may not like to think of this possibility, it is still a potential use case and must be addressed.
While we may have touched a bit on ethical implications in the previous section, I don’t think we gave it enough justice. Hence, in this section, we will be diving deeper exclusively on some of the social, philosophical and ethical implications of the technology. Previously, we discussed the uses of nanomaterials for non-medical enhancement. This raises an interesting question; where do we draw the line? What should we keep in mind while deciding whether to administer the therapy. These are inevitable, yet difficult questions to tackle, especially with the many cultures in the world, changing how we view different things. The concept of “normalcy” is a fuzzy one; what’s normal in one, may not be normal in the other. If nano-intervention was open to all, we would change the structure of society and exacerbate inequalities. It will produce and promote unfair competition, dividing society into two sects; one normal and the other enhanced. It is likely that richer people will fall in the latter, further deepening the roots of social inequality10. Another implication lies in the labs; dealing with nanomaterials pose huge risks. Materials of the nanoscale can travel through the body and may even accumulate at certain sites. This can lead to adverse effects on health. This is a major issue when it comes to clinical trials. Even when the nanomaterial is tested on an animal, it may react differently to human tests. It can also trigger different immune responses. Not surprisingly, it is said that risk management, risk assessment and risk communication are the biggest challenges in this field11. We must take special care to not underestimate the risks and overestimate the benefits with nanotechnology. At the same time, it is necessary to bring such topics to the public sphere as encouraging public dialogue is a necessity to shape perception and to come to better decisions. A common case study used to illustrate this is Europe’s reaction to GM crops12. Europe has had a negative perception of GM crops because of the approach industry representatives and manufacturers took in introducing this. While safety is a common concern towards novel technologies, the industry of Europe didn’t promote open discussion of the same and rather, forced their agenda onto the people. Hence, we must learn from that mistake and promote communication and open discussions surrounding nanomedicine.
Nanomedicine is still a relatively new field with both hidden advantages as well as disadvantages. With its many advantages pertaining to disease diagnosis, treatment and cures, it also raises the questions of medical enhancement, privacy and even the possibility that one may deliberately engineer these parts to have negative impacts. This raises the necessity of having a council or board to oversee activities related to the use of these technologies. As is with every field, communication of both risks and benefits are crucial to voluntary adoption and assurance to the public.