AMA Endorses Microchipping

Tim Post

Thu Jun 28 03:33:35 -0700 2007

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I don't think they're seeing the picture as a whole. Those devices are read by computers that are regulated to be tamper proof. This means, you can't change the code or limit the manufacturer's access to it if it can talk to a public network.

Many new devices are being designed so that they can and should talk to a public network, so that doctors could look in on patients from anywhere. The problem is, so can whoever made that device.

There is no significant legislation surrounding this, requirements that should exist do not. I'm not arguing RFID, I'm saying we're arguing the wrong thing. Doctors should first see clearly the technical implications of tamper proof devices. Only then can they talk about peripherals.

A really little cart just went in front of a really big horse.

AMA Endorses Microchipping

Michael Smith

Thu Jun 28 05:26:23 -0700 2007

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The system will work, regardless of whether the tag is embedded in your body, or stored in an RFID proof wallet.

They should make it open and hackable, like the bracelets which some people carry. Your doctor should be signing his entry in the tag with a public key, so that its validity can be checked when it is used.

You are right about the cart being before the horse. Lets talk about the information, rather than the hardware.

AMA Endorses Microchipping

Tim Post

Thu Jun 28 05:47:54 -0700 2007

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I'm not so sure they can be discussed at the same time, which sucks. I really want to see these things with better classification. Currently, devices lumped under the same class really shouldn't be, wandering patient monitors are one of the posterboys for this since the human never comes in contact with an energized device.

My worry is, can the patient erase the information at will? Then how about accidentally? What if the information is inaccurate, or someone else's info?

Since these fall under the same generic tamper proofing laws, it means that the manufacturer can retain the right to screw up the machine (sorry, update the machine) remotely.

If they mess up, every effort the doctor made to protect privacy might go down the tubes.

We should be talking about the information, I do agree. But I think we should be talking about the hardware at the same time. This is strange, because I don't think the conversations _can_ be 'combined' , but they need to progress equally and independently in a matter that they agree at the end.

While these things are regulated by what they are rather than what they do, this will be a problem.

AMA Endorses Microchipping

Thornton

Thu Jun 28 05:17:53 -0700 2007

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Holy crap. Do they think we're cattle?

AMA Endorses Microchipping

Tim Post

Thu Jun 28 05:49:30 -0700 2007

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I think the laws that regulate these things would best serve cattle. I think this is just a symptom of that.

AMA Endorses Microchipping

bill_mcgonigle

Thu Jun 28 18:37:50 -0700 2007

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It's not as important to capture every potential billable event with cattle.

The good, the bad...

wowbagger

Thu Jun 28 07:30:19 -0700 2007

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First of all, it depends upon whether this chip is actual information storage, or just an ID. If the chip is nothing more than an N-bit unique ID number, which then must be looked up in a database to gain the patient's chart, then this is not really useful unless you have a (potentially world-wide) database that all doctors, ER personnel, and first responders can gain instant access to - and that leads to all sorts of HIPPA and other security concerns.

However, when my cell phone's microSD card is smaller than my pinkeynail, and stores a gigabyte of data, the question of "why cannot the implanted device contain most of my medical history?" becomes relevant - if I fall down unconscious in a public place, and the first responders can query my medical history for heart trouble, allergies, and history of syncope, then they can better know what to do (or rather, what NOT to do). However, this ALSO raises the issues of privacy and security.

Obviously, if my chip only gives my Universal Medical ID number (which will never, ever be used as a government ID number, we swear) (shades of social security numbers) then all a potential bad guy gets by scanning me is who I am - he then has to access the Universal Medical Database to get anything interesting, and (snicker) hopefully it will be slightly more secure (cough, cough, bullshit, cough).

However, there are some good reasons to move in this sort of a direction. One of the members of my amateur radio club gave a presentation on what he did: he has a thumb drive with copies of his full chart on it, as PDFs. He carries this around his neck wherever he goes. He had already had a heart attack and bypass surgery, and he felt this was a good thing to have.

One day, while traveling on business in another state, he had another heart attack. He was rushed to the ER and admitted - thankfully for him still conscious. The told the ER personnel about the stick, and the doctor popped it into a computer and started looking. "Oh, good - so THAT'S what has been bypassed. OK, using that kind of stent... there's the previous infarcted areas... drug history.... OK, let's do this" and they immediately went to work on him, without having to do a bunch of tests just to identify what was what.

The presenter then went on to describe that, while recovering in the ICU, he was talking to another person in a similar state - emergency admission while out of town. That guy's chart was a couple of pieces of paper, the presenter's chart was a folder an inch thick, with all the previous data printed out. The doctors were VERY glad to have that data, as it really helped them treat the patient.

Of course, when he was discharged, he asked for (and got) all the data from the hospital, and added that to the thumb drive.

Now, I raised the issue of identity theft during the presentation, and the presenter admitted there was an issue, but he felt that since the thumb drive was always on his person, the risks were no larger than any other risks. (I disagree, but....)

So perhaps it might be good to have such a chip, IF it is cryptographically secure, IF the data on it is accessible to the implantee, IF there is no way the chip can be read without the implantee knowing about it (e.g. physical contact needed, reading time guaranteed to be longer than a couple of seconds, all accesses logged, etc.).

However, it STILL scares the Little Friskeys out of me that this sort of thing is happening....

THIS IS YOUR IDENTITY DISK....

The good, the bad...

ScrappyLaptop

Thu Jun 28 11:02:48 -0700 2007

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Now that would be wonderful: a physical appearance and data standardized  'micro' thumbdrive that is worn on a  lanyard  or bracelet...voluntary to wear, encrypted in case lost and instantly readable by emergency help.  THAT is what the AMA should be studying, not a system that has the possibility of physical harm to the patient, requires a medical procedure to implement and can be read without physical contact.  Of course, if each person physically carried their own medical history then the Hospital would have a much harder time controlling access and enforcing ownership of said records.

Not to sound paranoid, but when you put all the tiny little pieces together over the last few years, it sounds like the AMA is progressing well on it's way to claiming ownership...oops, I mean 'stewardship'...uh, make that 'guardianship'  (ah, that sounds benevolent enough)  of people's bodies.  Almost like the organization has been influenced by the folks that already claim 'ownership' of the DNA in those bodies, but that's another rant altogether.

The good, the bad...

David Leppik

Thu Jun 28 11:23:43 -0700 2007

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I agree. It makes me nervous, but I am in good health. Next week I could have a heart attack or a stroke, and I'd want one of those-- I wouldn't care if the FBI, KGB, CIA, or Al Quieda could read it-- another heart attack would kill me quicker. The important thing would be that I get to decide.

I already carry around a device all the time that can track me remotely wherever I go. It's called a cell phone. I'm none too happy to be carrying a tracking device, but so far the reward has been worth the risk. It's also optional and removable. But if I suddenly started turning it off at certain times or places, that too would be information that could be used for nefarious purposes. So I can be monitored by it whether I carry it or not.

I'm not opposed to RFID for nursing home patients, especially those with certain mental illnesses. They are already limited to being at a particular location for the rest of their lives, so their physical location isn't a practical secret. Nor are their medical records a secret to those who could read the RFID. In that case, the chip only serves to allow the medical electronics to recognize a person whom the nurse on staff should also recognize.

But that case is far removed from the FBI being able to, for example, electronically identify everyone in attendance at a protest. I think there's enough difference to have implanted RFIDs used for good and not evil.

AMA Endorses Microchipping

ScrappyLaptop

Thu Jun 28 08:34:29 -0700 2007

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I believe this may be the report referenced:

www.ama-assn.org/ama1/pub/upload/mm/467/ceja5a07.doc

Found using the following Google search term:

site:www.ama-assn.org RFID

With Firefox User Agent set to:

Googlebot/2.1

There  appear to be about two pages of results for 'RFID', but most are documents discussing the original 2006 motion-to-study; this document (ceja5a07.doc) appears to be the 2007 results, titled, 'REPORT OF THE COUNCIL ON ETHICAL AND JUDICIAL AFFAIRS' .

My guess is that since it is in the 'uploads' folder, it hasn't been published yet.  I'd also like to caution that it also could be slated for review, editing, or even thrown out for being submitted but not in line with AMA policies or just put in that folder as a joke; without context we just don't know.  Still, it kind of follows the recent AMA decision that it's okay to use experimental procedures and drugs on people unable to give their consent (i.e., not conscious) as part of helping the drug companies with their research...