Sociotechnical Imaginaries in Health and Biomedicine

Definition

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.

1. Introduction

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]. 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]. 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]. 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]. Cryopreservation practices are framed through visions of reproductive control and future optimisation [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]. 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]. 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]. Policy imaginaries increasingly present digital transformation as a moral imperative or inevitability, linking technological innovation to sustainability, competitiveness, or crisis preparedness [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]. East Asian developmentalist imaginaries emphasise national competitiveness and technological leadership [35,38], whereas Nordic imaginaries foreground equity, solidarity, and state responsibility in the adoption of AI and digital health [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.

2. Genesis and History

The concept of sociotechnical imaginaries emerged in the late 2000s within Science and Technology Studies (STS), consolidating around the work of Sheila Jasanoff and Sang-Hyun Kim. Their foundational publications [1,2] and later their edited volume [3] ultimately defined imaginaries as “collectively held, institutionally stabilised, and publicly performed visions of desirable futures” that link scientific and/or technological developments to social life and social order [4] (p. 4).

This formulation draws on two major intellectual traditions. As Jasanoff and Kim acknowledge, the concept is indebted to scholarship on “the construction of imaginaries in political and cultural theory and of sociotechnical systems in STS” [3] (p. 5). It extends Jasanoff’s earlier co-productionist argument—that scientific knowledge, technological practices, and social order evolve together [40]—and engages with broader theoretical accounts of how liberal states imagine and constitute themselves in relation to technoscience. Influential works in this area include Anderson’s analysis of imagined communities [41], Ezrahi’s examination of the cultural foundations of democratic authority [42], and Taylor’s reflections on the social imaginaries that underwrite modern political life [43].

Additionally, one of the most influential precursors to sociotechnical imaginaries comes from the sociology of expectations [44,45] and the study of promissory discourses in science and biomedicine [46,47]. Sociotechnical imaginaries overlap with expectations in their emphasis on futurity but extend the concept in key ways. While expectations focus on actors within scientific fields, imaginaries incorporate broader political cultures, state institutions, and national identities. They analyse not only how actors imagine the future but how these visions become stabilised, shared, and institutionalised across society, guiding long-term governance.

The first explicit conceptual articulation of sociotechnical imaginaries appeared in Jasanoff and Kim’s comparative study of nuclear power in the United States and South Korea. There, imaginaries were defined as “collectively imagined forms of social life and social order reflected in the design and fulfillment of nation-specific scientific and/or technological projects” [1] (p. 120). This formulation emphasised collectively envisioned, state-supported futures as the foundations of sociotechnical orders. Their analysis demonstrated that the United States drew on imaginaries rooted in individualism and scepticism toward state authority, whereas South Korea mobilised developmentalist imaginaries tied to national modernisation. These divergent visions shaped nuclear governance, structured public debate, and influenced technological trajectories, thereby showing how political culture and national identity become entwined with technological development.

The conceptualisation was subsequently expanded in Dreamscapes of Modernity, a collection that extended imaginaries analysis into domains such as bioscience, nanotechnology, and digital infrastructure [3]. Contributions by Burri, Lakoff, Jasanoff, and others demonstrated how imaginaries function as semi-institutionalised visions that stabilise technoscientific expectations through law, policy, regulation, and public discourse [4,32,48]. These studies highlighted imaginaries as infrastructures of the imagination that organise collective understandings of progress, threat, opportunity, and responsibility. This work synthesised multiple strands of STS—co-production, governance, anticipation, and modernity—into a framework for analysing how political communities envision and materialise their futures through science and technology.

While Jasanoff and Kim’s early formulations tied imaginaries closely to nation-states, emphasising their anchoring in political culture, historical experience, and constitutional arrangements [1,2], their later work refined the concept by foregrounding the institutional mechanisms that give imaginaries durability: regulatory agencies, legal regimes, strategic investments, and public communication [3]. In “Future Imperfect,” Jasanoff further consolidated the concept by arguing that imaginaries articulate normative visions of “how things ought to be” [4] (p. 22), thus guiding political and epistemic action.

Contributors to Dreamscapes of Modernity also extended the concept beyond national policy arenas. Burri showed how nanotechnology governance imaginaries diverge among Western countries [48], while Lakoff highlighted the role of imaginaries in global health security, where international institutions build anticipatory surveillance infrastructures grounded in threat-oriented visions of global interdependence [32]. These extensions broadened the empirical reach of the concept, demonstrating that imaginaries are multi-sited and multi-scalar, and underscoring their value for analysing risk, technoscientific promises, and transnational governance.

3. Development and Evolution of the Concept

This section traces how the concept has evolved, highlighting key moments of conceptual refinement, expansion, and critical reassessment, especially within health and biomedicine.

3.1. Conceptual Refinement Through Critical Scholarship

By the late 2010s and early 2020s, sociotechnical imaginaries had become a central concept within STS and adjacent fields. Their uptake in law, policy, anthropology, sociology, and media studies demonstrates their adaptability and explanatory power. Its evolution reflects both the dynamism of contemporary technoscience and the growing scholarly interest in how societies imagine and materialise futures. Today, imaginaries research is empirically broad, theoretically nuanced, methodologically diverse, and conceptually refined. Canonical reviews [49,50] and thematic special issues [11,51,52] reflect a growing recognition of imaginaries as central to the governance of science, technology and health, as well as their importance for analysing policy, institutional strategy, and the cultural politics of innovation.

Konrad and Böhle argued that sociotechnical futures, including imaginaries, are essential for understanding innovation governance, positioning them in relation to visions, scenarios, promises, and expectations [11]. Around the same time, Sismondo observed that sociotechnical imaginaries had become very widespread within STS [51], although other scholars have later warned that its rapid diffusion risks superficial or repetitive use, potentially detaching the concept from its theoretical roots [49]. Moreover, the analytic value of sociotechnical imaginaries remains limited unless scholars can show how these visions are sustained across time and space and what concrete effects they produce [50].

This potential critique regarding analytical overuse has encouraged researchers—particularly those studying highly promissory fields—to articulate imaginaries more precisely, emphasising their collective anchoring, institutional embedding, and material enactment. In fact, recent work emphasises infrastructures [30,53] and governance regimes [18,54] as key sites where imaginaries become stabilized, pushing imaginaries research toward more grounded empirical analysis and helping to clarify conceptual boundaries.

Further research underscored that sociotechnical imaginaries are never singular, hegemonic or uncontested. Increasing attention has been paid to resistance, scepticism, and alternative visions, showing that dominant technoscientific narratives coexist with counter-imaginaries articulated by publics, activists, and marginalised groups [33,55,56]. Public scepticism during the COVID-19 pandemic in Brazil, the UK, and the US, for example, revealed how distrust, nationalism, and lived experience generate rival imaginaries that challenge state narratives of crisis governance [33]. Similarly, work on energy transitions demonstrates how certain futures are prioritised while others are marginalised, highlighting the power asymmetries inherent in future-making [57]. This body of work shows that imaginaries are plural, contested, and politically charged, and that their study must account for the multiplicity and unevenness of imagined futures.

Parallel developments in media studies, anthropology, and feminist STS also enriched the conceptual terrain. Lupton’s work on digital health illustrated how emerging technologies are framed through techno-utopian narratives of empowerment and optimisation [58,59], while studies of robotics and care highlighted how either tinkering or “radical imaginaries” guide design processes and ethical debates [55,60]. This diverse intellectual background set the stage for sociotechnical imaginaries to become a coherent framework capable of analysing how visions of the future become materialised and institutionally anchored.

This conceptual development builds on research on promissory narratives, speculative futures, and anticipatory discourses in genomics, regenerative medicine, nanotechnology, and neuroscience. These fields have shown that technoscientific innovation depends not only on empirical achievement but also on imagined futures mobilised to attract investment, build legitimacy, and coordinate action. Work on promissory discourses in biomedicine [5,7,61], speculative ethics [62], and anticipatory governance [11,63,64] laid critical groundwork for the consolidation of imaginaries as a distinct conceptual lens.

Yet it remains open to further development, particularly as new technological domains—AI-driven care systems, environmental and planetary health, and data-driven medicine—continue to reshape how futures are imagined and governed. Therefore, it is expected that imaginaries continue to evolve in response to new technoscientific developments.

Taken together, this body of work consolidates sociotechnical imaginaries as a concept that has moved from a descriptive lens to a more analytically precise framework, increasingly focused on institutional embedding, materialisation, and the conditions under which imaginaries produce tangible sociotechnical effects.

3.2. Expanding Beyond Energy

Since its initial formulation, sociotechnical imaginaries have expanded considerably, evolving from an STS tool—first articulated through energy policy—into a widely used analytical framework across sociology of health, medical anthropology, media studies, political science, and legal scholarship. The concept quickly gained traction in health and biomedicine—domains marked by high expectations, substantial investment, and significant ethical stakes. This growth reflects broader scholarly interest in science–society relations, anticipatory governance, and the increasing prominence of future-oriented discourse in technoscientific domains.

Across the 2010s and 2020s, imaginaries became a prominent tool for analysing biomedical innovation, health digitalisation, and governance reforms. Scholars showed how imaginaries of efficiency, automation, and prediction underpin digital health strategies [27,28], while imaginaries of data integration animate projects such as the European Health Data Space [30]. Research on AI in media and clinical settings illuminated the oscillation between enchantment and anxiety in cultural narratives and professional discourses [24,26,65]. Moreover, imaginaries are operationalized in metaphors, infrastructures, technologies, and everyday practices, transforming abstract visions into concrete sociotechnical arrangements that subsequently reinforce the very imaginaries from which they emerged [66,67]. In biomedical contexts, infrastructures such as biobanks, data platforms, fertility clinics, robotics labs, and genomic sequencing facilities materialise specific imaginaries of evidence, efficiency, control, and futurity. Materialisation also occurs through institutional routines: triage practices, diagnostic pathways, or data-sharing agreements reproduce imaginaries in day-to-day operations, often without explicit reflection by practitioners.

At the same time, critical perspectives warned against assuming coherence or inclusivity in dominant visions. Scholars examined how imaginaries can obscure inequalities or environmental implications [19,68], how institutional visions may marginalise public perspectives [69], and how crises such as the COVID-19 pandemic can reshape imaginaries of innovation, resilience, and digitalisation [56,70].

Research in regenerative medicine illustrated how patient organisations, charities, and scientific networks mobilise promissory imaginaries to sustain research agendas in uncertain fields [5,7]. Work in reproductive biomedicine showed how national cultures shape imaginaries around kinship, autonomy, gender, and reproductive citizenship [6,12,13,14]. Meanwhile, studies of personalised medicine highlighted how imaginaries of empowerment, patient participation, genomic citizenship, and individual responsibility become woven into emerging healthcare models, often influenced by national welfare-state imaginaries or neoliberal logics [16,17,18].

Collectively, these studies demonstrate that sociotechnical imaginaries have evolved into a versatile analytical framework capable of capturing how diverse domains of health and biomedicine organise innovation, governance, and practice around shared but contested visions of the future.

3.3. Global Expansion and Field Diversification

From the mid-2010s onwards, imaginaries gained prominence in comparative policy research and international STS, deepening the global dimension of the concept. Studies of South Korea’s converging technology strategy [35], India’s bioinformatics infrastructures [71], and European genomic governance [64] demonstrated that imaginaries vary across political cultures, regulatory traditions, and economic models, offering insight into how states mobilise science for political legitimacy, development goals, or welfare commitments. Likewise, analyses of China’s precision medicine programme [64], Nordic AI health strategies [37,39], and gene editing media coverage and global governance across multiple countries [21,72] revealed how cultural values and political priorities shape visions of technological progress. Work on global bioethics and genetic self-knowledge highlighted the role of bioconstitutional imaginaries in framing citizenship and rights [73].

The concept’s evolution has also been marked by its adoption in legal scholarship, design studies, engineering, and public engagement research. Legal scholars have used imaginaries to analyse how regulatory regimes anticipate risks, allocate responsibility, and stabilise normative orders in emerging biotechnologies [63,64,74], emphasising the role of law in shaping institutionalised visions of the future. Scholars in engineering and design have examined how imaginaries are embedded in technology development, being enacted through design choices, prototypes, and technical standards. Research shows how engineers’ visions influence AI systems for geriatric care [75] and how designers of robots for care construct ideal users and ethical justifications [55,60].

4. Applications in Health and Biomedicine

This section examines how sociotechnical imaginaries operate across major domains of health and biomedicine, illustrating their empirical diversity and analytical value.

4.1. Assisted Reproductive Technologies (ARTs)

Assisted Reproductive Technologies (ARTs) have long been a central site for analysing sociotechnical imaginaries because they touch upon foundational cultural categories: kinship, gender, sexuality, heredity, and the social meaning of reproduction. Far from being merely biomedical interventions for infertility, ARTs generate symbolic, ethical, and political debates about emerging forms of life, parenthood, and embodiment. They are therefore a privileged field for examining how societies imagine desirable futures—particularly futures of family, reproductive citizenship, and biological connection—through technological means. STS and social studies in health and medicine have consistently shown that imaginaries surrounding ARTs shape regulatory frameworks, professional and clinical practices, and the lived experiences of users.

From their inception, ARTs have been entwined with imaginaries of hope, transformation, and reproductive possibility. Technologies such as in vitro fertilization (IVF), gamete donation, cryopreservation, and embryo manipulation emerged as tools for overcoming biological limits and enabling future families. These narratives echoed broader societal values concerning kinship, gender equality, and reproductive autonomy and helped define what kinds of families should exist and how reproductive futures should be made available to citizens [12,13]. Sperm banks, for example, have been conceptualised as infrastructures for producing reproductive futures, with donors framed as carriers of genetic potential and recipients as future parents constructing biologically mediated kinship [12]. Danish sperm donation practices—shaped by anonymity norms, genetic profiling, and global markets—illustrate how reproductive possibilities are linked to sociopolitical imaginaries of liberal reproductive citizenship and technological modernity. These visions are deeply normative, embedding expectations about reproductive planning, and technologically mediated family formation.

Imaginaries within ARTs also operate through cultural understandings of kinship and parenthood. ARTs simultaneously destabilise and reinforce normative assumptions about legitimate reproduction and acceptable family structures. Research on transmasculine reproductive citizenship in Denmark, for instance, shows how gendered and heteronormative imaginaries persist within regulatory frameworks, generating tensions between lived identities and legal definitions of parenthood [13]. Donor-conceived individuals similarly draw on emergent imaginaries shaped by digital connectivity, genetic databases, and global kinship practices to make sense of identity and relatedness [76]. These analyses reveal the multi-layered relationships between biotechnological infrastructures, cultural norms, and personal identity.

Cryopreservation technologies—egg freezing, sperm banking, and ovarian tissue preservation—embody imaginaries of reproductive control, flexibility, and futurity. They reshape temporalities of reproduction by promising to extend fertility and allow for long-term family planning. Bach and Kroløkke highlight how ovarian tissue freezing is associated with imaginaries of “happy futurity,” in which preserved tissue becomes a material promise of hope and reproductive possibility [6]. Likewise, Danish narratives of “eggs on ice” reveal how cryopreservation intersects with social pressures around ageing, career trajectories, and gender equality [14]. Cryopreservation becomes a cultural narrative about responsible motherhood, technological optimisation, and temporal autonomy. The frozen gamete or tissue becomes a materialised imaginary: a biological future suspended in the present.

Screening and selection practices such as preimplantation genetic testing (PGT) mobilise imaginaries of risk, normality, and “healthy” futures. These technologies enact normative assumptions about disability, heredity, and reproductive responsibility. Karpin and Mykitiuk show how donor screening processes reproduce imaginaries of disability grounded in medicalised risk assessment and ideals of normalcy [15]. Such practices establish expectations that prospective parents should prevent disability through technological means, raising ethical questions about valuation, genetic responsibility, and the boundaries of reproductive autonomy.

National regulatory regimes surrounding ARTs are anchored in wider sociotechnical imaginaries about reproduction, citizenship, and state responsibility. Denmark, for example, has developed liberal reproductive policies aligned with imaginaries of gender equality, welfare-state support, and reproductive autonomy, fostering diverse family structures and extensive donor systems [12,13]. Other European contexts have integrated ARTs into imaginaries of demographic futures, moral responsibility, or social cohesion, often resulting in stricter regulation. East Asian contexts, such as South Korea, articulate Human Embryonic Stem Cell Research through developmentalist imaginaries linked to national competitiveness and demographic vitality [77].

Imaginaries are not only institutional but also embodied and affective. Users of ARTs navigate experiences of infertility, cycles of treatment, embryo selection, and genetic uncertainty through deeply imagined futures: hoped-for children, feared diagnoses, and reconfigured identities. These affective worlds are shaped by the sociotechnical imaginaries circulating through clinics, media, and policy. In this sense, ARTs function as laboratories of sociotechnical imaginaries, aligning technological interventions with normative visions of kinship, gender, and family formation while simultaneously generating tensions around identity, inclusion, and reproductive citizenship. They bring into view how reproductive futures are imagined, institutionalised, and embodied across multiple scales: national identity and demographic strategy; clinical and laboratory practice; and the intimate experiences of users. Through ARTs, sociotechnical imaginaries become materially enacted in policies, infrastructures, biological substances, and everyday life, demonstrating that imagined futures in reproduction are never merely speculative but actively shape social relations, life trajectories, and the meaning of kinship.

4.2. Genomics and Precision Medicine

Genomics and precision medicine have become emblematic domains for the study of sociotechnical imaginaries because they combine scientific ambition, political hope, ethical contestation, and visions of social transformation. These fields project futures in which disease risk is predicted through genetic information, therapeutic interventions are tailored to molecular profiles, and health systems are reorganised around data-driven rationalities. They articulate powerful visions of personalised care, biological citizenship, and technological modernity, making them central to analysing how societies imagine the future of health. Within STS and social studies in health and medicine, genomics and precision medicine have been examined not only for their scientific practices but also for their cultural narratives, governance arrangements, and political projects [16,17,18,19].

The genomic imaginary originally centred on predictive and preventive futures in which genomic knowledge empowers individuals to manage biological risk. Imaginaries of empowerment and responsibility shape the figure of the “epigenomic self,” imagined as an active agent capable of modifying biological trajectories through lifestyle interventions informed by genetic and epigenetic knowledge [16]. Such narratives embed moral expectations of self-surveillance and optimisation. While framed as empowering, these imaginaries frequently shift responsibility for health outcomes onto individuals, obscuring structural determinants of health [19]. These anticipatory visions influence how citizens understand inheritance and risk, how clinicians conceptualise patient responsibility, and how health systems integrate genomic tools.

Personalised medicine also provides a clear illustration of how national sociotechnical imaginaries shape emerging biomedical fields. In Denmark, genomic infrastructures are framed within welfare-state imaginaries emphasising collective benefit, solidarity, and universal access [18]. By contrast, the United Kingdom has promoted personalised medicine through imaginaries of scientific leadership and economic competitiveness, exemplified by initiatives such as Genomics England [17]. In the United States, personalised medicine is increasingly framed through imaginaries of precision public health, combining data-driven surveillance and population-level risk stratification with logics of individual responsibility and innovation [19]. China, as Au shows, embeds precision medicine in state-led visions of national rejuvenation, technological modernity, and population management [36]. These divergent trajectories demonstrate that personalised medicine is not a universal project but a sociotechnical one shaped by political cultures, welfare traditions, and institutional histories.

Clinical professionals play a central role in mediating these imaginaries. General practitioners in the UK, for example, express both enthusiasm and ambivalence about the integration of genomics into primary care, recognising potential benefits while raising concerns about workflow disruptions, interpretive uncertainty, and expanded responsibilities [17]. Their perspectives highlight the tension between national policy visions and the realities of everyday clinical practice, revealing how professional imaginaries shape the pace and form of genomic mainstreaming.

Genomic futures also depend on extensive infrastructures—biobanks, databases, algorithmic tools, and data-sharing systems—that materialise these imaginaries. Faulkner’s work on bioinformatics in India and the UK shows how imaginaries of innovation and efficiency drive infrastructural development, even as systems remain heterogeneous and contested [71]. Similarly, tissue banking and large-scale genomic repositories embody assumptions about collective benefit, data solidarity, and future therapeutic breakthroughs [78]. Without these infrastructures, the promises of personalised medicine would remain speculative.

Ethical debates surrounding genomics—such as privacy, consent, discrimination, and data ownership—are themselves structured by moral imaginaries about responsible innovation. Wienroth and Scully demonstrate how “promissory ethical regimes” frame publics as beneficiaries of genomic progress while positioning ethical concerns as manageable through expert governance [20]. In Europe, imagined futures based on precaution and fairness influence regulatory approaches to gene editing and genomic data [64]. These ethical regimes constitute normative infrastructures that legitimise genomic research and shape public expectations.

Genomics also contributes to new forms of citizenship. Sociotechnical imaginaries shape what it means to participate in genomic societies by encouraging data donation, genealogical exploration, and risk-management practices. Hurlbut et al. describe “bioconstitutional imaginaries” through which rights, responsibilities, and political identities are negotiated in relation to genetic data [73]. Donor-conceived individuals encounter genomic identity in a datafied landscape where DNA databases and digital platforms render biological relatedness hyper-visible, generating new imaginaries of kinship and selfhood [76].

Despite their promise, genomic imaginaries are marked by tensions and blind spots. Svendsen and Spalletta show how precision medicine focuses almost exclusively on human data and technological fixes, neglecting ecological costs [68]. Kenney and Mamo highlight how precision public health imaginaries depend on data infrastructures that can reproduce social inequalities, privileging well-resourced populations while obscuring structural disparities [19]. Clinicians’ scepticism about the practical utility of genomic tools and the tendency of national projects to overstate technological readiness reveal gaps between political aspiration and clinical reality [17].

Genomics and precision medicine therefore constitute one of the most analytically fertile domains for the study of sociotechnical imaginaries. They demonstrate how visions of molecular futures reorganise health systems, reshape governance, and create new forms of citizenship and responsibility, while orienting biomedical innovation around prediction and personalization and exposing tensions related to inequality, data governance, and the limits of molecular knowledge. These imaginaries operate across multiple scales—national strategies, clinical practices, technological infrastructures, and personal identities—and actively shape the futures they predict. The strength of the imaginaries concept in this field lies in its capacity to illuminate the entanglement of political ambition, scientific uncertainty, ethical reasoning, and social inequality in the making of genomic futures.

4.3. Regenerative Medicine

Regenerative medicine has become one of the most generative domains for analysing sociotechnical imaginaries. Encompassing stem cell science, tissue engineering, gene therapies, and bioprinting, the field is sustained by visions of repair, renewal, and bodily transformation. These visions extend beyond scientific aspiration: they structure political strategies, shape institutional infrastructures, inform ethical regimes, and generate public expectations. As such, regenerative medicine offers a particularly revealing lens for examining how future-oriented narratives become embedded in health systems, how hope and hype are organised, and how biomedical innovation becomes entangled with national identity, economic ambitions, and moral orders.

The prospect of repairing damaged tissues or reversing degenerative disease animates research agendas, funding decisions, and public communication. Gardner and Webster show how institutions such as the Cell and Gene Therapy Catapult materialise imaginaries of accelerated innovation by coordinating actors and infrastructures around expectations of rapid translation and therapeutic value [61]. Duggal and Faulkner demonstrate how disease research charities perform “scenario maintenance,” sustaining expectations of future breakthroughs despite uncertainty or failure, thereby keeping regenerative medicine politically legitimate and institutionally viable [7].

At the core of regenerative medicine lies a powerful imaginary of bodily repair and rejuvenation: the body envisioned as modular, repairable, and open to technological intervention. This imaginary is both biomedical and normative, shaped by cultural ideals of health, productivity, independence, and longevity, and aligned with societal anxieties around ageing, chronic disease, and the sustainability of health systems. Acero shows how culturally specific narratives of regenerative futures weave together hope, risk, and national identity to justify public investment and political support [79].

Institutional infrastructures are central to materialising these imaginaries. Gardner and Webster illustrate how organisations created to accelerate innovation act as intermediaries between academia, industry, and government, presenting regenerative medicine as a strategic sector of economic growth and global competitiveness [61]. Such institutionalisation reflects a wider trend in which regenerative medicine becomes an instrument of innovation policy, grounded in imaginaries of linear development and inevitable translation from laboratory to clinic—assumptions that often exceed empirical reality and mask scientific uncertainties, regulatory challenges, and infrastructural fragmentation.

Civil society actors also play a critical role. Research charities and advocacy groups mobilise promissory and protective imaginaries that sustain hope while managing perceptions of risk [7]. By deploying patient narratives, defining temporal expectations, and framing regenerative medicine as a morally urgent field, these organisations function as brokers between publics, scientists, and policymakers, contributing to a political economy in which hope becomes a resource.

Imaginaries are further materialised in laboratories, biobanks, and clinical trials. Stephens shows how tissue banks embody assumptions about temporality and therapeutic potential, valuing samples for their imagined futures rather than their immediate utility [78]. Bioprinting technologies enact imaginaries of customised organs and modular bodies, stabilised through the material properties of printers, bioinks, and design protocols [80]. 3D bioprinting also gives rise to legal and sociotechnical imaginaries that envision new forms of bodily production, property, and authorship, where tissues are imagined as programmable, ownable, and governable [81].

Regulatory regimes are similarly shaped by imaginaries of future benefit, risk, and responsibility. European frameworks are influenced by imaginaries of precaution and collective welfare [63,64], while UK governance combines visions of responsible leadership with aspirations for scientific excellence [7,61]. In the United States, regulation aligns more closely with entrepreneurial imaginaries of innovation and market-driven development [82]. Regulatory structures thus crystallise political cultures and articulate which regenerative futures are encouraged, constrained, or legitimised.

Media representations reinforce these imaginaries by amplifying stories of “miracle cures” and “lab-grown organs,” sustaining expectations of rapid progress and shaping the public legitimacy of regenerative medicine [7,80]. These narratives feed into a cyclical dynamic in which scientific claims are amplified by media, received by publics, responded to by policymakers, and institutionalised through funding and infrastructure.

Despite their influence, regenerative medicine imaginaries are marked by ambivalence and inequality. Scientific uncertainty and translational bottlenecks—the “translational lag” noted by Aarden, Marelli, and Blasimme [82]—reveal the fragility of promissory futures and the extent to which they require continual maintenance. Access to regenerative therapies is often uneven, and imaginaries of universal benefit obscure socioeconomic disparities and geographic exclusions. Counter-imaginaries articulated by disability rights advocates, religious groups, or sceptical publics challenge the normative assumptions of regenerative futures, emphasising alternative moral understandings of bodily integrity, intervention, or acceptance.

Regenerative medicine thus exemplifies how sociotechnical imaginaries are co-produced across multiple sites—laboratories, regulatory agencies, innovation policies, patient organisations, media narratives, and biomedical infrastructures, mobilising promissory visions of repair and renewal to structure scientific agendas and institutional investment, while simultaneously exposing uncertainties, ethical tensions, and uneven distributions of risk and benefit. It demonstrates with particular clarity how imagined futures shape institutional arrangements, political investment, and scientific labour, making the field a paradigmatic case for understanding the role of sociotechnical imaginaries in contemporary biomedicine.

4.4. Digital Health and Artificial Intelligence

Digital health and artificial intelligence (AI) have become central domains for the study of sociotechnical imaginaries as health systems increasingly turn to digitalisation, datafication, and algorithmic governance. These technologies are framed as transformative solutions to structural challenges—rising costs, workforce shortages, ageing populations, chronic disease, and demands for personalisation. Across policy discourse, media representations, engineering practices, and clinical environments, digital technologies are linked to visions of optimisation, prediction, automation, and data-driven care. These imaginaries are, however, heterogeneous and contested. They reflect national political cultures, professional identities, ethical sensibilities, and public emotions that range from hope and enthusiasm to anxiety and scepticism. Digital health and AI thus constitute fertile terrain for examining how technological futures are culturally imagined and institutionally enacted.

Central to digital health imaginaries is the belief that data, algorithms, and digital platforms will render healthcare more efficient, rational, and predictive. Gardner describes how the “data-driven hospital” is envisioned as an institution where real-time analytics and interoperable systems overcome entrenched organisational constraints [23]. Ashuri and van Voorst similarly show how personalised healthcare is shaped by imaginaries of “networked biopower,” in which patients become nodes within infrastructures that monitor, classify, and predict [83]. Such visions rest on assumptions of seamless data flows and algorithmic neutrality, assumptions frequently challenged in practice.

AI amplifies these expectations. Media, policy, and industry routinely portray AI as a disruptive force that will transform diagnostics, triage, logistics, and treatment planning. Brause et al. demonstrate how media imaginaries across China, Germany, and the United States oscillate between optimism and concern [24], while Wang, Downey, and Yang observe similar ambivalence across the UK, China, and India [84]. Hoff shows how governments present AI as an unavoidable technological horizon, mobilising narratives of inevitability to justify investment and reform [27]. Nordic imaginaries analysed by Strange and Tucker intertwine technological progress with welfare-state commitments to equity and universalism, highlighting how AI visions remain culturally situated [37,39].

These transformations are enacted through what Schwennesen calls “algorithmic assemblages”: hybrid constellations of data infrastructures, predictive systems, professional routines, and interpretative labour [85]. Ivanova and Simonsen extend this perspective through their analysis of “immersive imaginaries,” where care is envisioned as unbound from physical settings and mediated through virtual, algorithmically structured environments [86]. These studies underscore that imaginaries are not only discursive but also embedded in the material and organisational practices that shape how digital technologies are implemented.

Digital health imaginaries also circulate within consumer cultures. Femtech, for example, is shaped by imaginaries of datafied female health, linking self-tracking to empowerment and bodily control while simultaneously reproducing normative assumptions about gender, responsibility, and reproductive citizenship [29]. Therefore, digital health information systems cultivate imaginaries of the “citizen-patient,” who is expected to be informed, responsible, and digitally engaged [87]. Lupton shows how wearable devices encourage imaginaries of optimisation and self-surveillance, extending public health logics into intimate domains and reshaping bodily experience [59].

Engineers and designers contribute significantly to these visions. Breuer et al. show how design imaginaries construct ideal users who seamlessly integrate robotic and AI systems into care routines, often misaligning with the complexities of real clinical settings [75]. Mossfeldt Nickelsen similarly demonstrates how roboticists’ practices are guided by speculative expectations about user behaviour and technological capability [60]. Stimson highlights how children with brittle bone disease participate in co-design processes, generating imaginative visions of robotic care that reveal the negotiated, multi-actor character of sociotechnical imagining [88].

Policy actors also play a key role in stabilising digital health imaginaries. Breuer and Müller demonstrate how German policy discourse frames AI and robotics as pathways to “good care and good work,” linking technological innovation to broader imaginaries of social welfare and labour sustainability [28]. Enlund shows how the European Health Data Space is imagined as a unified continental data infrastructure, projecting a future of interoperability and cross-border health governance [30]. These policy imaginaries are performative: they shape funding priorities, institutional mandates, and regulatory reforms, while simultaneously narrowing democratic deliberation by presenting particular technological futures as inevitable or universally beneficial.

Media narratives reinforce and circulate these visions. Brause et al. identify cultural differences in the portrayal of AI—national competitiveness in China, ethical concern in Germany, and technological ambivalence in the US [24]—while Wang, Downey, and Yang reveal similar divergences across the UK, China, and India [84]. Watson and Wozniak-O’Connor show that portrayals of emerging healthcare technologies combine enthusiasm with warnings about ethical risk, producing a distinctive narrative ambivalence that shapes public imagination [26].

Affective dimensions are central to digital health imaginaries. Lysø et al. show how men discussing AI for prostate cancer express ambivalent expectations shaped by embodied experience, moral concern, and trust or distrust in digital systems [65]. Lupton and Leahy demonstrate how participatory storyboarding reveals curiosity, apprehension, and hope, underscoring the emotional undercurrents through which lay publics negotiate digital futures [89]. Affect thus becomes a key analytic register for understanding how AI and digital health are domesticated or resisted.

Counter-imaginaries further complicate the landscape. Cibin shows how digital transitions can intensify inequalities, producing visions of exclusion that challenge technocratic futures [56]. Strange and Tucker emphasise imaginaries prioritising relational care, caution, and socio-technical risk, while broader public scepticism targets data privacy, autonomy, and algorithmic bias [37]. Lang and colleagues examine how digital health technologies animate imaginaries of data-driven futures while producing competing visions of what care ought to be—relational, algorithmic, or commodified [90]. These critical imaginaries illuminate the blind spots of dominant narratives and open space for contestation.

Digital health and AI have therefore become major arenas in which sociotechnical imaginaries are produced, circulated, and challenged. They frame healthcare as increasingly data-driven, predictive, and automated, while also generating tensions around professional roles, governance, inequality, and the limits of technological solutionism. These imaginaries assemble technological optimism, policy ambitions, engineering assumptions, professional expectations, media narratives, public emotions, and ethical reasoning into overlapping and often competing visions of the future of healthcare. They do more than anticipate technological developments; they actively shape institutional decisions, public investments, and the cultural politics of health. At the same time, their fragilities—technical, ethical, and social—highlight the contingent and contested nature of digital health futures within contemporary societies.

4.5. Health Data, Infrastructure, and Governance

Sociotechnical imaginaries surrounding health data have become central to contemporary visions of health governance. As health systems rely increasingly on digital infrastructures, predictive analytics, and transnational data flows, datafication is framed as both a technical resource and a transformative force capable of reshaping clinical practice, public health governance, and biomedical research. These imaginaries project futures in which data are seamlessly collected, interoperable, and continuously mobilised to generate insights, anticipate risks, and guide decision-making. The production, circulation, and governance of health data therefore constitute a key domain for understanding how technological futures are imagined and enacted.

Datafication refers to the rendering of health practices, bodies, behaviours, and environments into digital data, underpinned by imaginaries that attribute epistemic, predictive, and organisational value to such data. Ashuri and van Voorst show how personalised healthcare imaginaries rely on pervasive data capture, algorithmic optimisation, and continuous surveillance: data become proxies for health states, risk profiles, and future outcomes, positioning individuals as nodes in networks of monitoring and intervention [83]. These visions rest on assumptions of objectivity, completeness, and representativeness, even though, as Nafus demonstrates in the context of environmental advocacy, data often fail to capture lived experiences, embodied conditions, and structural inequalities [53]. In health, these limitations raise questions about whose bodies become legible in data infrastructures, how data are curated, and who benefits from algorithmic insights. The imaginary of the “datafied patient” thus reflects not only representational practices but also a normative vision of anticipatory, personalised, and responsibilised health governance, in which patients are cast as continuous producers of actionable data rather than merely recipients of care.

Predictive analytics consolidate powerful imaginaries of anticipatory governance. Lazaro and Rizzi argue that predictive analytics constitute a new sociotechnical imaginary for governing uncertain futures, repositioning risk as calculable and intervenable through algorithmic projection [31]. Lakoff’s notion of the “pathogenic imaginary” further illustrates how global health security infrastructures imagine pathogens as threats to be detected and contained via real-time data-driven surveillance [32]. These futures depend on the premise that data can reliably predict health trajectories, stratify populations into risk categories, and enable timely intervention. In practice, however, these assumptions encounter clinical complexity, infrastructural fragmentation, and persistent data gaps, revealing predictive imaginaries as aspirational constructs that require ongoing stabilisation through organisational routines, political narratives, and ethical justifications.

Health data infrastructures materialise these imaginaries. Enlund shows how the European Health Data Space is shaped by visions of interoperability, integration, and harmonised governance, imagining Europe as a unified data ecosystem enabling innovation, surveillance, and research [30]. Infrastructures are not neutral backdrops: they embody assumptions about what data should exist, who may access them, and for what purposes. Interoperability enacts imaginaries of seamlessness and unity; standardisation embodies imaginaries of objectivity and comparability; security protocols reflect imaginaries of vulnerability and trust; and transnational platforms operationalise imaginaries of solidarity, competitiveness, or sovereignty. Aarden’s analysis of the Singapore Tissue Network illustrates how infrastructures are contingent achievements: constructed around imaginaries of “usefulness,” they can collapse when they no longer align with institutional goals, funding priorities, or political visions [91].

Comparative research highlights how political cultures shape imaginaries of data governance. In the Nordic region, AI and data strategies are framed within welfare-state imaginaries that emphasise equality, universalism, and public stewardship [37,39]. Tarkkala, Helén and Snell show how personalised medicine in Denmark and Finland is embedded in narratives of public good and social solidarity [92]. Here, data infrastructures are imagined primarily as tools for sustaining equitable care rather than as commercial assets. By contrast, Anglophone contexts often foreground innovation, entrepreneurship, and corporate partnership, presenting datafication as a competitive advantage in global markets and aligning health data governance with neoliberal logics. Lakoff demonstrates how global health security infrastructures, particularly those influenced by U.S. policy, blur public health with national security, legitimising expansive surveillance and data collection [32]. Leonel da Silva and Au show that COVID-19 scepticism in Brazil, the UK, and the US reflects divergent imaginaries of expertise, trust, and state authority that directly challenge technocratic visions of data-based public health management [33].

These developments are sustained by ethical imaginaries that articulate fairness, public good, and civic obligation. Wienroth and Scully describe “promissory ethical regimes” in genome editing, where imagined futures of benefit and harm inform current governance [20]. Similar regimes underpin health data infrastructures, where participation in data ecosystems is framed as contributing to societal progress and where “data citizenship” interpellates individuals as responsible contributors to population-level datasets. Yet these ethical imaginaries expose tensions between privacy and collective benefit, autonomy and surveillance, solidarity and commercialisation, inclusion and marginalisation. Such tensions reflect clashes between competing visions of how societies should organise health, knowledge, and technological futures.

Health data infrastructures also reconfigure professional imaginaries of expertise. Data scientists, clinicians, and policymakers must negotiate their roles within emergent data assemblages. In genomic medicine, general practitioners articulate futures that oscillate between optimism and concern, recognising both the promise of personalised insights and the challenges of institutional and infrastructural integration [17]. Rowland, Brydges and Kulasegaram show how academic medicine institutions invoke sociotechnical imaginaries of innovation and data-driven excellence in strategic planning, aligning organisational identities with broader trends toward datafication and precision medicine [93]. These transformations demand new interpretative labour, cross-professional collaboration, and epistemic humility as expertise becomes distributed across algorithmic systems and data pipelines.

Despite strong promissory narratives, health data infrastructures frequently encounter breakdowns that expose the limits of datafication imaginaries. Nafus emphasises how blind spots and exclusions undermine claims to completeness and objectivity, while in health such gaps disproportionately affect marginalised populations and risk reproducing existing inequalities [53]. Enlund reveals that even ambitious initiatives like the European Health Data Space face difficulties in political coordination and infrastructural alignment [30]. These failures reveal that sociotechnical imaginaries require continual discursive, institutional, and material maintenance to sustain their coherence and legitimacy.

Counter-imaginaries also introduce additional complexity. Cibin shows how digital transitions in public services during the pandemic exacerbated inequalities and generated resistance to data-driven governance [56]. Critical imaginaries foreground relational care over algorithmic optimisation, human judgement over automation, public deliberation over technocratic decision-making, and ecological and social context over narrowly biomedical data. Svendsen and Spalletta demonstrate how precision medicine initiatives often fail to imagine ecological dimensions of health, reinforcing constrained biomedical imaginaries that overlook broader determinants of wellbeing [68]. These counter-imaginaries open space for alternative visions of data governance rooted in ecological awareness, community participation, and epistemic diversity.

Health data infrastructures thus encapsulate some of the most influential sociotechnical imaginaries in contemporary biomedicine. They promote visions of integration, prediction, and anticipatory governance, while also revealing frictions related to data quality, equity, accountability, and infrastructural fragility. They link visions of predictive governance, personalised care, and scientific innovation with institutional reforms, ethical narratives, and political cultures, reconfiguring patient identities, redistributing expertise, and reshaping boundaries between public good and private interest. At the same time, they are fragile, contested, and unevenly experienced. Datafication is therefore not only a technical process but a sociocultural project through which societies imagine, negotiate, and sometimes resist futures of health, risk, and governance.

5. Practical and Policy Implications of Sociotechnical Imaginaries

Sociotechnical imaginaries offer a powerful framework for analysing how societies envision, organise, and govern technological futures in health and biomedicine, but their use raises important practical, conceptual, and policy challenges. Their strength lies in revealing how collective visions of desirable futures underpin scientific trajectories, institutional reforms, and political cultures; their weakness is the risk of becoming an all-purpose label for anything future-oriented. Using the concept productively therefore requires methodological discipline, conceptual precision, and reflexive attention to power and inequality.

A first practical issue concerns empirical identification. Imaginaries often manifest through language—policy documents, strategy papers, media narratives, expert interviews—but they are not reducible to discourse. Following Jasanoff and Kim’s emphasis on imaginaries as “collectively held and institutionally stabilised,” researchers must attend to practices, institutional arrangements, legal frameworks, and material infrastructures, not just rhetorical flourish. This is especially challenging in expectation-rich fields such as regenerative medicine or digital health, where promissory claims abound. Duggal and Faulkner’s notion of “scenario maintenance” illustrates how charities and intermediaries sustain promissory narratives without these necessarily crystallising into fully stabilised imaginaries, while Lupton’s work on wearables shows how widely shared themes of optimisation and empowerment may reflect consumer discourses more than institutionally embedded visions. The analytical task is to distinguish imaginaries from more transient forms of hype, marketing, or individual enthusiasm.

Conceptually, the most frequently noted danger is thus over-extension and dilution. As Hendriks and colleagues have warned, the term can lose analytic sharpness if it is applied mechanically to any future-oriented discourse. In biomedicine, narratives of personalisation, automation, or innovation are ubiquitous; not all of them constitute imaginaries in the stronger sense of collectively anchored, institutionally entrenched visions that link technological futures to social order. Konrad and Böhle’s reflection on sociotechnical futures is helpful here: imaginaries are one modality among others (visions, expectations, hype, scenarios, promises), and they should be reserved for cases where there is clear evidence of collective uptake and institutional stabilisation.

Imaginaries also tend to operate across multiple sites and scales. They are assembled in laboratories, clinics, regulatory bodies, engineering teams, charities, media, and publics. Gardner’s analysis of the “data-driven hospital” shows that imaginaries emerge in organisational routines as much as in official policy, while Ashuri and van Voorst demonstrate how personalised healthcare imaginaries are enacted through data infrastructures, professional practices, and managerial logics. Reliance solely on document analysis—through governmental strategies, for example—risks privileging elite visions and neglecting practitioner, patient, or civil-society imaginaries. Multi-sited, ethnographic, and participatory approaches are therefore often necessary to track how imaginaries are operationalised in everyday practice and how they are contested from below.

Temporal questions amplify these difficulties. Imaginaries are inherently oriented to the future but anchored in specific historical moments and political circumstances. Burri’s comparative analysis of nanotechnology governance and Gardner and Webster’s longitudinal study of regenerative medicine institutions show how imaginaries evolve, fragment, or lose momentum as scientific and political conditions change. Aarden’s case of the Singapore Tissue Network illustrates how an imaginary can collapse when institutional support and perceived “usefulness” evaporate. This raises difficult questions about when a vision becomes stabilised enough to be called an imaginary, how to identify turning points or fractures, and how to distinguish co-existing or competing imaginaries within the same field.

Debates also persist over what counts as “collective.” In its original formulation, sociotechnical imaginaries are anchored in constitutional structures, national institutions, and widely shared cultural narratives. Subsequent work, however, has applied the concept to more circumscribed collectivities: engineering teams developing robotics and AI, or specific patient or activist groups. These uses can be analytically fruitful but raise the question of whether such visions are best described as imaginaries or as professional, technoscientific, or subcultural visions. At stake is not only terminological clarity but the ability to compare imaginaries across scales—national, sectoral, organisational, and grassroots.

Normativity and contestation are central here. Imaginaries define desirable futures, but what counts as desirable is rarely uncontested. Precision medicine imaginaries of empowerment and responsibility, regenerative medicine narratives of repair and futurity, and digital health imaginaries of optimisation and responsibilisation all encode moral and political commitments. Additionally, the promise of future collective benefit legitimises present-day decisions and institutional designs. However, counter-imaginaries—from COVID-19 scepticism to critiques of data-driven public services and radical design imaginaries in robotics—reveal that imaginaries are never total or fully consensual. Therefore, comparative work can slip into national essentialism if internal diversities and fractures are ignored. And without explicit critical framing, imaginaries research risks underplaying structural inequalities, global asymmetries, and the politics of exclusion. Empirical research must therefore examine whose futures are institutionalised, whose are marginalised, and how conflicts over imagined futures are negotiated.

Despite these challenges, the concept has clear advantages. It integrates technological, political, and cultural analysis, extending the co-production argument by foregrounding how futures structure present institutions and practices. In biomedicine, imaginaries have allowed scholars to analyse regenerative medicine, genomics, digital health, AI, and reproductive technologies not merely as scientific projects but as political, moral, and social ones. The framework is particularly well suited to comparative work, as shown in studies of cross-national AI imaginaries and divergent welfare-state articulations in the Nordic region. It also bridges scales: from global health security and European data spaces to hospital routines, design studios, and patient narratives.

A further strength is its emphasis on infrastructures as sites where futures are materially embedded. Analyses of tissue banks, bioinformatics and data infrastructures, robotics and AI platforms, and health data systems all show how imaginaries are stabilised through investments, standards, architectures, and institutional arrangements. This moves beyond discourse to highlight the material and organisational conditions of future-making.

These conceptual and methodological issues have direct policy implications. Because imaginaries function as “compasses” for policy, they shape strategic priorities, regulatory regimes, infrastructural investments, and public communication. Precision medicine strategies justified through narratives of personalisation and competitiveness, large-scale investments in regenerative medicine infrastructures, and ambitious data integration projects like the European Health Data Space are all driven by specific collective visions of the futures that genomics, regenerative medicine, and datafication should deliver. Legal and regulatory frameworks embed imaginaries of responsible innovation, risk, and public benefit, constituting what Hurlbut and colleagues term “bioconstitutional imaginaries” that organise citizenship, rights, and bodily autonomy.

Digital health and AI policy are particularly illustrative. Research on AI strategies shows how imaginaries of optimisation, efficiency, and rationalisation justify wide-ranging reforms, while Nordic cases reveal how AI is framed as a tool for sustaining welfare-state ideals. Yet such visions can naturalise surveillance, responsibilisation, and data extraction, obscure ecological dimensions of health, and reproduce inequalities in access and participation. Media imaginaries of AI and digital health further shape public perceptions and the legitimacy of policy choices, often amplifying promissory themes and narrowing the space for alternative futures.

For policymakers, the key lesson from imaginaries research is the need for reflexive and pluralistic governance. This entails making underlying visions explicit, subjecting them to democratic scrutiny, and engaging with counter-imaginaries articulated by civil society and marginalised communities. It also requires attention to infrastructural inequalities, the regulation of hype and speculative promise, and the alignment—or misalignment—between global, national, and local scales.

In sum, sociotechnical imaginaries constitute a concept of considerable analytical value but also genuine risk. When used carefully, they offer a robust framework for understanding how futures organise the present in health and biomedicine, exposing the normative commitments, institutional arrangements, and power relations that shape technological change. When used indiscriminately, they risk becoming vague shorthand for futurity, losing their critical edge. The practical task for researchers and policymakers alike is therefore not to abandon the concept, but to sharpen it: to use it in ways that clarify, rather than obscure, how biomedical futures are imagined, materialised, contested, and governed.

6. Conclusions

Sociotechnical imaginaries have become a powerful and widely adopted analytical lens for examining how societies envision, organise, and govern technological futures. Across health, biomedicine, and digital innovation, they illuminate how visions of desirable futures guide institutional action, structure public policy, legitimise investment, and shape ethical evaluation. By conceptualising imaginaries as collectively held and institutionally stabilised visions of the future, STS and social studies in health and medicine have shown how political cultures, moral commitments, and sociotechnical infrastructures interact in shaping the development and governance of biomedical innovation.

This entry has traced the evolution of the sociotechnical imaginaries concept from its formulation by Jasanoff and Kim to its contemporary applications across diverse biomedical domains. Its intellectual trajectory demonstrates a notable capacity for conceptual expansion without losing its core analytic purpose: clarifying the normative, cultural, and political foundations of technoscientific futures. Research across regenerative medicine, genomics, digital health, AI, data infrastructures, and reproductive technologies shows that emergent medical innovations are never merely technical accomplishments. They are embedded in broader collective understandings of progress, valued forms of life, and desirable futures.

Across these fields, imaginaries help elucidate how molecular promises reshape patient responsibilities in precision medicine, how promissory structures drive innovation and speculative investment in regenerative medicine, how data infrastructures and algorithmic systems reorganise governance in digital health and AI, and how reproductive technologies reconfigure kinship, gender, and citizenship. The strength of the concept lies in its ability to link macro-level political visions with meso-level institutional infrastructures and micro-level experiences, integrating discourse with materiality, ethics with governance, and public narratives with technological design.

The concept has matured substantially. From its origins in comparative nuclear policy to its widespread deployment in health, biomedicine, and digital governance, it has proven empirically generative, theoretically nuanced, and methodologically flexible. Yet this expansion also highlights limitations that require careful attention. The risk of conceptual over-extension—treating any future-oriented discourse as an imaginary—remains persistent. Distinguishing imaginaries from expectations, visions, hype, or scenarios is essential, as is empirically demonstrating their collective and institutional dimensions rather than assuming them. Moreover, imaginaries are rarely unified: counter-imaginaries and dissident visions reveal tensions, exclusions, and competing normative orders. Recognising such pluralities enriches rather than weakens the framework, allowing for more democratic and reflexive analyses of future-making.

As sociotechnical landscapes evolve, new research frontiers emerge. Intensifying datafication and algorithmic governance raise questions about automated decision-making and inequalities in data infrastructures. Ecological and planetary crises call for imaginaries that link environmental and biomedical futures. Crisis governance—exemplified by pandemics, climate emergencies, and geopolitical instability—demands attention to how states mobilise imaginaries of resilience, exception, and emergency. Community-driven and activist imaginaries increasingly challenge institutional visions and highlight the need for more pluralistic future-making. These developments indicate that the concept will continue to evolve and require ongoing refinement. It should be noted, however, that much of the existing Anglophone literature remains concentrated in Euro-American contexts, highlighting the need for further research that foregrounds perspectives from the Global South and other underrepresented settings.

Ultimately, sociotechnical imaginaries render visible the politics of the future—how futures are authorised, contested, and institutionalised. They reveal not only what societies imagine but also what they refuse to imagine or systematically ignore. For STS and social studies in health and medicine, the concept offers a robust framework for analysing how technological change is embedded in social norms, moral orders, and governance practices. For policymakers and practitioners, imaginaries underscore the importance of reflexivity: interrogating the visions that guide decisions, the interests they serve, and the social worlds they help construct.

The task ahead is not to stabilise a single definition of sociotechnical imaginaries but to refine and deploy the concept in ways responsive to emerging sociotechnical challenges. This requires analytical precision combined with openness to conceptual evolution, empirical breadth paired with clear differentiation from adjacent concepts, and sustained attention to issues of power, inequality, and exclusion. In doing so, imaginaries research will remain a vital tool for understanding—and shaping—the futures of health, biomedicine, and society more broadly.