Nanotechnology is one of several fronts on which technological development is proceeding at a pace that seems to exceed the capacity of human political institutions to come to terms with the challenge of striking a balance between the practical benefits it has to offer and the potential threat to our traditional notions of personal autonomy and privacy. The applications that are being developed in the field of health care are a striking example.
‘Smart pills’ with chips, cameras and robotic parts raise legal, ethical questions
As the size and cost of chip technology has fallen dramatically over the past few years, dozens of companies and academic research teams are rushing to make ingestible or implantable chips that will help patients track the condition of their bodies in real time and in a level of detail that they have never seen before.
Several have been approved by the Food and Drug Administration, including a transponder containing a person’s medical history that is injected under the skin, a camera pill that can search the colon for tumors, and the technology, made by Proteus Digital Health, that Snodgrass is using. That system is being used to make sure older people take their pills; it involves navigating a tablet and wearing a patch, which some patients might find challenging.
But while the technology may be within reach, the idea of putting little machines into the human body makes some uncomfortable, and there are numerous uncharted scientific, legal and ethical questions that need to be thought through.
What kind of warnings should users receive about the risks of implanting chip technology inside a body, for instance? How will patients be assured that the technology won’t be used to compel them to take medications they don’t really want to take? Could law enforcement obtain data that would reveal which individuals abuse drugs or sell them on the black market? Could what started as a voluntary experiment be turned into a compulsory government identification program that could erode civil liberties?
Every six months I have to get up and go to the lab for fasting blood tests without even a cup of coffee. While understanding the medical necessity of that, I am inclined to experience it as a fundamental personal indignity. I have often thought that if I won the loto I would hire a nurse to show up at my door and draw my blood while I was sitting here in my bathrobe. Now there is a real prospect of all that becoming antiquated technology with tiny robots implanted in my body providing far more information with far less immediate personal inconvenience. But as with most benefits there are risks.
Certainly there are medical risks. More conventional medications and treatments all carry risks and side effects. Drugs that are powerful enough to alter biological processes have the potential for doing harm to some people. It is often not possible to know in advance which people are susceptible to serious side effects. That always raises questions about the wisdom of putting people on medications for preventive management of potential problems or waiting until someone is already seriously ill. The use of statin drugs for the management of cholesterol is a controversy in point.
Medical devices that record and report data about internal bodily functions also raise privacy issues. Medical information is widely regarded as very personal and private in nature and there is a body of law to protect the confidentiality of it. Health care is about the only area in which the federal government has established something like comprehensive privacy regulations for electronic records. However, we are increasingly aware that the internet is really not a secure environment. The question seems to be whether the government or private hackers will be the first to get their electronic mits on your personal data. When data about the state of your innards is being passed over the internet, you really can't be entirely certain that it is secure.
However, if I had to chose between letting the CIA know what I had for dinner the night before and going to the lab without coffee, I would definitely let the spooks have their wicked way with me.