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Nanotechnology S Johnson, Center for Practical Bioethics, Kansas City, MO, USA

ª 2012 Elsevier Inc. All rights reserved.

Glossary Distributive justice Systems by which social goods

are distributed equally throughout society.

Nanomedicine Nanotechnology as it applies to

nanomedicine.

Nanoscale Particle in the range of 1–100 nm.

Nanotechnology Understanding and control of matter

at dimensions of roughly 1–100 nm, where unique

phenomena enable novel applications.

2

Precautionary principle If there is a potential risk

or harm that comes from an action, then the burden

of proof for proving that there is no harm that will come

from said action falls to the actor to provide said

evidence. In absence of such evidence, the action ought

not be taken.

Procedural justice Fairness in the processes that

allocate resources and resolve disputes.

Introduction

Much ado has been made regarding the potential uses of nanotechnology. Heralded as our ‘next Industrial Revolution,’ nanotechnology has already made its way into more than 1000 consumer-based household products. Yet fewer than 1 in 10 Americans would say they know a lot about nanotechnology, and only 1 in 5 would say they know even some.

Yet nanotechnology remains a relatively little explored and poorly understood area in the field of bioethics. As Allhoff and Johnson have stated, the literature in nanoethics is paltry at best and progressing at, even the with most conservative estimates, one-tenth the pace of scientific discoveries in nanotechnology and nanomedi­

cine. Is this lagging scholarship the result of a (sub)field still emerging, or is it the result of the fact that in fact ethics in nanotechnology lacks the substance to be its own field at all? Much debate over the ethics of nanotechnology has occurred in three main areas: (1) whether nanoethics ought to be a separate area of ethical debate at all; (2) if in fact, nanoethics is an area of discrete moral discourse, what ethical issues constitute its make up; and (3) the procedural, structural, or organizational solutions for moral problems in nanotechnology and nanomedicine.

This article will first define nanotechnology, providing some context to these debates, and setting the stage for

how nanoethics has most rapidly and most rigorously developed – in the area of nanomedicine. Then each of the three major scholarly areas in which debates over nanotechnology and nanomedicine will be explored in greater detail.

What Is Nanotechnology?

One of the most widely accepted definitions of nano­technology from the U.S. National Nanotechnology Initiative is the following: ‘‘[n]anotechnology is the understanding and control of matter at dimensions of roughly 1 to 100 nanometers, where unique phenomena enable novel applications.’’ (A nanometer is one-billionth of a meter, or 1/75,000th the size of a human hair. An atom is about one-third of a nanometer in width. Here is the size of some common objects expressed in nanometers: (1) a basketball is about 24 cm (240 million nm); (2) a flea is about 1 mm (1 million nm); (3) an anthrax bacterium is 1 mm (1000 nm); and (4) a DNA molecule measures around 2.5 n m wide. A sugargranule is about 1 m m, w hile a single s ugar molecule isabout 1 nm.) Nanomedicine is, put simply, the novel application of those phenomena in developing medical products and devices for drug delivery and other inter­ventions. The great utility of working with matter at this

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incredibly small scale is that molecules behave differ­ently and exhibit different properties on the nanoscale (and even the micron scale) than they do when they are larger. This allows for the creation of materials and products with incredible properties for use in medicine, military defense, material science, environmental science, and engineering that were unimaginable dec­ades ago. The belief in the utility of these particles and the products they can make is the reason why each year, the U.S. government alone spends more than $1 billion on nanotechnology research and development.

Is There an Ethics of Nanotechnology?

There has been a rather rigorous debate among bioethi­cists and philosopher as to whether there is an ethics of nanotechnology at all. The camp that has taken issue with ‘hyphenated ethics’ and the exceptionalist view of nanotechnology has argued that there are no new issues in nanoethics at all, but in fact the ethical issues involved with this latest technological field are in fact the very same as those that arose with genetics and neuroethics and other novel technologies. Thus, the desire to partition off nanoethics as its own subfield of applied ethics or bioethics (in the case of nanomedicine) is unnecessary, as all of the ethical concerns raised can be addressed by the ethical principles, methods, and frameworks already established for the technologies that have preceded it. What has been acknowledged by many scholars on both sides of this divide is what isdecidedly and obviously new about nanotechnology and specifically nanomedicine: the convergence of technol­ogies. What is relevant ethically is that this convergence of technologies results in multidisciplinarity that forces multiple ethical codes (and perhaps ethical frameworks) to converge as well.

Alternatively, there are those who argue that there are clearly ethical issues that are inherent to the nature of working on the nanoscale that make the ethics of nano­technology necessary. Allhoff, for example, argues that while many issues inherent in nanomedical research and someday treatment are the same as with other kinds of technologies, there are at least some (such as extreme profitability) that are unique. Ellen McGee argues a step further in response to Allhoff’s claims, stating that ‘‘nano­technology as applied to medicine will put novel forms of pressure on privacy, informed consent, autonomy and justice; the task of applied ethics is to look for practical ethical responses to such posited problems’’ (McGee, 2009: 14–15).

There is a third camp in the nanotechnology litera­ture that is in favor of abandoning the ‘nano’ label

altogether. They advocate for recategorizing nano­technologies not by their size but by their function. This way ethical analysis can proceed according to what a technology does in regard to individuals or society or the environment rather than merely being analyzed in categories according to the size of the particles being manipulated. This would skirt the debate entirely, allowing for the use of existing ethical frame­works, language, and terminology under the ethics of whatever fields these nano-interventions would come to fall.

Ethical Issues in Nanotechnology

Regardless of whether the ethical issues in nanotechnol­ogy as it applies to fields like medicine are wholly novel or not, it is obvious that the development of nanotechnol­ogies and their applications to fields like medicine raises ethical issues that cannot be ignored, even if they are subsumed by other existing disciplines or are part of a new or subdiscipline.

Safety

The majority of the literature in the ethics of nanotechnol­ogies and nanomedicine, to date, has focused upon safety, framed in the positive, or risk, framed in the negative. In the nanotechnology literature, there has been a clear focus upon the moral imperative to assess risk and establish safety for nanoscience research and the development of nanotechnologies. As Maynard et al. explain, ‘‘systematic risk research is necessary if emerging nano-industries are to thrive’’ (Maynard et al., 2006: 267–269).

Whether justified by the precautionary principle or some other moral justification, most scholars when dis­cussing the ethical concerns at stake in nanotechnology mention safety, yet fail to flesh out the claim as either preventing harm or minimizing risk.

Utility

Utility concerns the idea that the benefits of a certain intervention or practice must outweigh the risks or extern­alities of that intervention if it is to be morally justifiable. Such a principle provides a warrant for applying nano­technologies to medicine and justifies its use over other types of interventions. As Maynard et al. discuss, ‘‘the safe handling of nanotechnology’’ requires addressing ‘‘five grand challenges’’ to ‘‘support sustainable nanotechnolo­gies, in which risks are minimized and benefits are maximized’’ (Maynard et al., 2006: 267–269). Jotterand

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embraces this notion as one of three key norms at play in nanotechnology that is utilized by the massive public expenditures on nanotechnology research and develop­ment as well as the overall social utility that nanotechnology is likely to bring as its products come to market.

Procedural Justice

Another essential value for nanotechnology and nanome­dicine focuses on public participation and a fair, open, and transparent process for the public to participate in discus­sions about these technologies. Some studies have already been done to assess public attitudes regarding nano­technologies, but as Cameron claims, the fundamental changes to the human condition made possible through nanomedicine and nanotechnology require public con­sultation and deliberation. If nanotechnologies are actually as revolutionary and all-encompassing as many scientists and futurists predict, then it is incumbent upon society to engage in discourse about those technologies before, during, and after their development to ensure that this is in fact the technologies society wants to develop.

Distributive Justice

Nanotechnologies have been heralded by some to be the great equalizer for the developing world, providing revo­lutionary new benefits through advances in energy storage, agriculture, and water treatment. As Nigel Cameron has said, the focus on the ‘human potential of everyone’ addresses the principle of global ethical dimen­sions of these technologies, and their transformative capacity to benefit not simply those who develop them – an important counterweight to anxieties that have been expressed about the emerging ‘nano divide’ like the one Allhoff expressed about the extreme profit­ability of nanomedicine. Others have expressed similar concerns about nanotechnology exacerbating the divide between the developed and the developing world’s access to certain medical technologies via this ‘nano divide’ and have discussed strategies to mitigate against it via ‘respon­sible development.’

Privacy and Confidentiality

Multiple nanotechnologies will have the capacity to cap­ture, measure, and transmit, in real-time and in situ, health information about patients. This raises a number of con­cerns about privacy and confidentiality in regard to the transmission of data, data storage, data security, and a whole host of issues. Regardless of whether these issues are novel to other implanted or other devices like radio-frequency identification (RFID) tags or other transmit­ters, many scholars writing about nanotechnology note

that the key to making such devices ethically permissible will be putting such privacy protections in place.

Potential Solutions to Moral Problems in Nanotechnology and Nanomedicine

Even less has been written in the academic literature in regard to the practical solutions to moral problems invol­ving nanotechnology and nanomedicine.

As nanotechnology regards the environment, Meaney has suggested that nanoethics take a page from the sus­tainability movement ‘‘by integrating multiple perspectives into the analysis and evaluation of the impact of technologies’’ (Meaney, 2006: 682–688). Best and Khushf, in regard to nanomedicine, advocate for upstream ethical analyses, ‘‘to allow the highest possible degree of freedom in establishing systems’’ (Best and Khushf, 2006: 733–740).

The challenge, of course, as regards regulation or policy-making, or even ethics guidance, for that matter, is that there is no overarching governmental agency or ‘‘watchdog group to reign in rogue scientists, misfits or charlatans. There is no ethics organization, code of ethics for nanoscientists. . .’’ (Johnson, 2009: 1–2). Absent formal regulations, frameworks like Resnik’s risk minimization, risk management, and risk communication for clinical trials in nanomedicine are a key step toward formalizing processes for research involving human subjects and nanotechnology.

Yet others argue that ethical frameworks and regula­tory structures that address the moral problems are insufficient to capture all the moral values at stake. In order to ensure procedural justice, Cameron argues, ‘‘our new manipulative powers over human nature and the social order require the full glare of public debate. . .a conversation that draws the center of conscience in our culture and its grounding’’ (Cameron, 2006: 280–300). In other words, public discourse about nano­technology is required because of the fundamental individual- and society-altering potential it has. While there are many barriers to public participation such as the scientific complexity of nanotechnology, ‘‘the goal is to include all those creating, using, and being affected by converging technologies’’ (Roco, 2006: 1–23).

Conclusion

There has been little written in the academic literature on nanotechnology and nanomedicine as regards ethics. What has been written has focused primarily upon three areas: whether nanoethics is an area of bioethics scholar­ship at all, what constitutes the principles or domains of nanoethics among those who consider it to be an area of

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bioethics scholarship, and finally, the various regulatory, advocacy, or legal remedies available to ethical problems in nanomedicine. Among these, the first two have had the most scholarship devoted to them, most likely because so much of the scientific research in nanotechnology and nanomedicine is still in the proof of concept stage. But as the field of nanomedicine matures, it is likely that so too will nanoethics.

See also: Precautionary Principle; Transhumanism.

Further Reading

Allhoff F (2009) The coming era of nanomedicine. The American Journal of Bioethics 9(10): 3–11.

Berne R (2004) Toward the conscientious development of ethical nanotechnology. Science and Engineering Ethics 10(4): 627–638.

Best R and Khushf G (2006) The social conditions for nanomedicine: Disruption, systems, and lock-in. Journal of Law, Medicine and Ethics Winter, 733–740.

Cameron N (2006) Nanotechnology and the human future: Policy ethics and risk. Annals of the NY Academy of Science 1093: 280–300.

Gordijn B (2005) Nanoethics: From Utopian dreams and apocalyptic nightmares toward a more balanced view. Science and Engineering Ethics 11(4): 521–533.

Grunwald A (2005) Nanotechnology: A new field of ethical inquiry. Science and Engineering Ethics 11.

Johnson S (2009) The era of nanomedicine and nanoethics: Has it come, is it still coming or will it pass us by? The American Journal of Bioethics 9(10): 1–2.

Jotterand F (2006) The politicization of science: Its implications for nanotechnology. Journal of Law Medicine and Ethics Winter: 658–666.

Litton P (2007) Nanoethics. What’s new? Hastings Center Report 37(1): 22–26.

Maynard A, et al. (2006) Safe handling of nanotechnology. Nature 444: 267–269.

McGee E (2009) Nanomedicine: Ethical concerns beyond diagnostics, drugs and techniques. The American Journal of Bioethics 9(10): 14–15.

Meaney M (2006) Lessons from the sustainability movement: Toward an integrative decision-making framework for nanotechnology. Journal of Law, Medicine, and Ethics Winter, 682–688.

Resnik D and Tinkle S (2007) Ethical issues in clinical trials involving nanomedicine. Contemporary Clinical Trials 28(4): 433–441.

Roco M (2006) Progress in governance of converging technologies integrated from the nanoscale. Annals of the NY Academy of Science 1093: 1–23.

Salamanca-Buentello F, Persad DL, Court EB, Martin DK, Daar AS, and Singer PA (2005) Nanotechnology and the developing world. PLoS Medicine 2(5): e97.

Sandler R (2009) Nanomedicine and nanomedical ethics. The American Journal of Bioethics 9(10): 16–17.

Relevant Websites

http://www.nanotechproject.org/inventories/consumer/ – Wilson Center Project on Emerging Nanotechnologies. Consumer Product Index 2010.

Biographical Sketch

Dr. Summer Johnson is the Director of Graduate Studies at the Center for Practical Bioethics. At the Center, Dr. Johnson directs the Certificate Program in Clinical Ethics and Health Policy, an online ethics training program for health professionals devel­oped in collaboration with The American Journal of Bioethics (AJOB) and Apple. Dr. Johnson is also the Executive Editor of The AJOB family of journals, including AJOB, the top journal in all of health law, ethics, and policy, AJOB Neuroscience, and AJOB Primary Research. The AJOB family of journals is one part of the Bioethics Education Network (bene), an innovative organization co-created and co-owned by Dr. Summer Johnson that serves more than 28 million readers every year with information about ethics in medicine and science, via bioethics.net, the world’s most utilized bioethics resource and a partner of Google and Apple. Dr. Johnson is the author of the most read publication in all of bioethics – blog.bioethics.net – covering all topics in bioethics and health policy.

Dr. Johnson is a summa cum laude, Phi Beta Kappa graduate of Indiana University, where she designed the university’s bioethics major. She is a former recipient of both a Fulbright and a Javits fellowship, and received her Ph.D. in Bioethics & Health Policy from The Johns Hopkins University’s Bloomberg School of Public Health at 25. She has published extensively on public participation in bioethics and public policy.