Wired patients Notes 1. National Science Foundation and Department of Commerce. Converging Technologies for Im- proving Human Performance: Nanotechnology, Biotechnology, Information Technology, and Cognitive Science. Arlington, Virginia: NSF/DOC; 2002. aim of this paper is to identify present and near-future uses(10-15 years) of implantable microchips and biosensors and to examine their implications for patient care. This, of course, does not mean that there are not other important philosophical and metaphysical questions or long-term consequences surrounding the use of implantable microchips and biosensors, for example, nanotechnology, transhumanism, and the creation of self-replicating cybernetic organisms. For an interesting discussion of these topics, see Hooks CC. Cybernetic and nanotechnology. In: Cutting-Edge Bioethics: A Christian Exploration of Technologies and Trends, Grand Rapids, MI: W.B. Eerdams: 200 3. This taxonomy is not the only possible taxonomy, as some microchips and biosensors have nultiple functions. The purpose of this particular taxonomy is simply to provide some conceptual and organizational framework for the ethical analysis of these new technologies and their applications. 4. Kennedy PR, Bakay RAE. Restoration of neural output from a paralyzed patient by direct brain connection. NeuroReport 1998; 9(8): 1707-11. For more background on the history of brain implants, see Maguire GQ, McGee EM. Implantable brain chips? Time for debate. Hastings Center Report 1999; 29(1): 7-13 5.Cnn.comBrainimplantdevicesapprovedfortrialsAvailableathttp://www.webmd.com, stroke/news/20040415/brain-implantsandhttp://www.cis.upenn.edu/-bracy/brain/. 6 FormoreinformationonMedtronicandtheMedtronicnetworkseewww.medtronic.com. 7. For more on the ethics of PDAs, see De Ville KA. The ethical implications of handheld medical computers in medicine. Ethics Health Care 2003: 6(1): 1-4. 8. Bauer KA. Home-based telemedicine: A survey of ethical issues. Cambridge Quarterly of Health care ethics2001;10(2:137-46 9. In the case of the elderly, externally worn transmitters and GPS are currently being used to monitor and track loved ones who su m Alzheimer's disease and other forms of dementiaFormoreonthisseehttp:// techbot. com/p-02876 html 10. Ritchtel M. Voices in your head? Check in your arm. New York Times 2002: Novem ber 10 11. National Science Foundation and Food and Drug Administration. Report of the Workshop on Home Care Technologies for the 21st Century. Rockville, MD: NSF/FDA; 1999 12. There is some concern that these new technologies would only be available to those persons who can afford them and, subsequently, lead to greater disparities in healthcare. This is a ossibility. On the other hand, the use of such technologies could prove to be a less expensive way for healthcare centers and the state to provide healthcare services to more people. On the patient side, the use of these technologies could create less expensive and less burdensome ways for patients to obtain healthcare. This, of course, is not a question that can be answered a priori but rather an empirical issue that will need to be tested. 13. Although medicine in general has for many years placed an emphasis on prevention, the success of this emphasis is less than complete. Moreover, in the case of emergency medicine, its very nature as a reactive specialization makes prevention very difficult. Implants, however, may be able to change this, at least in a limited way. 14. Vicente K. The Human Factor: Revolutionizing the Way Pe ve with Technology. New York: Routledge Press: 2004. 15. Needless to say, all patients should be viewed as bio-psycho-social beings, as persons, not just bodies. Unfortunately, for a variety of reasons, not all healthcare professionals view their patients this way. Geographically distant and electronically mediated provider-patient inter- actions could exacerbate this undesirable behavior 16. For information on the federal rules for governing investigational devices, see the Code of Federal Regulations, CFR 21, Part 812. This information can be obtained by searching the U.S. Food and Drug Administration's Web site 17. Evans H. High-tech vs"high touch": The impact of medical technology on patient care. In Clair M, Allman R, eds Sociomedical Perspectives on Patient Care, Lexington, KY: The University Press of Kentucky: 1993Notes 1. National Science Foundation and Department of Commerce. Converging Technologies for Im￾proving Human Performance: Nanotechnology, Biotechnology, Information Technology, and Cognitive Science. Arlington, Virginia: NSF/DOC; 2002. 2. The primary aim of this paper is to identify present and near-future uses (10–15 years) of implantable microchips and biosensors and to examine their implications for patient care. This, of course, does not mean that there are not other important philosophical and metaphysical questions or long-term consequences surrounding the use of implantable microchips and biosensors, for example, nanotechnology, transhumanism, and the creation of self-replicating cybernetic organisms. For an interesting discussion of these topics, see Hooks CC. Cybernetics and nanotechnology. In: Cutting-Edge Bioethics: A Christian Exploration of Technologies and Trends, Grand Rapids, MI: W.B. Eerdams; 2002. 3. This taxonomy is not the only possible taxonomy, as some microchips and biosensors have multiple functions. The purpose of this particular taxonomy is simply to provide some conceptual and organizational framework for the ethical analysis of these new technologies and their applications. 4. Kennedy PR, Bakay RAE. Restoration of neural output from a paralyzed patient by direct brain connection. NeuroReport 1998;9(8):1707–11. For more background on the history of brain implants, see Maguire GQ, McGee EM. Implantable brain chips? Time for debate. Hastings Center Report 1999;29(1):7–13. 5. CNN.com. Brain implant devices approved for trials. Available at: http://www.webmd.com/ stroke/news/20040415/Brain-Implants and http://www.cis.upenn.edu/
bracy/brain/. 6. For more information on Medtronic and the Medtronic network, see www.medtronic.com. 7. For more on the ethics of PDAs, see De Ville KA. The ethical implications of handheld medical computers in medicine. Ethics & Health Care 2003;6(1):1–4. 8. Bauer KA. Home-based telemedicine: A survey of ethical issues. Cambridge Quarterly of Health￾care Ethics 2001;10(2):137–46. 9. In the case of the elderly, externally worn transmitters and GPS are currently being used to monitor and track loved ones who suffer from Alzheimer’s disease and other forms of dementia. For more on this, see http://www.politechbot.com/p-02876.html. 10. Ritchtel M. Voices in your head? Check that chip in your arm. New York Times 2002; Novem￾ber 10. 11. National Science Foundation and Food and Drug Administration. Report of the Workshop on Home Care Technologies for the 21st Century. Rockville, MD: NSF/FDA; 1999. 12. There is some concern that these new technologies would only be available to those persons who can afford them and, subsequently, lead to greater disparities in healthcare. This is a possibility. On the other hand, the use of such technologies could prove to be a less expensive way for healthcare centers and the state to provide healthcare services to more people. On the patient side, the use of these technologies could create less expensive and less burdensome ways for patients to obtain healthcare. This, of course, is not a question that can be answered a priori but rather an empirical issue that will need to be tested. 13. Although medicine in general has for many years placed an emphasis on prevention, the success of this emphasis is less than complete. Moreover, in the case of emergency medicine, its very nature as a reactive specialization makes prevention very difficult. Implants, however, may be able to change this, at least in a limited way. 14. Vicente K. The Human Factor: Revolutionizing the Way People Live with Technology. New York: Routledge Press; 2004. 15. Needless to say, all patients should be viewed as bio-psycho-social beings, as persons, not just bodies. Unfortunately, for a variety of reasons, not all healthcare professionals view their patients this way. Geographically distant and electronically mediated provider–patient inter￾actions could exacerbate this undesirable behavior. 16. For information on the federal rules for governing investigational devices, see the Code of Federal Regulations, CFR 21, Part 812. This information can be obtained by searching the U.S. Food and Drug Administration’s Web site. 17. Evans H. High-tech vs “high touch”: The impact of medical technology on patient care. In: Clair M, Allman R, eds. Sociomedical Perspectives on Patient Care, Lexington, KY: The University Press of Kentucky; 1993.


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