Top 10 Ethical Challenges in Future Medicine: A Prospectus by Dr. Bertalan Meskó

While writing The Future Medicine Guide, I often contemplated the array of ethical and moral issues that disruptive technologies might trigger in the future. I am optimistic by nature; if you observe recent developments in medicine, you will recognize that this optimism is well-founded. However, without adequate preparation for the successive waves of impending change, physicians, patients, and all stakeholders will face certain threats and ethical dilemmas as they strive to integrate these technologies into routine care.

I firmly believe that we still have time to prepare for the future of medicine, which is rapidly evolving yet remains uncertain. Beyond new technologies, what is indispensable is that we initiate public discourse now. Listed below are the ten most likely ethical and moral issues that we will face in the near future.

1) Medical Devices Hacked
It has been proven that medical devices such as cardiac pacemakers and insulin pumps have fallen victim to hacking. Security experts warn that such attacks could potentially be lethal to users at any time. How, then, can we safeguard these wearable devices connected to our physiological systems from hacking while still enabling remote control?

2) Safeguarding Our Privacy
Surveys indicate that we share far more information externally than we realize. By visiting mypermission.org, a third-party platform for reviewing app permissions, we can see how many applications and devices are authorized to access our personal data. What happens when we begin using augmented reality glasses—devices that overlay computer-generated data onto the real world—to instantly retrieve information about people around us? Children born in recent years are the first generation to have their daily lives comprehensively recorded. While these big data resources can significantly improve healthcare outcomes, how can we prevent companies and governments from misusing them?

3) Home Devices
Portable home-use devices are a medical assistive technology favored by nearly all patients and physicians. However, some doctors are concerned that patients may search online for treatment plans based on their symptoms and even provide incorrect information to their physicians. When patients can perform scans, blood tests, and even genetic analyses at home, can we still persuade them to consult a doctor rather than relying solely on computational algorithms? If you think this is merely science fiction, look into the finalists of the “Nokia Sensor Innovation Challenge.”

4) Technology Selection for the Healthy Population
Matthew James was born with limb deformities, a congenital condition. At the age of 14, James wrote to his favorite Formula One team, Mercedes, proposing that if the company could provide financial assistance, he would display its logo on his prosthetic limb. He received £30,000 in funding but did not participate in any advertising campaign. This story illustrates that the adoption of such technologies in daily life cannot depend solely on individual choices. But what if the trend evolves to a point where people begin to request that doctors replace healthy limbs with mechanical ones?

5) Biological Differences
Modern society is striving to combat gender inequality and financial inequity. However, as technology increasingly empowers individuals, those who can afford the associated costs become smarter, healthier, and more agile. Yet how should we address the biological disparities arising from societal financial inequality?

6) What would happen to society if we could all extend our lifespans?
Longevity research has been conducted for decades. Several factors behind the ultimate secrets of longevity have been revealed; although we have not yet truly achieved extended lifespans, we will sooner or later. What would our society become if the majority of humans could live beyond 100 years?

7) Bioterrorism Enabled by Nanotechnology
In the vast landscape of the future, tiny nanorobots in the bloodstream will be able to detect diseases. Perhaps in a few decades, thanks to nanotechnology, the word “symptom” will cease to exist, as no one will fall ill. Nanorobots could send alerts to our smartphones or other devices before diseases even develop. If this vision becomes reality and nanorobots circulate freely in our blood, how can we ensure that terrorists do not manipulate them to control people’s health—or even their lives?

8) Technological Advancements vs. Evidence-Based Medicine
(Note: Evidence-based medicine refers to "medicine that follows evidence." Its core principle is that medical decisions should be made on the basis of the best available clinical research evidence, while also valuing the integration of individual clinical experience.)

In recent years, technology has advanced at such a breakneck pace that it has become increasingly difficult to monitor. Meanwhile, evidence-based medicine dictates how we access healthcare services—a process that is inherently lengthy. While specific medical solutions, such as computerized perceptual stimulation, can address problems more rapidly, they still lag behind the speed of technological development. As patients witness these astonishing innovations yet remain unable to access them, what changes will traditional medical practice undergo?

9) Transhumanism and Singulitarianism
Many sports and philosophical theories propose only a single concept or approach, even though it is highly likely that a singular solution cannot lead to a bright future. It is the interconnection among people, devices, and ideas that can address global challenges. We do not advocate adopting merely one course of action or theory, such as transhumanism or singularitarianism. A reasonable solution in the coming decades should integrate all these concepts. Before embracing any vision of the future, we should maintain a skeptical and analytical stance. Throughout human history, the proliferation of ideas has never been as rapid as it is today. However, recognizing this is no easy task.

10) The Technification of Sexuality
A man named Davecat lives with his wife and mistress, both of whom are life-sized dolls specially designed and manufactured. Davecat identifies as a technosexual. Although some people cannot understand Davecat’s perspective on partners, his story indicates that such diverse concepts and ideas will continue to emerge in the coming years. If we cannot resolve today’s gender issues, how can we prepare for the future?

Original Author: Dr. Bertalan Meskó
Compiled by Zhou Yanxun
Editor: Huang Jia