Wired patients nologies, such as standard telephone lines and the Internet, on which some im- plantable microchips and biosensors will rely will also require testing for reliability and usability, as well as security. Until we have a better understanding of the usability and reliability of implantable microchips and biosensors, especially when they are integrated into a larger telecommunications network, the quality of care that implanted patients receive will remain in question Provider-Patient Relationships Worries about the impact of medical technology on provider-patient relation- ships and patient care are not new, nor only the result of high-tech medical devices. Many physicians, for example, initially rejected the stethoscope be cause they believed that the distance it created between them and their patients would undermine the quality of patient care. For these physicians, good medical practice demanded they have direct physical contact with their pa tients, whether it be a hand on a patient's fevered brow or an ear on his congested chest lead to more or less involvement with patients by healthcare providers? will greater self-care be required of patients who are fitted with implantable computer chips and bic iosensors? Will these technologies along with increases in electronically mediated interactions impede the development of empathy and compassion between patients and healthcare providers? In more general terms, is the art of healthcare being swallowed up by the science of health care, which is a proclivity for technological fixes rather than personal, human engagement? 8 In addition to the above concerns, one long-held duty that is central to the provider-patient relationship and likely to be altered by the use of implantable microchips and biosensors is the provider's duty to maintain patient confiden- tiality. The duty to maintain patient confidences has roots that stem from the Hippocratic tradition. The duty of confidentiality is significant because it allows patients to divulge physical and psychological information about them ing and socially stigmatizing, will not be shared with others. In sharing rsonal information, patients are able to provide healthcare professionals with the information necessary for making accurate diagnoses and for prescribing appropriate and effective treatments But the duty to maintain patient confidentiality is likely to become more difficult, if not impossible, for healthcare pr rofessionals w hen patient data is being automatically monitored and collected by implantable microchips and biosensors and automatically transmitted over airwaves and phones lines by intelligent software agents. 0 In such a healthcare environment, ought it to be the responsibility of healthcare professionals to guarantee the security of the Insecured phone lines and wireless devices that implantable microchips and biosensors will use to transmit and to store patient data? Before answering this estion, however, we need to ask and answer a more basic question: Are ealthcare professionals who use these devices able to give such guarantees?nologies, such as standard telephone lines and the Internet, on which some im￾plantable microchips and biosensors will rely will also require testing for reliability and usability, as well as security. Until we have a better understanding of the usability and reliability of implantable microchips and biosensors, especially when they are integrated into a larger telecommunications network, the quality of care that implanted patients receive will remain in question. Provider–Patient Relationships Worries about the impact of medical technology on provider–patient relation￾ships and patient care are not new, nor only the result of high-tech medical devices. Many physicians, for example, initially rejected the stethoscope be￾cause they believed that the distance it created between them and their patients would undermine the quality of patient care.17 For these physicians, good medical practice demanded they have direct physical contact with their pa￾tients, whether it be a hand on a patient’s fevered brow or an ear on his congested chest. Today, similar worries and questions abound over the use of implantable microchips and biosensors. Will implantable computer chips and biosensors lead to more or less involvement with patients by healthcare providers? Will greater self-care be required of patients who are fitted with implantable computer chips and biosensors? Will these technologies along with increases in electronically mediated interactions impede the development of empathy and compassion between patients and healthcare providers? In more general terms, is the art of healthcare being swallowed up by the science of health￾care, which is a proclivity for technological fixes rather than personal, human engagement? 18 In addition to the above concerns, one long-held duty that is central to the provider–patient relationship and likely to be altered by the use of implantable microchips and biosensors is the provider’s duty to maintain patient confiden￾tiality. The duty to maintain patient confidences has roots that stem from the Hippocratic tradition.19 The duty of confidentiality is significant because it allows patients to divulge physical and psychological information about them￾selves with the confidence of knowing their revelations, sometimes embarrass￾ing and socially stigmatizing, will not be shared with others. In sharing personal information, patients are able to provide healthcare professionals with the information necessary for making accurate diagnoses and for prescribing appropriate and effective treatments. But the duty to maintain patient confidentiality is likely to become more difficult, if not impossible, for healthcare professionals when patient data is being automatically monitored and collected by implantable microchips and biosensors and automatically transmitted over airwaves and phones lines by intelligent software agents.20 In such a healthcare environment, ought it to be the responsibility of healthcare professionals to guarantee the security of the unsecured phone lines and wireless devices that implantable microchips and biosensors will use to transmit and to store patient data? Before answering this question, however, we need to ask and answer a more basic question: Are healthcare professionals who use these devices able to give such guarantees? 21


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