Path creation by public agencies — The case of desirable futures of genomics

Abstract

Public agencies are central actors in the emergence of technologies. They use their cognitive resources and instruments (regulation, public procurement) to deal with new technologies, against the backdrop of institutional frames and particular responsibilities in serving the ‘public good’. How these public agencies anticipate emerging sociotechnical futures has so far remained underexplored. This article aims to explore public agencies' anticipatory role as a ‘knowledgeable actor’. A conceptual model is proposed that builds on path creation and mindful deviation literature. This conceptualization is explored for the case of genomics in health care insurance in the Netherlands by making an innovative link between a retrospective study on the integration of genomics in public health insurance with prospective scenarios of possible futures for genomics and insurance. Our findings show that policy agents enter anticipatory exercises in a tentative way, carefully drafting next steps, taking into account current boundaries, positions and historical institutional contexts. Their ‘local’ approach to emerging technologies can, however, influence ‘global’ technological and institutional developments. In this context, path creation scenarios can contribute to anticipatory governance that serves societal interests by early-stage identification of moments of potential intervention.