One of the most pressing questions of mankind has been for millennia what the future is about to bring upon us. What will it look like? How can we prepare for it? Before the industrial revolution and the age of Enlightenment, the Gods and Goddesses and their mouthpieces such as prophets and oracles had all the answers. In the latest centuries of rapid technological progress, instead of the Gods, technology is interrogated constantly about the future – for example in the form of science fiction.

Inception - Science Fiction

Science fiction is a form of conversation between technology and society about the future

It is a vivid conversation. It makes us think, debate and learn. And it’s not a one-way street, but rather a strong interaction – while science fiction feeds on the ground that technology offers, it also gives ideas about how to build a better world for our children. Science and science fiction walk forward hand in hand.

Do we have the time machine set out in the time travel story described in H.G. Wells’ The Time Machine (1895)? Well, we are so far away from it as the nearest galaxy with signs of life on it, but we keep the idea in mind for future generations. Do we have the Hoverboard from the iconic 1980s movie Back to the Future? Well, we are not quite there yet, but we are working on it. Do we have advanced spaceships as proposed by the great science-fiction TV series Star Trek? Sure, we are not quite there yet, but technologists all over the world are actively working on its modern version, the solar sails.

Science and science fiction

And lately, science fiction is getting more and more intertwined with technology. Perhaps nothing better demonstrates their close tie than what is called “design fiction”—imaginative works commissioned by tech companies to model new ideas. Some corporations hire authors to create what-if stories about potentially marketable products.

It should be accepted as a universal truth that science fiction is an intellectual glue binding together desire with reality – see my take on the future of healthcare. It also helps us design a better future by showing the dark sides, the pitfalls and the loopholes in the system waiting to be exploited by people with bad intentions or self-interests. Thus, the more science fiction we read and watch, the sooner we can start talking about the effects the technological-cultural revolution will have on us.

Instead of predictions, have the talk!

When talking about the future, it is trendy to make predictions. There are some futurists who even log their performance and there are also famous authors remembered worldwide due to “getting things right”. For example Jules Verne for contemplating about what life would be like in the year 2889.

The June 9, 1955 Charleston Gazette lays out the vision of Dr. Lowry H. McDaniel, a very optimistic doctor of his era, for the year 1999. His predictions included a 150 year life span, a cancer vaccine, and the complete eradication of infectious disease. However, I believe that instead of making predictions, society should have meaningful discussions about the risks and pitfalls the future may bring – so when the big changes are here, we know what to do and what to avoid at all costs.

Plastic Saucer - Science Fiction
Decades after the 1950s, and we’re still not flying around in plastic saucers.

I have been watching movies and reading books in science fiction since I was a little kid. Sci-fi is the fuel for my brain and I need my dose every day. Literally, all my visions and precautions as The Medical Futurist come from science fiction and a desire to make the best ideas real in everyday healthcare.

I have learnt the most in these books and movies and I hope you will share your favorite ones too.

1) The dark side of genomics

Molecular biology and genetics are often linked to the biggest questions about life and death itself – where does life stem from or how does life spring up -, which result in serious questions in bioethics. Many people fear that medical scientists and healthcare itself might attempt to “play God” and “the Creator” with the use of genome sequencing or gene modification. And it is the reason why the topic is so popular among artists and fiction writers.

All those fears appear in the world-famous dystopian work of Aldous Huxley’s Brave New World, where people live peaceful, healthy, drug-addicted lives – and the only ones who cannot fit in or have doubts about the workings of the system are the ones with badly managed genetic make-up. And the result? Sterile, neutral, perfectly dehumanized robots living the simulation of life and society. The issue of genetic modification also appears in Ursula K. le Guin’s award-winning 1969 novel, The Left Hand of Darkness—set on a distant world populated by genetically modified hermaphrodites. The book is a thought experiment about how society would be different if it were genderless. Gattaca, a science-fiction drama starring Ethan Hawke, also paints a rather dark picture about the possible outcomes of genomics. The movie imagines humans categorized into groups based on their genetic make-up, and the categories bestow people with various possibilities in life.

                                                    Gattaca - Science Fiction

The artists warn us: humanity cannot allow the creation of a society in which there are genetically inferior people – nobody should suffer from disadvantages because of their DNA. This is just a blueprint, we are more than what our genes code for.

2)  All-mighty Artificial Intelligence

I believe artificial intelligence has unimaginable potentials. Within the next couple of years, it will revolutionize every area of our life, including medicine. One of the greatest fears of mankind is that AI will become so sophisticated that it will work better than the human brain and after a while it will aim to take control over our lives and people lose their ability to think freely. Stephen Hawking even said that the development of full artificial intelligence could spell the end of the human race.

Stanley Kubrick’s iconic science fiction movie 2001: A Space Odyssey based on Arthur C. Clarke’s book touches upon these feelings. It aims to cover the whole history of mankind – from prehistoric, barbaric times until the final race between men and machine. According to its story, some time in the distant past, someone or something nudged evolution by placing a monolith on Earth (presumably elsewhere throughout the universe as well). Evolution then enabled humankind to reach the moon’s surface, where yet another monolith was found, one that signals the monolith placers that humankind has evolved that far. Now a race begins between computers and human to reach the monolith placers. Kubrick’s movie is exceptional in its story-telling, in its film-making technique and it can even teach some tricks to healthcare.

Space Odyssey 2001 - Science Fiction

Ex Machina (2015) tells the same story on the micro-level. While 2001: A Space Odyssey spans the whole human history, Ex Machine plays out in a week between just two persons and an AI. According to the story-line, a junior programmer gets the possibility to spend a week at the CEO’s estate/research facility where he has been working on androids with superior AI. The programmer’s job is to test how “human” the android is: the result is a manipulative game between the AI and the programmer.

Ex Machina - Science Fiction

The artists warn us: AI will find its way. It will revolutionize our lives but we need to decide the conditions for it. We should try to be in control for as long as possible.

3) Love and technology

Does love and intimacy have a chance in the era of technosexuals, people living with life-sized dolls on a permanent basis, the Hug Shirt which is sending hugs over distance or virtual reality porn? According to the movie Her (2013), Joaquin Phoenix falls in love with an AI operating system. The film is about their relationship and it shows the imagined similarities and differences of attachment between real people and what humans and machines might have.

Her - Science Fiction

The artists warn us: we should teach our kids how to love, how to feel empathetic towards others or how to form long-lasting bonds. We would be wise to also set limitations on how much influence technology will have on our lives and on our sexuality. Technological change is happening fast, though, so we need to do these things soon if we want to preserve the core of what it means to be human. Otherwise we are facing a future in which one of the most precious human interactions — touching one another to show intimacy and care — will be replaced by a colder virtual reality.

4)  Big Brother is watching you

Since Edward Snowden’s revelations about the NSA and its widespread metadata-gathering practice, privacy concerns are painfully real. And it is not only about phone-calls and computer usage, but we have more and more data due to all kinds of extra devices – and due to the spread of healthcare trackers and sensors, this will not be any different in the future.

The greatest fear concerning data accumulation is connected to power. The omnipotent gaze of the Big Brother who supervises and controls everything – and punishes the ones who do not behave as expected. George Orwell’s famous dystopia, 1984 is one of the most brilliant books ever written about the topic or generally, for that matter. How power and first of all political power appears in every corner of life, and it makes no sense to revolt against it, because the result can only be total defeat. The Circle, a book written by Dave Eggers narrates the power of social media and internet for the life of the individual – who willingly sacrifices his or her own privacy in exchange for certain services and free stuff.

                           George Orwell 1984 - Science Fiction Dave Eggers The Circle - Science Fiction

The artists warn us: in order not to completely succumb to the technological world or political power having access to our data, we need to build checks and balances into the system which control the depositories of political power as well as the giant tech-companies having the key to technologies transforming our lives. We need to try to better defend our own privacy.

5)  Do we live in someone else’s fantasy?

There’s a billion to one chance we’re living in base reality, said Elon Musk, Tesla’s visionary CEO, meaning that one of the most influential and powerful figures in tech thinks that it’s overwhelmingly likely we’re just characters living inside a simulation. Disturbing.

It is even more so, if you remember the iconic The Matrix movies made more than ten years ago, which also set out the dystopian world where AI and other machines control the universe and they built up a simulated world for humans growing in laboratories and spending their whole lives in virtual reality. Minority Report (2002) starring Tom Cruise goes even further. According to the story, a special police unit is able to arrest murderers before they commit their crimes. And what if the officer from that special unit is accused of a future murder? Does he have a free will to change the course of events and his own fate? Do we have the ability to judge freely or are we programmed to behave in certain ways?

The Matrix - Science Fiction

Artists warn us that the development of technology challenges the core of being a human: our ability to have a conscious mind and judgement. And while we have to do everything in our power to keep it, we have to acknowledge that our present approach to life and the meaning of it will be changed significantly – and we need to start the discussion about the conditions of such change as soon as possible.

6)  Do we care for the 99 per cent?

Last year, ahead of the annual World Economic Forum meeting in Davos Oxfam warned that the combined wealth of the richest 1 percent will overtake that of the other 99 percent in 2016 unless the current trend of rising inequality is checked.

The movie entitled Elysium (2013) resonates with the growing inequalities on the Earth today. According to its story, in the year 2154, two classes of people exist: the unimaginably wealthy, who live on a pristine man-made space station called Elysium, and the rest, who live on an overpopulated, ruined Earth. The small paradise even features a special pod which cures cancer immediately. Meanwhile on Earth, care is sporadic and of low quality.

Elysium - Science Fiction

Artists warn us that technological improvement should not divide society. For example concerning healthcare, disruptive, thus affordable and available technologies can make it possible not to create or deepen health-related differences based on the existing financial gaps. If the technology is not affordable, it’s not disruptive enough.

7)  Robot companions

From R2-D2 until RoboCop, there are famous robots illuminating the world of cinema – which also shows that the interest in the interaction between humans and machines is (at least considering the film industry) decades old. Lately, robots not only feature in movies as episode-characters but started to gain more significant roles – as a reaction to happenings in real life.

There are already certain robot companions who can serve as a social partner in order to alleviate loneliness or treat mental health issues. Jibo, Pepper, Paro and Buddy are all existing examples. Some of them even have touch sensors, cameras and microphones, thus their owners can get into discussions with them, ask them to find a great concert for that night or just remind them about their medications.

Such robot companions might offer a solution in an aging society, where it is going to be more and more important and challenging to take care of the elderly. Robot & Frank (2012) touches upon the issue with great sensitivity. It focuses on a robot with artificial intelligence that can do this job in almost a human way. While the television show Humans (2015) deals with the realities of a family living in the not that distant present, for whom the latest must-have gadget is a highly-developed robotic servant – who is so similar to a real human, it is transforming the way we live.

Robot and Frank - Science Fiction

Artists warn us that the way we treat animals and the way we will treat robots will describe what we are like inside. We need to live with them keeping this in mind.

Why science fiction matters

The core of science fiction is the so-called “cognitive estrangement”. The cognitive part refers to what we can do within the boundaries of science today. The estrangement part is where the author tries to extrapolate and think ahead which creates the feeling of alienation in the reader. This is a wonderful way of thinking about the future while keeping current possibilities in mind.

Science fiction is amazing and we need to digest not only those pieces that feature paradises and utopias, but also those describing a dystopic world. Sci-fi is not only for geeks and nerds. It is for everyone who contemplates about the future of mankind every now and then – thus I truly believe that by digesting science fiction on a regular basis, we can create a more humanistic healthcare too.

Free guide and infographic: 40 trends of the future of medicine