Keith a. bauer As it stands, the security of standard phone lines, much of the Internet, and wireless transmissions is not within the power of individual healthcare pro- fessionals. The overall security of our telecommunications infrastructure in- olves, for example, federal and state governments, encryption technologies, and hospital policies about who can access patient information. Maintaining the security and confidentiality of patient data in modern medicine is increas- ngly becoming a systemic task that no one healthcare professional can achieve for his own patients. The expanded use of implantable microchips and bio sensors will only make this task more difficult. Hence, it may be misguided to impose a duty of confidentiality on healthcare professionals when it is not within their power to do so. If I am correct on this point, the use of im- plantable microchips and biosensors, in conjunction with telecommunication hnologies, will contribute further to changing what is an ethical corner tone of provider-patient relationships: the duty to maintain the confidential of their patients. In the end, augmented use of implantable microchips and biosensors is very likely to make the protection of patient confidences less of a duty for individual providers and more of a duty for healthcare institutions and government. Conclusion My goal in this paper has been to identify and examine some of the ethical and social issues associated with the use of implantable microchips and biosensors in patient care. I provided a taxonomy of three broad functions performed by these devices-prosthetic, monitoring, and enhancement-and explored two likely and desirable consequences of these devices for patients and our healthcare system, the first, that microchips and biosensors are likely to support independent living and facilitate continuum of care; the second, that increased use of these devices is likely to make healthcare professionals and the healthcare system more proactive and preventative, rather than reac tive and episodic I also looked at some of the concerns about the quality of care that implanted patients will receive. First, I discussed that before these devices are adopted for use on a wide scale more human factors research is necessary. Second, we need to recognize that implants, especially when linked with other kinds of infor- mation and communication technologies, could have a deleterious impact on traditional provider-patient relationships. In particular, the use of these devices could make a healthcare professional's duty of confidentiality harder to fulfill and thereby further alter what many consider to be the ethical bedrock of provider-patient relationships n closing, I want to reemphasize that the real power of todays implantable microchips and biosensors to transform patient care, whether for better or worse, is not simply their implantation into the human body. Rather, the real power and significance of these devices is their capacity to"wire" patients to a ast, external information and telecommunications network. That is, as these devices are integrated into the human body, the human body itself is more fully Integrated into its various environments. Hence, by transforming the human in the worldAs it stands, the security of standard phone lines, much of the Internet, and wireless transmissions is not within the power of individual healthcare pro￾fessionals. The overall security of our telecommunications infrastructure in￾volves, for example, federal and state governments, encryption technologies, and hospital policies about who can access patient information. Maintaining the security and confidentiality of patient data in modern medicine is increas￾ingly becoming a systemic task that no one healthcare professional can achieve for his own patients. The expanded use of implantable microchips and bio￾sensors will only make this task more difficult. Hence, it may be misguided to impose a duty of confidentiality on healthcare professionals when it is not within their power to do so. If I am correct on this point, the use of im￾plantable microchips and biosensors, in conjunction with telecommunication technologies, will contribute further to changing what is an ethical corner￾stone of provider–patient relationships: the duty to maintain the confidential￾ity of their patients. In the end, augmented use of implantable microchips and biosensors is very likely to make the protection of patient confidences less of a duty for individual providers and more of a duty for healthcare institutions and government. Conclusion My goal in this paper has been to identify and examine some of the ethical and social issues associated with the use of implantable microchips and biosensors in patient care. I provided a taxonomy of three broad functions performed by these devices—prosthetic, monitoring, and enhancement—and explored two likely and desirable consequences of these devices for patients and our healthcare system, the first, that microchips and biosensors are likely to support independent living and facilitate continuum of care; the second, that increased use of these devices is likely to make healthcare professionals and the healthcare system more proactive and preventative, rather than reac￾tive and episodic. I also looked at some of the concerns about the quality of care that implanted patients will receive. First, I discussed that before these devices are adopted for use on a wide scale more human factors research is necessary. Second, we need to recognize that implants, especially when linked with other kinds of infor￾mation and communication technologies, could have a deleterious impact on traditional provider–patient relationships. In particular, the use of these devices could make a healthcare professional’s duty of confidentiality harder to fulfill and thereby further alter what many consider to be the ethical bedrock of provider–patient relationships. In closing, I want to reemphasize that the real power of today’s implantable microchips and biosensors to transform patient care, whether for better or worse, is not simply their implantation into the human body. Rather, the real power and significance of these devices is their capacity to “wire” patients to a vast, external information and telecommunications network. That is, as these devices are integrated into the human body, the human body itself is more fully integrated into its various environments. Hence, by transforming the human body internally, we also transform externally how individuals interact and live in the world.


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