Comments
asdf • December 11, 2017 8:37 AM
Reminds me of a The Onion panel video titled “Is the Government Spying on Schizophrenics Enough?”
In the video, they raise increasingly invasive suggestions for psych patient care haha.
keiner • December 11, 2017 8:40 AM
“Patients who agree to take the digital medication, a version of the antipsychotic Abilify, can sign consent forms allowing their doctors and up to four other people, including family members, to receive electronic data showing the date and time pills are ingested.”
This whole thing is megabullshit. People needing a potent antipsychotic can NEVER EVER “sign” any “consent form” or “agree” to anything like that. Will hopefully never approved in the EU (at least Germany, I think, can never accept something like that, based on patient laws/data protection laws).
Just a cheap try to reduce costs on psych wards and produce more bullhit data to incapacitate people/patients…
vas pup • December 11, 2017 8:44 AM
I guess as any technology could be used or abused.
Same pill for old folks to confirm they actually took prescribed medication (no doubts – objective confirmation) as well as for contraceptive pills (confirmation could be sent to both partners – no ‘games’).
me • December 11, 2017 9:05 AM
from the article: FDA notes that the drug’s maker has not shown that people using the special pill are more likely to take their drugs.
also what if i place it in a cup of water? it incorreclty say that i have taken it?
also… “secure web portal” mmmm….
Petre Peter • December 11, 2017 10:02 AM
Remember! i am willing to share my info w/o a privacy policy only for convenience and security. Problem is i cannot figure out if healthcare is part of security or safety because intentions are difficult to asses: did i know that sugar excess can cause diabetes; did i know that the medicine withdrawal can kill me. Portable computers are great for looking at data in new ways but they cannot report things like temperature, and blood pressure. Such readings can only be done from inside the body. If I agree that i trust my Doctor with my life, then i trust my doctor with my privacy. i would take the pill as long Z it comes in two colors: red or blue. Also, the FCC must fix the shareable calendar mess because i would never buy a phone that can only call certain numbers (network).
Hospital It Security • December 11, 2017 10:12 AM
Doctors are not infallible. Too often I see patients agree to treatments they do not want or need because the health provider holds hostage other meds they need by refusing to renew Rx unless the patient agrees.
Just another chink in the armor of privacy.
echo • December 11, 2017 10:29 AM
While this kind of tool can be very useful I believe questions do arise about the ehtics and use these devices may be put to.
@Hospital It Security
Under EU case law it is unlawful to attach preconditions to receiving medically necessary healthcare. In practice I have discovered dogmatic or inadequately trained doctors can attach unecessary preconditions, or “medicalise” a difference of opinion by conducting unecessary examinations or creating prodedural delays which is also unlawful. The paper trail often does not record sufficient detail to detect this often by omission and sometimes by reframing and implying the patient is irresponsible.
In the UK at least it is not unlawful for a citizen to use a covert recording device. (Some legal caveats apply such as responsible disclosure, typically the recording is retained solely for consideration by the courts not unjustified publication.) Within the NHS policy now exists, in line with legislation and even the treacle like progress of banks, empowers patients to make notes or request other reasonable adjustments for disability. A recording device fits within this criteria. However, doctors can proceed with a business as usual attitude or even threaten patients or decline to proceed when the patient asserts their rights in law.
I have copies of minutes obtained under Freedom of Information law, policy citations, and logs and audio recordings to substantiate this claim. I also have copies of studies and NHS internal investigations which add additional proof.
Marcus • December 11, 2017 11:09 AM
@echo
At least in the US, physicians have a right to decline treatment (with just a few exceptions).
If a woman want birth control pills and she is an active smoker, a doctor can refuse to write the prescription.
If I smoke, am overweight and hypertensive, a doctor can refuse to see me if I don’t follow his recommendations to lose wight and stop smoking.
A doctor can refuse to see you if you don’t pay your bill.
Your rights as a patient stop when they interfere with the doctor’s rights.
Bob Paddock • December 11, 2017 11:36 AM
FDA approves pill with sensor that digitally tracks if patients have ingested their medication
New tool for patients taking Abilify
FDA approves Abilify MyCite, a pill with a sensor that digitally tracks if patients have ingested their medication
Release
The U.S. Food and Drug Administration today approved the first drug in the U.S. with a digital ingestion tracking system. Abilify MyCite (aripiprazole tablets with sensor) has an ingestible sensor embedded in the pill that records that the medication was taken. The product is approved for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder and for use as an add-on treatment for depression in adults.
The system works by sending a message from the pill’s sensor to a wearable patch. The patch transmits the information to a mobile application so that patients can track the ingestion of the medication on their smart phone. Patients can also permit their caregivers and physician to access the information through a web-based portal. “Being able to track ingestion of medications prescribed for mental illness may be useful for some patients,” said Mitchell Mathis, M.D., director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research. “The FDA supports the development and use of new technology in prescription drugs and is committed to working with companies to understand how technology might benefit patients and prescribers.”
It is important to note that Abilify MyCite’s prescribing information (labeling) notes that the ability of the product to improve patient compliance with their treatment regimen has not been shown. Abilify MyCite should not be used to track drug ingestion in “real-time” or during an emergency because detection may be delayed or may not occur. Schizophrenia is a chronic, severe and disabling brain disorder. About 1 percent of Americans have this illness. Typically, symptoms are first seen in adults younger than 30 years of age. Symptoms of those with schizophrenia include hearing voices, believing other people are reading their minds or controlling their thoughts, and being suspicious or withdrawn. Bipolar disorder, also known as manic-depressive illness, is another brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks. The symptoms of bipolar disorder include alternating periods of depression and high or irritable mood, increased activity and restlessness, racing thoughts, talking fast, impulsive behavior and a decreased need for sleep.
Abilify MyCite contains a Boxed Warning alerting health care professionals that elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Abilify MyCite is not approved to treat patients with dementia-related psychosis. The Boxed Warning also warns about an increased risk of suicidal thinking and behavior in children, adolescents and young adults taking antidepressants. The safety and effectiveness of Abilify MyCite have not been established in pediatric patients. Patients should be monitored for worsening and emergence of suicidal thoughts and behaviors. Abilify MyCite must be dispensed with a patient Medication Guide that describes important information about the drug’s uses and risks.
In the clinical trials for Abilify, the most common side effects reported by adults taking Abilify were nausea, vomiting, constipation, headache, dizziness, uncontrollable limb and body movements (akathisia), anxiety, insomnia, and restlessness. Skin irritation at the site of the MyCite patch placement may occur in some patients. Prior to initial patient use of the product, the patient’s health care professional should facilitate use of the drug, patch and app to ensure the patient is capable and willing to use the system. Abilify was first approved by the FDA in 2002 to treat schizophrenia. The ingestible sensor used in Abilify MyCite was first permitted for marketing by the FDA in 2012.
The FDA granted the approval of Abilify MyCite to Otsuka Pharmaceutical Co., Ltd. The sensor technology and patch are made by Proteus Digital Health.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
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Page Last Updated: 11/14/2017″
https://www.schneier.com/blog/archives/2017/11/friday_squid_bl_601.html#c6764476
echo • December 11, 2017 11:45 AM
@Marcus
I prefer to restrict myself as closely as possible to published policies, and science and law. I agree there are issues of the balance of power.
The topic can easily become a contentious political argument. I have citations from a UK perspective which can expand on your observations but am mindful of not pushing too far beyond the scope of this topic and Bruce’s hospitality.
I would have to dig around for citations but one medical study and a comparitive analysis of US and UK policing by consent spring to mind. These kinds of studies have their flaws but I have found them useful in understanding differences of method and attitude, and how both sides may view each other. I will need to check through my notes but I have discovered recent and not so recent US analysis of WWII civilian and war economies, and modern military organisation and professional integrity. I find the American habit of public formal analysis very constructive and believe it offers insight into both UK domestic and foreign affairs issues with both a medical and military perspective.
David Wilson • December 11, 2017 11:46 AM
“Have you checked your weight today?”
albert • December 11, 2017 12:04 PM
This technology is old. Pills were developed for the study of mountain climbers to determine if their internal temperatures dropped to the danger zone. Continuous temp data was recorded by external devices. That data helped doctors study the effects low-temp/low-oxygen environments. At least the old systems were bespoke radio, as opposed to putting everything out on the Internet.
Somewhat related: Ancestry.com is offering a ‘service’ that uses samples of your DNA to determine where you came from. What could possibly go wrong? -Voluntarily- submitted DNA might as well have a signed search warrant attached to it. And yes, the company does say that your DNA may be used by LE.
Most folks are probably better off -not- knowing where they came from.
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Wael • December 11, 2017 12:10 PM
That’s pretty resilient:
The sensor, containing copper, magnesium and silicon (safe ingredients found in foods), generates an electrical signal when splashed by stomach fluid, like a potato battery,
Surely no one will game the pill. Rumor has it that R. P. McMurphy won’t get away with it in the sequel using the same tactic. He’s gonna give the pill to another moron.
What’s the effect of a buffer overflow inside the body?
Iggy • December 11, 2017 12:30 PM
I’d like to know how many people who would normally access traditional Western medical care are not doing so because of developments such as this “medical advancement.” I stopped seeing MDs because increasingly, they act as if they are agents of the government. Instead of alleviating suffering, they’re obsessed with being sure they’re compliant, confident they’re excellent lie-detectors, or, confident they aren’t so they’ll just treat you as if you are lying.
This only exacerbates an already increasingly inimical field between doctor and patient, one where lack of insurance WILL see you met with open hostility. My budget policy they hate just as much.
I’ll just keep taking my OTC drugs, and will see them only when it’s too late for them to try torturing me back to life. And after learning this? The Pharma-Med Industrial Combine won’t see me again unless found unconscious.
Humbolt • December 11, 2017 12:44 PM
@VAS Pup
What do you mean “no games”? The pill only detects whether it is swallowed, it does not authenticate the contents of the pill.
albert • December 11, 2017 1:20 PM
@Wael,
I don’t know exactly how it works (the news reports don’t really say).
I expect they would be trivial to fool.
Is the information stored in the pill, patch, or phone?
What other information is stored?
For good fiction on the computerization of the human body (brain is this case), see “The Terminal Man”, by Michael Chrichton. The book is way better than the film, BTW.
Someday soon, we’ll have little implants (under the guise of ID tags) that will monitor brain waves, and report back to the LE/IC. And of course there will be AI programs that will determine who’s naughty or nice. Santa Claus will be the least of your worries.
Merry Christmas!
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Lisa • December 11, 2017 1:37 PM
@Marus
I do not know about the situationing in your specific country, but in many other western democratic countries, doctors are simply not allowed to refuse treatment on the basis of race, religion, ethnicity, etc.
If they refuse treatment, it has to be solely for medical/biological reasons directly related to the treatment risk and effectiveness for each patent, as well as extrenal factors such as costs and resource availability (hospital beds, scheduling, etc.). Patients who think they are being discriminated against can bring up their case before a medical ethics review board, and also before a judge in court.
Wael • December 11, 2017 1:44 PM
@albert,
Merry Christmas to you too.
Someday soon, we’ll have little implants (under the guise of ID tags)
Coming very soon. Inevitable evolution towards collective consciousness. There will be no individuals. You are the many; the one…
Greetings!
albert • December 11, 2017 2:34 PM
@Wael,
@Hah! I was thinking about the Borg before I followed the link. Interesting how the Borg spokesperson speaks without lungs or vocal track. How do they do that?r
“Resistance is futile. You will be assimilated!”
The demise of personal freedom is the worst sort of fate. Kind of like a living Hell.
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Wael • December 11, 2017 2:55 PM
@albert,
I was thinking about the Borg before I followed the link.
Not surprising. Things are played on TV first to prepare us for what’s coming in real life. Call it a ‘dry run’.
Interesting how the Borg spokesperson speaks without lungs or vocal track. How do they do that?
Let’s make a deal: I tell you how they do that and you tell me how likely we’ll be able to teleport in the next millennium or two.
Data does the same. My phone, TV, and radio have neither lungs nor vocal cords. They have what’s called a speaker. You might have heard of it? Lol 🙂
The demise of personal freedom is the worst sort of fate. Kind of like a living Hell.
What’s left of it?
Sheila • December 11, 2017 3:29 PM
I fear that for most people the security/privacy implications will be irrelevant.
But that’s from my middle-aged+ point of view. Future generations have already evidenced that they’re unconcerned? uninterested? oblivious to the implications? willing to pay the unknown price?
Take this guy and this scenario: “Why I injected myself with an untested gene therapy.”
(And he did so on Facebook.) http://www.bbc.com/news/world-us-canada-41990981
To boot, over the last 25 years, there’s been a tremendous increase in medical interventions, from prescriptions to surgical procedures, each of which is a trackable data point.
It’s all so Foucauldian.
PS @Lisa Re: doctors refusing treatment. I’m afraid you’re not up to date on Italy’s conscience-objectors—doctors refusing to do abortions, although they’ve been legal since 1978.
B.J. Douma • December 11, 2017 4:04 PM
As long as it runs Linux.
albert • December 11, 2017 4:06 PM
@Wael,
That ‘?r’ means it’s a rhetorical question. 🙂
A talking head* is one thing, but the writhing ‘spinal column'( with its red lights) is quite another! It can be ‘plugged’ in to a ‘body’, though I expect that lots of quotes are needed when discussing Borg technology:)
- the term is used in TV lingo in reference to on-air ‘talent’, i.e. Teleprompter readers. Notice the similarities:) ‘Blow-dryed meat puppets’ is another, less flattering term.
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Wael • December 11, 2017 4:24 PM
@albert,
That ‘?r’ means it’s a rhetorical question. 🙂
New thing I learned!
Clive Robinson • December 11, 2017 7:57 PM
@ Wael,
The sensor, containing copper, magnesium and silicon (safe ingredients found in foods)
Are we playing “Spot the Deception”[1] game here?
Ever heard of “copperiedus”?
There is a reason why they talk about “Esential minerals” not “Essential metals”[1] but do talk about the likes of “Heavy metal” poisoning…
Whilst some cultures do add very fine silver or gold leaf to celebration food it is realy not recommended[2] even occasionaly.
Copper is a poison and people do get ill from acid foods being cooked in uncoated copperware or copper getting into the stomach acid (which is why you should never ever use copper cookware or tabelware with making or presenting jams, chutnies and other sauces and condiments).
As for magnesium, too much can make you ill, but to little of it’s salts will make you realy ill if not kill you… It’s why you realy must eat your “greens” unless you want major heart problems and an early and painfull death. But don’t eat the metal it’s the salts your body needs.
[1] For those that don’t know, whilst the mentioned metals are in food, unlike the pill they are not in their metalic state, and usually in the pico-micro gram range not the gram or two range.
Further in food they are not being used to generate electricity unlike the pill. As a chemistry teacher will show you there are reasons people avoid dropping metals into either acids or alkalis. Or you may have had a demonstration by having had the misfortune to remove a corroded AA battery from a transistor radio and then have to try to clean the contacts and find it’s a lost cause…
[2] Gold for instance especially via salts of gold is actually an accumulative heavy metal poison. Silver in some forms used in anti smoking gums can make your skin go blue and be photo sensitive, which all jokes aside is a bit of a negative reaction for most people,
http://abcnews.go.com/Health/internet-sensation-papa-smurf-dies-blue-people-live/story?id=20368758
Wael • December 11, 2017 8:27 PM
@Clive Robinson,
Whilst some cultures do add very fine silver or gold leaf to celebration food it is realy not recommended[2] even occasionaly.
I heard about it. Perhaps I’ll try one! It’s supposed to be “inert”!
Anura • December 11, 2017 9:43 PM
Gold is the most inert metal there is. Goldschläger was one of the most popular drinks in my high school, and as far as I know most people I went to high school with is still alive so it can’t be too bad.
Wael • December 11, 2017 10:16 PM
@Anura,
most people I went to high school with
Perhaps they accelerated the arrival to their golden years 🙂
Iggy • December 11, 2017 11:00 PM
@Anura, alive, yes, but brimming with vim and vigor?
Actually met a man who self-treated with colloidal silver as a remedy for his arthritis. He claimed it worked, but it made him a social oddity and he became increasingly reclusive.
Gold leaf on the once a year wedding cake slice, ok, but that’s just for sheer decadent fun, not for nutrition.
Decadent fun for me is a Krispy Kreme donut, egg and bacon sandwich.
A tear in the space time continuum never tasted so good.
vas pup • December 12, 2017 9:04 AM
@Humbolt • December 11, 2017 12:44 PM
I mean you(he) know for sure she took the pill, then you get no surprise like ‘sorry, I forgot to take a pill, you will pay child support for about 20 years’. Fair game means no unbalance of power, no lies. You may trust, but have objective verification now. That was considered just in prospective. Technology could be applied for contraceptive pill – I guess. Each type of drug with same technology may have own digital signature for multiple medications to be taken. That is just my opinion
MikeA • December 12, 2017 10:16 AM
@albert
Terminal Man (Yes, I read the book) — Doctors in Psch hospital are shocked to discover that stimulating pleasure center when a seizure is sensed leads to patient learning to trigger seizure. Apparently they were asleep when their freshman psych 1 class discussed Skinner’s work.
Jurassic Park (OK, the funniest bits were “closer than they appear” mirror shot, and of course the lawyer being eaten) — Biologists so savvy they can clone dinosaurs are surprised that an all-female population can have offspring, and they include amphibian DNA in the process. Apparently they were asleep when parthogenesis in lizards, and the way some amphibians “choose” gender during development (sometimes covered in High School biology).
We used to joke that Crichton’s next book would have a Noble-prize winning plumber shocked to discover after 250 pages that sewage does not flow (unaided) uphill.
echo • December 12, 2017 2:46 PM
On topic: Via friends I had an acquantance who was a then youngish black man who suffered from schizophrenia. I have read subseuently that discrimination can be an aggravating factor as can poor quality healthcare especially staff attitudes. It’s very difficult to comment without the full and unbiased facts but I and other friends found this rather sad. He was a lovely and kind man and not at all stupid. For reasons of his own, possibly lack of confidence in his healthcare or uncomfortable with the consequences of his healthcare regime, didn’t take his medication which led to further deteroriation and fallign between the cracks.
I’m sure a technology like smart pills could be beneficial especially with edge cases where patients self-harm or become a risk to society. The question is how can we best serve people liek this without becoming oppressive or doing more harm or, indeed, using this technology as a cover for our own ignorance and biases?
albert • December 12, 2017 4:16 PM
@MikeA,
“A little learning is a dang’rous thing; / Drink deep, or taste not the Pierian spring.” – A. Pope.
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Frances • December 12, 2017 10:46 PM
Some people with certain mental illnesses – schizophrenia, bi-polar disease and probably others – will sometimes stop the medications that are controlling the symptoms that upset their lives because they are convinced that they don’t need the meds. The result is sometimes tragedy, for that person or for others. A method that keeps track of their pill-taking would work to their benefit. I appreciate that many of you worry about privacy and coercion for the patient but bear in mind that sometimes the taking of the medications is a legal requirement, otherwise the patient would have to be confined in a mental hospital.
Wesley Parish • December 14, 2017 2:30 AM
I have to admit I can see all sorts of abuses in this. I suppose it’s better than “chipping” someone … but not by much.
It would appear the pill transmits on a radio frequency. Which one? And it has a range of about a metre, give or take 30 or so centimetres. Is it “plaintext” or encrypted? (I assume the data stream is the simplest possible.)
It has interesting fiction possibilities. Frankly they scare me.
Security Sam • December 14, 2017 5:57 PM
My Dear Watson it’s quite elementary
FDA will analyze the canal alimentary
By mapping all its nooks and crannies
And discover a solution for congestion
That’s been around since our grannies
Eat bran for an explosive decompression.
The Gates • December 15, 2017 3:01 AM
Did someone else read on first view “The FBI has approved”? Either I am too paranoid or had not enough coffee yet.
vas pup • December 15, 2017 9:32 AM
Researchers use WWII code-breaking techniques to interpret brain data:
https://www.sciencedaily.com/releases/2017/12/171213124727.htm
A team of researchers has used cryptographic techniques to decode the activity of motor neurons. Their approach has allowed them to predict, from brain data, and with only generic knowledge of typical movements, which direction monkeys will move their arms.
“As this capability grows, our technique becomes more useful,” Kording said, “At the same time, I think we need to be very careful about the possibility of it being applied to people without their consent. What spy agencies could do with this technology is scary.”
Sarah • January 11, 2018 3:47 AM
Vitamin surveillance, bon apetite!
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Sidebar photo of Bruce Schneier by Joe MacInnis.
Alejandro • December 11, 2017 8:22 AM
I think I saw the movie about 10 years ago.