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Sociotechnical Imaginaries in Health and Biomedicine: Comparison
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Please note this is a comparison between Version 2 by Perry Fu and Version 1 by Catarina Delaunay.

Sociotechnical imaginaries are collectively held and institutionally stabilised visions of desirable futures that link scientific and technological development with social and political order. Developed within Science and Technology Studies, the concept highlights the co-production of knowledge, technology, and governance, showing how ideas of progress are embedded in cultural values, moral assumptions, and political priorities. These imaginaries function as normative horizons that orient innovation, legitimise policy, shape regulation, and guide clinical practice. In health and biomedicine, sociotechnical imaginaries are particularly salient, as medical innovations directly affect life, death, and embodiment. Within medical sociology, the concept has been used to analyse how technologies such as assisted reproductive technologies (ARTs), genomics, regenerative medicine, and digital health are framed through narratives of hope, responsibility, risk, and transformation. These imaginaries shape what counts as legitimate knowledge, who accesses treatment, and how ethical debates are structured, from autonomy in ARTs to individualised care in precision medicine. Imaginaries are also shaped by national and institutional contexts. Comparative research shows that the United States, Europe, and East Asia produce distinct biomedical futures, reflecting different political traditions and governance models. As an analytical lens, sociotechnical imaginaries reveal health and biomedicine as domains where futures are imagined, contested, and enacted.

  • sociotechnical imaginaries
  • science and technology studies
  • social studies in health and medicine
  • expectations
  • promissory discourses
  • anticipatory regimes
  • biomedicine
  • governance
  • controversies
The concept of sociotechnical imaginaries has become a central analytical tool within Science and Technology Studies (STS) and social studies in health and medicine for understanding how collective visions of desirable futures shape technological development, political order, and social life. Methodologically, sociotechnical imaginaries have been studied through approaches such as discourse analysis, ethnography, document analysis, and participatory methods, all of which seek to capture how future-oriented visions are articulated, shared, and enacted across sites.
Sociotechnical imaginaries refer to collectively held and institutionally stabilised visions that embed normative ideas about what societies should strive toward and how science and technology might help bring those futures into being [1,2,3][1][2][3]. These visions do not merely reflect cultural values but participate in the co-production of knowledge, authority, and social order, illuminating how scientific and technological innovations are imagined, legitimised, and incorporated into organisational and governance arrangements [4].
Importantly, sociotechnical imaginaries may orient both the production of scientific knowledge and the development of technological applications, although these dimensions do not always coincide: imaginaries of scientific discovery often emphasise epistemic breakthroughs, whereas imaginaries of technological innovation tend to foreground utility, implementation, and social transformation.
The growing use of sociotechnical imaginaries reflects a broader shift toward analysing anticipatory regimes and practices of future-making. These issues have acquired renewed urgency in the context of rapid digitalisation, the expansion of data-driven and AI-mediated healthcare, and recent public health crises such as COVID-19, all of which intensify the need to understand how future-oriented visions shape present governance and practice.
Across health and biomedicine, imaginaries are particularly influential because medical technologies directly involve reproduction, embodiment, illness, ageing, disability, and mortality. Medical innovations generate potent symbolic and political meanings, and long-standing work in the Sociology of Health shows how they reshape subjectivities, redistribute responsibilities, and redefine the boundaries between normal and pathological. Sociotechnical imaginaries extend this tradition by examining how such processes are propelled by future-oriented narratives—promises of cure, improvement, optimisation, efficiency, or personalisation—mobilised by states, industries, experts, and publics. These narratives define what biomedical futures are imagined as possible, desirable, or inevitable, guiding policy decisions, clinical work, research priorities, and public expectations.
Promissory narratives underpin emerging biotechnologies, functioning as resources for mobilising funding, political support, and moral legitimacy [5,6,7][5][6][7]. Such discourses stabilise particular trajectories of innovation while marginalising alternatives and contribute to what has been described as “promissory identities,” whereby scientific actors, institutions, and technologies acquire future-oriented roles within innovation systems [5]. In post-devolution Scotland, reforms of health and research infrastructures have been driven by imaginaries of innovation and national renewal that mobilise shared visions of a modern, competitive, and socially responsive biomedical innovation system [8]. Likewise, UK policy discourse draws on imaginaries of Japan as a model of innovation and technological efficiency to shape and legitimise domestic scientific futures, using these comparative, aspirational visions as rhetorical resources for policy reform [9]. Closely related work on expectations shows how imaginaries orient scientific and regulatory activities even when envisioned futures remain uncertain or unrealised [10,11][10][11]. Studying sociotechnical imaginaries therefore clarifies how scientific and sociopolitical futures are enacted well before they materialise.
Sociotechnical imaginaries are produced and stabilised through multiple, interrelated processes, including policy discourse, expert knowledge production, media representation, and everyday practices. They circulate through both institutional arenas—such as regulatory frameworks, strategic documents, and scientific infrastructures—and mediated environments shaped by digital platforms, where visibility, controversy, and attention dynamics influence which technological futures gain prominence. However, these processes are not uniform: different actors—including policymakers, engineers, clinicians, patients, and various publics—produce and sustain distinct, and sometimes competing, imaginaries shaped by unequal positions, interests, and forms of expertise. This highlights the multi-actor and contested nature of imaginaries.
While closely related to expectations, visions, or promissory narratives, sociotechnical imaginaries differ in their collective anchoring and institutional stabilisation, referring not merely to projected futures but to socially shared and politically embedded frameworks that link technological development to broader social order. Likewise, sociotechnical imaginaries are distinguished from more localised or individual forms of imagining—such as user expectations or situated anticipations—by their relative durability, collective uptake, and institutional embedding.
Within health and medicine, imaginaries shape numerous domains. In reproductive biomedicine, imaginaries of kinship, autonomy, productivity, and demographic futures inform regulation and clinical practice. Assisted reproductive technologies (ARTs) are entangled with cultural narratives about family formation, gender, and reproductive citizenship [12,13][12][13]. Cryopreservation practices are framed through visions of reproductive control and future optimisation [6,14][6][14], and disability rights debates on gamete and embryo screening expose tensions between imaginaries of genetic quality control and imaginaries of inclusive citizenship [15]. These cases show how reproductive medicine becomes a site where embodied social, biological, and political futures are negotiated.
Genomics and personalised medicine form another central arena. Personalised healthcare frequently relies on imaginaries of empowerment, self-knowledge, and responsibility, positioning genomic data as tools for proactive health management [16,17][16][17]. Welfare-state contexts such as Denmark articulate personalised medicine through imaginaries of collective benefit and equitable access [18], whereas precision public health in the United States draws more heavily on data-driven prediction, surveillance, and risk stratification [19]. Gene editing activates imaginaries of molecular intervention and societal benefit while simultaneously provoking cross-national ethical and media controversies [20,21][20][21]. Risk-based governance—such as blood donation screening [22] or donor-gamete selection [15]—embeds imaginaries of health, purity, and citizenship that categorise certain groups as “risky,” reinforcing social boundaries and moral hierarchies. Across these areas, imaginaries function as epistemic and political tools that align heterogeneous actors and resources around shared biomedical futures.
Digital health and AI now occupy a central place in contemporary imaginaries of medicine. The “data-driven hospital” has become a recurring motif symbolising efficiency, automation, and predictive care, while simultaneously exposing the tensions and fragilities of digital infrastructures [23]. Public imaginaries of AI oscillate between utopian hopes for improved diagnostics and dystopian fears of surveillance, dehumanisation, and professional disempowerment [24,25,26][24][25][26]. Policy imaginaries increasingly present digital transformation as a moral imperative or inevitability, linking technological innovation to sustainability, competitiveness, or crisis preparedness [27,28][27][28]. Femtech exemplifies how imaginaries of empowerment intersect with commercial logics and normative assumptions around femininity, risk, and responsibility [29]. These imaginaries illustrate the heterogeneity of sociotechnical expectations and their implications for equity, labour, and everyday care practices.
Health data infrastructures and global health governance are likewise shaped by imaginaries. European initiatives such as the European Health Data Space are grounded in visions of integrated and innovation-friendly data ecosystems, yet confront unresolved debates around privacy, consent, and data justice [30]. Big data imaginaries have helped legitimise predictive analytics and new governance modes for uncertain futures, raising questions about risk, accountability, and democratic participation [31]. Pandemic preparedness is organised around “pathogenic imaginaries” that define threats, vulnerabilities, and appropriate forms of surveillance [32]. During COVID-19, imaginaries shaped public communication, trust, and crisis management, as illustrated by cross-national variations in scepticism, contestation, and institutional narratives [33], and by adjustments in emergency practices—such as loudspeaker mobilisation in China—that reveal frictions and improvisations in crisis governance [34]. These examples show that imaginaries inform both long-term innovation regimes and acute public health responses.
Importantly, sociotechnical imaginaries are neither uniform nor universally shared. Comparative studies demonstrate how welfare states, developmental states, liberal democracies, and authoritarian regimes articulate distinct visions of how healthcare and biotechnologies should be governed and to whose benefit [35,36,37][35][36][37]. East Asian developmentalist imaginaries emphasise national competitiveness and technological leadership [35[35][38],38], whereas Nordic imaginaries foreground equity, solidarity, and state responsibility in the adoption of AI and digital health [37,39][37][39]. These variations reflect deeper historical trajectories, institutional cultures, and political ideologies, illustrating how imaginaries are embedded within systems of meaning and power. This analytical perspective also has methodological and policy relevance, as it enables scholars and policymakers to interrogate the normative assumptions, power relations, and institutional commitments embedded in technological futures before they become materially entrenched.
Sociotechnical imaginaries thus offer a robust framework for examining how social visions and technological futures co-produce one another, shaping the governance of health and biomedicine in historically situated, normatively laden, and materially consequential ways. Tracing sociotechnical imaginaries across reproductive medicine, genomics, precision medicine, digital health, global health, and AI reveals how biomedical futures are imagined, contested, stabilised, and reconfigured, thereby deepening sociological understanding of medical innovation as a future-oriented political project that continually redefines what societies consider possible, appropriate, and worth striving for. This entry brings together the conceptual foundations, empirical applications, methodological challenges, and policy implications of imaginaries research in health and biomedicine, demonstrating both the analytical power of the concept and the need for conceptual precision, and ultimately arguing that its enduring value lies in exposing the normative, political, and infrastructural forces through which biomedical futures are envisioned and enacted.

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