Very scary microchip tells docs if you’re taking your meds!!

Microchip Tells Docs If Patients Have Taken Their Pills, Why That’s Scary

By Philip Dawdy

News is out in the UK of a US-made microchip (in capsule or pill form, swallowed) that would monitor (from one’s stomach) whether or not a patient has complied with a prescribed drug therapy and, then, report back to the patient’s doctor in real time (via a transmitter on the patient’s back and, then, by cell phone). Yes, you read all this right and, yes, this technology, developed by Proteus Biomedical, will undergo two clinical trials in the UK later this year.

On one level, this kind of technology is fascinating and interesting for all the usual dorky techie reasons (wow, telemetry has gotten that advanced and so have transmission technologies–it’s all so very sci-fi and high tech triumphant), but on another more important level it’s downright frightening. That’s because I see this “intelligent medicine” technology as a potentially massive intrusion on individual freedom and privacy.

In the above news article, look at the range of prescribed meds that’s discussed as being monitoring-worthy (and in an unquestioning way): psychotropics, heart meds (statins, etc.) and even birth control pills.

Do any women really want their docs monitoring what they put in their bodies in such a fashion? Is there anyone who takes anti-depressants who wants his or her doc probing their medication compliance so intimately? I doubt it. What would the doctor even say if a woman missed taking the Pill for a week? “Hi, we’ve noticed a disturbing pattern in your estrogen intake. Oh, you are trying to get pregnant? Come into my office for mandatory counseling and depression screening? I need to sell you pills of some kind.”

OK, so I’m being flippant, but if anyone thinks that such a scenario isn’t somewhat realistic, then they are naive.

Now, if someone does voluntarily wish to be monitored and consents to being monitored, so be it. But just about the only scenario were I could see such monitoring being acceptable–assuming it even works–is in cases where psych patients have a proven track record of violence (as determined by a court, not a social worker) and there’s a court order in place to allow such monitoring. Other than that, the mandatory use of such technology would violate individual liberties.

Even more worrisome to me is that such chip-in-a-capsule technologies could be used to monitor what people eat and drink and be used to report back to some central authority who could then determine if you’ve had too much soda (beer, wine, etc.) and send the public health department over to “counsel” you.

But there’s another worry I have over the potential misuse of this technology:

“Professor Nick Peters, a cardiologist at Imperial College London, who is co-ordinating trials, said the technology was ‘transformative’.”‘This is all about empowering patients and their families because it measures wellness, and people can actually be tracked getting better,’ he said.”

“‘Psychologically speaking, that’s hugely helpful for patients and enormously reassuring for carers.'”

This kind of thinking relies on two assumptions: One, that medicine always provide wellness and, two, that all people respond to medicines the same way.

Apply that to statins, which are very widely-used in the US. They are presumed to be benign meds and while I’m not questioning their cholesterol lowering powers, let me point you to the FDA’s adverse events database on Lipitor, which has just under 50,000 reports through the third quarter of 2008.

Just as with anti-depressants, not everyone responds to allegedly benign meds the same way. For some people, statins are clearly awful drugs and I know of multiple cases from my personal orbit where people have been put on Lipitor and had powerful muscle cramps, liver problems, lost their memory and so on. When they went to their prescriber, they were told in each case that Lipitor couldn’t be the cause and that they had to stay on the drug or they would die (cadiologists may approach psychiatrists for their religious attachment to their specialties’ meds). In case, the people blew their docs off and away went the cramps and nerve problems and back came their memories. Interestingly, none of them re-developed problems with high cholesterol.

Think of that kind of thing when you think of “intelligent medicine.”

Posted by Philip Dawdy at April 13, 2009 01:37 PM