Watching Them Watching Us

Posted by Thomas Jeffry

An interesting development from the American Medical Association is worth noting.

The AMA House of Delegates met in Chicago at the end of June where it received a report previously requested by that group’s governing body on the medical and ethical implications of the use of implantable radio frequency identification (RFID) microchips in humans. Use of RFID chips were approved for use in humans by the Food & Drug Administration in 2004. Similar versions of such chips are commonly used to tag pet dogs and cats for identification purposes.

However, the chips used in humans have a potential broader use. Although the current chip is designed to transmit a unique 16-digit identifier, other data can be linked to that identifier including the identity of a patient along with his or her medical information. The “passive” chips only provide response when activated by a specialized reader at relatively close range. However, “active” chips store more data, transmit autonomously with an internal power source, and can be picked up by readers at a longer range.

The report issued by the AMA’s Council on Ethical and Judicial Affairs stated that RFID tags could “promote the timely identification of patients and expedite access to their medical information” as well as improve efficiency within the health care system if adequately integrated into existing electronic systems and databases. At the same time, the report acknowledged that the “security of RFID devices has not been fully established” and cautioned that physicians could not assure patients that any information contained on the tags or in databases presumably tied to identifiers on the tags could be protected. The Privacy and Security standards under HIPAA mandate that physicians and other health care providers who might use RFID technology take measures to protect health information from unauthorized uses and disclosures.

Concern was also expressed about the non-medical applications of implantable RFID devices in humans such as for tracking or surveillance of individuals and the need to continuously reassess the role of physicians who participate in RFID labeling of humans. The report advised that physicians advocate for patients by promoting the use of other, less intrusive alternatives when available, and to adopt other protective measures to safeguard the confidentiality and privacy of patients.

Kudos to the AMA for recognizing the significant implications RFID devices may have on the privacy and individual liberties of patients. While the report acknowledged benefits on certain clinical applications for these implantable tags, it recognized the potential problems related to patient privacy and left open to door to ultimately reject the use of RFID devices in the future if the “negative consequences” of such devices outweigh the benefits. Although some claimed that the report was a recommendation of these devices, a close reading shows that it appropriately falls far short of any enthusiastic endorsement of human tagging. Yet another example of how legal and ethical issues related to privacy need to manage and guide the development and use of emerging technologies.