Co-Imagining the Futures of Implementation Precision Medicine Using Scenario Analysis and Design Fiction

Precision medicine has a long history dating to the early 20th century when inquiries into the biochemical basis of large person-to-person variations in susceptibility to human diseases and response to medicines had first begun. Yet, personalized medicine in the 21st century is far from being "future-proof." Emerging technologies such as artificial intelligence, and changing human values and preferences, call for anticipatory, rather than reactive, approaches to the governance of precision medicine futures. In this context, anticipatory governance is an innovative approach to understanding technology and innovation futures. Anticipatory governance and its corollary anticipatory ethics on emerging technologies require interdisciplinary collaboration and communication to cultivate shared language, imagination, and orientation toward plausible sociotechnical innovation trajectories. This study reports, for the first time in the literature to the best of our knowledge, an anticipatory governance experiment on "implementation precision medicine (IPM)" using scenario analysis and design fiction. Participants were undergraduate students and experts who collaboratively imagined the plausible futures of precision medicine. Given the long history of the precision medicine field, and recent calls for translating big data to real-life clinical applications, implementation was chosen as a key focus area of precision medicine futures. We report here several plausible future innovation scenarios of interest to precision medicine scientists and engineers and researchers in the fields of emerging technology governance, responsible innovation, and social studies of science. Of importance, we found that the playful quality of the design fiction methodology and the pedagogical orientation facilitated by undergraduate student involvement created an engaging creative safe space to build transdisciplinary dialog examining the social and anticipatory ethics dimensions of IPM. Demonstrating the possibilities of such cross-disciplinary dialog and differential expertise, this article is conceptualized and coauthored by all participants further attesting to the importance of co-designing and co-imagining innovation futures in IPM.