Future-Making From Afar: Digital Twins in Medicine

Digital twins in medicine are packaged as inevitable, disruptive technologies that will revolutionise healthcare, yet their integration into clinical practice remains slow. In this article, we extend current research on digital twins by shifting attention to the actors behind the technology and their visions. Drawing on multi-sited fieldwork, we identify from where and how the In Silico medicine community envisions the future of medicine and trace embedded ideas and logics. Our analysis reveals a friction between the narrowing of visions of medicine, the human body and clinicians and the technical features of digital twins, which are intended to open futures and possibilities through virtual interventions. We show how digital twins are developed at a distance from the very practices they seek to revolutionise and how the field attempts to navigate this distance through conversion and training. As with other digital health technologies, the burden of adjustment is placed on clinicians. By attending to how distance between modellers and clinical settings plays out in practice, we show how this "future-making from afar" constrains but also enables specific modes of engagement. It offers a starting point for demystifying digital twins in medicine and reflects on the kinds of futures the field promotes.