Monday, May 21, 2007

Chip Implants: Ethical or not?


Would you want your loved one to have a radio frequency identification chip placed in her/his forearm? This is the debate that is going on at Alzheimer's Community Care in West Palm Beach, Florida. (AbcNews.Com)
The chip, which is slightly larger than a grain of rice, is implanted under the skin of the right forearm. Each chip will contain a unique 16-digit number that, when scanned in an emergency room, will link to the patient's medical records.
Seems pretty simple and straightforward to me. Taking care of Alzheimer's patients, I've always found it difficult to try to get all the information that I need when the patient presents to the emergency room in the early hours of the morning. Going through photocopies of information from the nursing home can be very confusing and time consuming. And, family members are not always available immediately to answer questions.
"This whole medical trial … really raises some pretty important issues about informed consent," said Katherine Albrecht, the founder of the advocacy group Consumers Against Supermarket Privacy Invasion and Numbering.
Officials at the facility state that this program is voluntary and issues of informed consent will be addressed with the patient and families before any procedure is performed. Ms. Albrecht continues...
"There are other technologies that are far less invasive and can achieve the same goal," she said.

Albrecht promotes the MedicAlert bracelet as the ideal way to solve the problem of Alzheimer's patients who cannot relay their medical information reliably. MedicAlert bracelets bear a recognizable medical symbol on the outside and have the patient's medical conditions listed on the back.
The article goes on to interview a couple of medical ethicists about their opinions about the placement of an identification chip.
But he [Jeffrey Spike of Florida State University] worries because the chip program has not yet been evaluated by a review board. Such a board, Spike said, would need to look at potential risks both physical and psychological -- and let prospective participants know their right to withdraw by having their chip removed or deactivated.

"If this has not been reviewed by [a review board], then it's natural to be suspicious that it has been carefully thought out," said Spike.
Presuming that the ethical and logistical details can be worked out (and I assume that they will), I don't see a problem with placing these identification chips in these patients. The wave of the future will be to somehow have your entire medical history easily accessible. I don't know if these ID chips are the answer, but they are certainly worth a try.

26 comments:

Cathy said...

I think I would have to vote thumbs down on this one Dr. A....I cannot imagine that I would have allowed them to insert one of these in my mother. But, there also was never a time she went to the hospital, that I didn't go with her.

It may well be ok for ALZ patients, Althgough I still think it isn't. But, don't you really only need their name and birthdate to enter into the computers for their records to come up? We dont need something implanted in us for that.

Not only that, think of this. ALZ patients today and the rest of us tomorrow. If this would work then it would not be long until it would spread beyond using it for only one illness. We will all be walking around implanted. The next thing we know along comes law enforcement to put a chip under our opposit arm that they can scan when they stop you on a traffic violation.

No, this one scares me. I dont want any chips in me or anyone else.

NeoNurseChic said...

I personally love the medic alert bracelet system. It is connected by a phone number, and then the patient (or patient's family in these sorts of cases) can input all important med information: conditions, medications, allergies, and so on. They even make a USB key now that allows the patient to basically cart their medical record (or the highlights anyhow) around on the USB key - including radiologic films! I actually have that, but never used it much - I let my medic alert subscription expire because it is a little costly (not like implanting a chip is free!), and I got sick of wearing the bracelet all the time. I had a cute bracelet that looked just like normal jewelry - but I did have people at work ask me what my medic alert bracelet was for. So it wasn't completely unobvious. I wanted it to look like regular jewelry, but also be easily identifiable in an emergency.

I don't know about the whole chip thing. I can see some benefits, but also - is it safe? Would this be some sort of invasion of privacy? Will this make more people paranoid about who is reading these implanted chips? Isn't this the paranoid person's worst nightmare?

I like the bracelet - but then, this also means that they will not take it off.... My grandma has one of those alert buttons (The whole, "I've fallen and I can't get up" thing..), but the one time she fell, she didn't have it on, and so she was stuck on the floor for 4 hours, unable to get up...which makes me want to cry just thinking about it! She just didn't feel like wearing the alert. Oy....

Nothing is ever black and white, I suppose! I wouldn't want an implantable chip in my arm or anywhere. However, I like the medic alert jewelry.

Hugz,
Carrie :)

word verif: ssosrk (There's an SOS in there!)

twilite said...

If I were ALZ, I'd go for the medic bracelet or anything external but NOT implants! Thanks.

Dissent said...

As a healthcare professional who is also very much involved in preserving and protecting privacy, I do not really see a problem with this application of chipping, if there is IRB approval and consent. I blogged about this issue on my own blog.

Lois Grebowski said...

ID microchips just scare me...Maybe it's just the whole "big brother" thing...

NO WAY!

gledwood said...

People are going to say this stuff is "Mark of the Beast" next ...

Pieces of Mind said...

Microchips are already used as a form of cat and dog ID, so there's some precedent already out there.

They've been somewhat problematic for various reasons, e.g. there are different manufacturers of pet microchips and the scanning technology to read the chip is not always compatible from one manufacturer to the next, nor are the registries centralized. Microchips also have been known to migrate under the animal's skin.

The idea of being "chipped" makes me a little uneasy. There would have to be some kind of central registry, no? And once the chip is in, I'm guessing it would be permanent.

If tracking someone with Alzheimer's is an issue, why not try something less intrusive such as GPS?

HP said...

I had a medic alert bracelet but it was always breaking and no one ever noticed it. I always had to point it out which kind of defeats the purpose so I let it lapse.

I don't have a problem with the chip personally but it should be an individual decision and with informed consent. My only issue is that I'm not sure I would like something artificial implanted in me.

Dreaming again said...

Given my religeous background, my mind went to the mark of the beast thing ...but I'm not hypervigilent in that area ...

I'm also not too fond of Big Brother ...

But ... my son when he was little was very much autistic like and the idea of loosing him was always on our mind ... we actually had child safety gates in his window because he'd climb out the window in the middle of the night.

My mom is has some kind of dementia, probably Alz ..and I can see the day coming when we will wonder if we will need to 'keep track' her. I do see her as someone who will wander.

My feelings on this ...100% mixed.

Rights vs safety. Do I want an implant on me? 100% NO WAY!
Would I have done it to my son when he was 4 and he could run faster than me and I was sick (myasthenia gravis) and he had no concept of what it meant to be safe or to look both ways or to stay with mom and dad?

????

What about 2 ...3 ...4 years when my mom isn't coherant enough to know where she is?

I don't know. I just don't know.

Dr. A said...

What if you suffered a cut on your hand and needed stitches at 3am? When was your last tetanus shot?

If you've had heart bypass surgery in the past, can you tell me exactly what vessels they operated on? Can you tell me the results of your latest stress test or cardiac cath?

If you're a health professional and you receive a cut on the job, can you tell me the exact dates of your Hepatitis B immunization series?

If you've had a history of brain surgery, can you tell me the results of your latest MRI? Sure, if you're at the same hospital, but what if you're at a hospital across the country on vacation?

What if I told you I can not only tell you all this information, but I can squeeze it onto a chip that happens to be in your arm.

This information would not only prevent needless retesting, it would also help expedite care wherever you're at. And, we're all after the best patient care, aren't we? Just food for thought...

Cathy said...

People don't know when they last had a tetnus shot? I had one in 2004 and usually they give you a card to carry in your wallet with the info on it.

I also would not, no how, no way, allow my CAT to have a chip implanted in him either. But, even if I did, we are human beings, not animals. ALZ PATIENTS ARE HUMAN BEINGS, NOT ANIMALS!

PK< yes, ALZ patients do wander. They wander alot and they do not sleep at night. I can't tell you how many nights I slept in the chair by the front door all night. Now there was no chips back then but the visiting nurse did suggest that I LOCK her in her bedroom during the night...She had her own bathroom that was connected to her bedroom so using the bathroom wouldn't have been a problem. Do you think I locked my mother in her bedroom? Heavens, I hope someone would have locked me up some where if I had done such a thing. But, we made it through it. for more than a decade we made it with no chips and no locking her up any where.

Maybe Im not understanding all of this. Are you saying that patients show up in the ER and NO family comes with them to give the hospital information? If so, well that should be a crime right there. Put a chip in the family members so you can locate them when you need them.

Steve, CEO PassportMD said...

I do think if the chips function properly and they are demonstrated to be reliable than in that patient population , I believe it is reasonable. The breakdown with that system is inevitably on the reader side... as readers need to be available wherever that implanted patient shows up. Another alternative to MedicAlert and chip implantation, is a free service for the company I founded several years ago. PassportMD is a free web based online health record that is password accessed and always available online. Baby boomers and children of Alzheimer inflicted parents..can enter and control their parents health records, living will and other important life information via the internet and thus from any location. There are many products and services available out there similar to PassportMD , although most are not free, but the point is that services like PassportMD still enable physicians and hospitals to access someones health history and record without the contoversy of implanting a chip or the burden of insuring that a reader for the chip will be wherever the implanted patient turns up. Ultimately, all of these services benefit the healthcare consumer, and I believe server society's interests.

Steven M Hacker MD
Founder & CEO
PassportMD, Inc

Anonymous said...

Nationalhealthcare. EMR. This is part of the same phenomenon.Everyone being tagged. It can't be assumed that this information will be used only for good or for medical reasons.It is not a good thing.Carry the info with you if you must but the citizens must take some responsibility or it all will be done for us.

coaster1robert said...

Well,I agree with the Doc,it would be helpful for them,it's the government we all worry about,can we trust them? as you can see when it comes to our country,and illegal, not always.It should be choice whether to implant.
Robert

NeoNurseChic said...

The Medic Alert e-health key does the same thing, as far as providing all of the info you are describing in your comment there, Dr. A., without being implanted in your body. Granted, I realize something like this can get lost, but still, I find this preferable to the idea of someone implanting some tracking device in my body. (I know it's not really a tracking device, but who's to say it won't get to that point?)

I can just hear the news broadcasts now: "Today the FDA reports that the *such and such brand* implant to identify personal information and keep track of life-saving medical data has now been found to cause cancer." or "Recalls are now happening on the implant because it has been found to leak radioactive dyes into the skin, causing severe health problems" and so on and so forth. And what happens if you have to go through the metal detector at the airport? Is it like the rest of implants...can't do that anymore?

I realize that I'm being dramatic about it and giving hypotheticals that would probably never happen, but how often do we hear about bad things that happen with inventions/innovations that were thought to be great at the time? Daily.

I just don't like this concept personally. I think there are a lot less-invasive methods out there....we have all kinds of technology and never hesitate to carry around cell phones, pagers, PDAs, iPods, and so on - how hard is it to put a little USB key flash drive on your keychain?

My 0.02. Take care!
Carrie :)

Marilyn said...

My Mother-in-law was temorarily in a nursing home for a while and it is obvious to me that there is a communication problem between the nursing homes and all of the medical care providers involved. It doesn't seem to be limited to this one nursing home.

The chip seems like a handy solution but the public will never go for it. This is still a big problem that isn't being solved by medic alert bracelets.

whispers said...

I honestly don't see why not. If it ensures quicker and safer treatment for those who are unable to speak for themselves.

ERC said...

I think it is a good idea. My hubby has a MedicAtlert Dog tag, cards in his pocket with his ICD serial #'s and the MedicAlert card that lists all his meds. I've thought about doing the MedicAlert USB records but that is something to keep up with, hope the medics find it and hope the hospital can read it. While I'm all for the MedicAlert Dog Tag, it seems if he had something electronic and that was readable at all hospitals, it would be beneficial and speed up the process.

My hubby has COPD and CHF with an EF=15% so, god forbid,when something does happen and if I'm not with him, the Medical folks will need all the info they can get and quick.

My only concern now is that if he needed a medic & I wasn't around, how do I let them know which hospital to take hubby? Some hospitals in our area are not equipped to deal with someone like him.

muddy said...

No thanks. I would not have one implanted in me. I carry a medical alert card of sorts that all of my immediate family know about that lists medications I am on, my allergies and conditions. Rarely do I travel, rarely am I without a family member with me. I have considered a medical id bracelet-but most are very expensive and ugly (though I have seen the ones mentioned above that are "cute"). At this point, I prefer not to wear one. I dont think that the trade off of whoever treating me having the convenience of what he might gain from an implant outweighs my own personal desire to not walk around with one in my body. I trust God that He will keep me alive if that is His purpose, or call me home if He wills otherwise. Neither of these situations depend on a medical chip.

I thought that part of the reasons medical professionals were now requesting social security numbers was to streamline the information stored about you. That's what we were told here in NC anyway...in particular at Duke University Hospital.

Fucc said...

ethic or not...for me is an important step the we must done. yes problably are a little invasive...but think about people sick...with a chip implant they can be monitored constanlty...
http://fucc.blogspot.com

Priscilla said...

With increased power and technology, always brings with it, increased ethical dilemnas that are not remotely as liberating as the original purpose of the proposition. Remember, what CAN be done, cannot necessarily be MANDATED to occur as a higher standard, for EVERYONE... Individual preference must ALWAYS be considered to appropriately address patient needs, in nearly EVERY patient care issue!

Best patient care is definitely a goal, but the equation is much more complex than the factors that can easily be considered.

bracelets, keychains, etc...THAT doesn't sound as though it has negative repurcussions.
People are so much more than the data than can be contained in the chip, and the best patient care will always include treating the WHOLE person, in a human and humane way, first...

implanting a chip into a person raises astronomically, more dillemnas than those that it addresses, and is by far not worth it even with the obvious benefits discussed here.

priscilla said...

Can you honestly say, Doc A, that this idea does not bother you? Just a question; do you think this may breed even MORE of a sense of impersonal facelessness in patient care...and though in emergency situations that concept may bring relief, would it not also create more questions to answer than it actually solves?

Priscilla said...

I wonder why my web page is not posting: www.myspace.com/priscillastrange
just my personal site

Anonymous said...

Well I reckon it is a great idea. Some people always go stupid over new ideas; remember when microwave ovens first became available for domestic homes (having been used commercially for years) and people thought they were going to be radioactive if they used them?
I've never heard of any animal having an adverse effect from a microchip, and there is no reason whatsoever they would do anything to humans.

Anonymous said...

you reckon? sounds like a well-thought out rebuttal...
do you not remember the Holocaust, and how putting that much power to control other people, in human hands, just might have negative repurcussions? What about Privacy? Does that have value to you? There should be reasonable limits to what we do to keep track of people.

CreditGal said...

I would not like some foreign matter living under my skin. A better was is to use a bracelet or other possible variants.