Alzheimer's And Tracking Chips.

[picchick]

[quote]Radio frequency identification (RFID) may seem like something borne out of The Jetsons or the latest sci-fi thriller.

But this identification technology isn't as futuristic as it sounds. In fact, RFID has existed for several years (dating back to the late 1940s) and is gaining popularity in its use in credit cards, toll booths, passports and subway systems. It's also become more common among pet owners who have their animals imbedded with RFID chip implants to make it easier to identify Fido should he get lost or "petnapped."

More recently and more controversially, RFID is being tested by healthcare providers in an attempt to protect Americans living with Alzheimer's disease who are at risk for wandering.

While there are positives associated with this usage, some argue that RFID implants are a violation of human rights, especially in the case of a person with Alzheimer's who cannot give his consent to the procedure due to his cognitive condition.

[b]Protecting The Patient[/b]

In February 2007, officials with Alzheimer's Community Care - an organization based in West Palm Beach, FL, that cares for more than 2,000 Alzheimer's patients and caregivers throughout a three-county radius (Palm Beach, Martin and St. Lucie) - partnered with neighboring RFID technology manufacturer VeriChip to begin a 2-year pilot program using the company's latest RFID device - the VeriMed microchip.

Said to be about the size of a grain of rice, the VeriMed chip is inserted by syringe into a patient's upper arm and contains a 16-digit personal identification number (PIN). This allows ED personnel to access an existing database that provides a host of information identifying the individual and listing his healthcare diagnoses, medications, allergies, etc.

To date, about 100 patients and caregivers with Alzheimer's Community Care have undergone successful RFID implants with another 100 expected to be implanted by February 2009.

"They say that you have innovation out of necessity," said Mary M. Barnes, president and CEO of Alzheimer's Community Care. "The area we serve has the highest incidence rate of Alzheimer's in the world, so we've seen this program as a great opportunity to serve our community with our expertise in this specialty area."

Through the pilot, the chips have come without cost to patients and caregivers. However, they have not come without controversy or debate.

[b]The Case Against RFID[/b]

According to an ABC News report that ran in August, certain privacy groups are arguing the VeriMed and other related instruments, "strip Alzheimer's patients of their dignity."

"I don't think that because it's useful in animals is a reason why we should do it in human beings," Katherine Albrecht, founder of Antichip.com, a Web site that openly refutes the use of such materials in humans, told ABC.

Additionally, Wisconsin and North Dakota have banned human implanting of RFID devices without consent, while California is considering doing the same.

Officials with the ethics advisory panel of the Alzheimer's Association, an entity that claims to be the leading voluntary health organization in U.S. Alzheimer's research, believe these chips should not be of a permanent nature or implanted into those with Alzheimer's. Nor do they endorse any such product or service.

"While intended to ensure the safety of the person with Alzheimer's, [tracking devices] may be perceived as infringement on personal autonomy," the association's official statement reads. The panel [feels] that using these devices is acceptable so long as they do not violate the expressed wishes of a competent individual."

Instead, the ethics panel suggests caregivers and healthcare providers discuss issues related to wandering risks, such as establishing protocol on how to quickly access medical records when needed, immediately after an Alzheimer's patient's diagnosis is made.

According to the statement, "The manner in which an individual chooses to provide access to medical records is a personal decision best made by the individual."



[b]Piloting For Protection[/b]

But Barnes and other officials with Alzheimer's Community Care don't necessarily agree, stating that diagnosing and caring for an individual with the disease is not a clear-cut issue. Plus, they argue that the vast majority of their patients, if not all of them, are beyond early-stage dementia and require a power of attorney or legal guardian to make their healthcare decisions.

"Anyone who's had a family member with Alzheimer's knows that the issue of ethics is a moot point," Barnes explained. "When you're a caregiver, you know how vulnerable these patients are in acute settings. They don't know what they're suffering with. We found ourselves morally responsible to get into a project like this because we are advocates for care and safety, and cannot miss a beat when it comes to this disease and our patients."

Still, Barnes acknowledged that facilities and families need to be comfortable in using the technology.

"If people out there think the chip isn't ethically appropriate, that's their individual choice," she added. "It's a free country."

That's why the program has been strictly voluntary per the approval and consent of the individual's caregiver, Barnes said.

"And not everybody elects to have the procedure done," she said. "But it has been so popular that we were able to meet our initial goal of getting 100 patients on board in 1 year within a matter of months."

However, Barnes along with Patricia Oram, chief operating officer with Alzheimer's Community Care, insist that no client was persuaded or coerced into participating to meet the program's goal.

"We've looked at this project as being another choice, not the only choice, for families and patients to consider when determining their healthcare," Oram said. "We see this as an appropriate, convenient method for us to ensure patient safety."

Those patients and families considering participation meet with Ann Moyer, RN, family nurse consultant with Alzheimer's Community Care and lead nurse on the VeriMed project, in their homes or resident facilities.

Moyer explains the program in its entirety and gets signed consent before a physician can implant the patient's chip, which is inserted below the shoulder on the right arm so facilities know where to look for it.

"Our talks tend to go very smoothly because people at that point are strongly considering the chip," she said. "We wouldn't try to talk someone into it if they weren't comfortable. I go there also to answer any questions they may have or address any anxieties they may have."

[b]Program Logistics [/b]

The implant takes just a few seconds to insert and requires no more healing time than a general needle stick would, Moyer said.

"The area on the arm is numbed and the chip is inserted with a syringe comparable to one that would be used to draw a pint of blood," she said. "There are no allergic reactions that have to be considered."

Once implanted, the patient's chip number, which is determined during manufacturing, is entered into an online database that is accessible only to those facilities who've agreed to tap into the VeriChip network. Approximately 15 hospital EDs throughout the three aforementioned counties are currently participating, Barnes said. Those who participate are equipped with an electronic wand to read chips and are given access to an online patient database.

Although some 100 participants currently have chips, the system hasn't been put through an actual test because no Alzheimer's client has wandered since undergoing the procedure.

If someone were to wander and taken to a participating ED, the chip would only be activated if scanned with an electronic wand provided by VeriMed, officials said.

"But the benefit is that we can also give our caregivers as much peace of mind as we can," Barnes said. "They deal with so many changes in their lives, just with the disease progressing. If we can do anything to make the family stronger, that's what our job is. With the chip, they know their loved ones can get the care they need if they end up in an ED."

This should also help skeptics realize the product is about information retrieval, not placing tracking devices into human beings, said Oram.

"We originally thought it was like a GPS system, but we quickly learned that it isn't," she said. "It's a passive device that's more of a means of having medical information readily accessible when providers are in a medical situation where they can't communicate with the patient."

[size=2][b]Addressing HIPAA, Security Concerns[/b] [/size]

[size=2]Like all new healthcare innovations, the VeriMed chip could eventually affect HIPAA and other patient privacy/security measures. But, this currently isn't an issue, said Clyde Hewitt, principal consultant with Forsythe Solutions Group, an independent national service technology consulting company. [/size]

[size=2]"HIPAA does not come into play unless the organization is a covered entity as defined by Health and Human Services, meaning it has to bill insurance companies using electronic invoice," said Hewitt. "The VeriChip implementation is not currently covered by insurance, so there will be no insurance claims. But I qualify that statement with the term 'yet.' And that doesn't relieve those facilities using the chip of other security requirements." [/size]

[size=2]Hewitt said facilities have to consider state disclosure laws related to patient privacy and what legal protocol calls for should a facility lose personally identifiable information. [/size]

[size=2]"The chip itself contains no personal identification," he said. "But, in terms of general security, you have to consider how the numbers are designed and how easily it could be for someone to look up people just by their numbers." [/size]

[size=2]Patient numbers are randomly generated, making the assignment of numbers more secure and less likely of opening the person to ID theft, said Allison Tomek, vice president of investor relations with VeriChip. [/size]

[size=2]While Hewitt agrees random numbers make the technology safer, he still worries that scanners could one day be strong enough to read the chip from further distances, thereby possibly allowing unwarranted individuals to access the numbers. [/size]

[size=2]But Tomek says this is also a non-issue. [/size]

[size=2]"The chips can only be read by a scanner that's within 3-6 inches," she said. "Even if another device could pick up a chip number [in the future], it wouldn't be worth anything unless you have access to the database." [/size]

[size=2]The database itself is also guarded, Tomek adds. "We use a secure, password-protected database, but we wouldn't want to compromise the integrity of the system by discussing it." [/size]

[size=2]Alzheimer's Care officials agree there are valid questions concerning the frequency in which this patient population's healthcare information changes and how quickly updates could be entered into the database. [/size]

[size=2]Barnes said the organization has assembled a professional review committee to recommend protocol as well as appropriate staff and patient education procedures should the program become increasingly popular. [/size]

[size=2]"I see this [chip], long-term, as a potential benefit," Hewitt concluded. "It's definitely ahead of it's time now, but the time is coming fast." [/size]

[size=2][i]Joe Darrah is associate editor at[/i] ADVANCE.[/size][/quote]


[size=2]This is very interesting. My grandpa has alzheimer's yet he is past the wandering stage. I am not sure what I think about this. I do not like the idea of Identification chips in human beings because I believe that there is an issue of a lack of privacy. However, Alzheimer patients who wander could benefit from this. I do not want to anything to decrease the dignity of patients but maybe this is a way for patients unable to commuincate with emergency staff (police, ER staff). The staff will be able to securely access the person's information and help them.

There are other things out there but some of them require the patient to wear a chain or a bracelet. My grandpa would not keep those on.

Just thought I'd get some thoughts.
Meg[/size]

[corban711]

im not going to lie....as potentially useful as these things could be for suffering patients...it really just rubs me the wrong way. i think to "chip" humans is going to open the doors for big problems. i don't think it is good. where would it stop? people will say, "well we already put chips in people for alzheimer's...we should do it for this too" i can't imagine how hard it would be to have a loved one with alzheimer's. people who are suffering severely need constant care, love and probably protection too. but i think thats a door that prolly shouldn't be opened.

[prose]

The next obvious one will be children.

It is a slippery slope.

There are bracelets and anklets that lock onto a person that can not be removed without a key. This seems more logical to me.

[corban711]

agreed!

[picchick]

Ok...I am in line with you guys...I was trying to sort through things. I can see what they are saying and can agree with some of what they are saying but to me this chip thing seems a little animalistic?

Thanks all, feel free to discuss further!
Meg

[CatherineM]

When I was a teenager, my grandfather was in a nursing home with Dementia. He often figured out a way to escape from the home, and we would have to drive 2 hours up to help look for him. Luckily he never wandered in winter. He was a gardener, so in spring when things started growing, he wanted to go out and dig in the dirt I guess.

Having him LoJacked would have been very comforting. I'm pretty sure an ankle bracelet would have been no problem for him to get around. He was practically Houdini.

[Alycin]

I don't agree with chipping people because it has shown health problems in the animals it has been used in, but I don't think it's a slippery slope.

The slippery slope argument has a lot of errors.

[picchick]

[quote name='Alycin' post='1591612' date='Jul 4 2008, 09:05 PM']I don't agree with chipping people because it has shown health problems in the animals it has been used in, but I don't think it's a slippery slope.

The slippery slope argument has a lot of errors.[/quote]

Although I agree with you that the slippery sloe argument has a lot of errors, I believe that it can be somewhat true in these instances where life is being discussed. If we look back in the recent history, we can see that ethical issues dealing with life has lead from one to another to another.

I am wondering too if the process of chipping has improved. I remember when it needed to be surgically implanted. Now it is just an injection. So I am not sure what I think now as far as the health.

For me it is a matter of the dignity of a human vs. an animal. Autonomy and privacy.

[Alycin]

I would partially agree that it is infinitely more important to not risk it when it comes to human life, but at the same time, slippery slope works against us, too.

For instance, we use adult stem cell research and it is turning out a lot of great results. One of the arguments against stem cell research (that used to be used because of the embryonic argument) was that it could lead to furthering the science for human cloning.

Now, we should not throw out everything just because of that fact, right?

Another example of slippery slope argument is that we cannot outlaw pornography because before you know it, censorship will be out of control and it will be back to the days of burning books. Obviously this isn't actually true. Lines are drawn all the time in everyday life with rules and laws. Even within the Church, lines are drawn and we don't rely on absolute either/or theory... like with the death penalty.

Edited July 5, 2008 by Alycin

[kujo]

I remember we lost my grandfather for a few hours once. He had alzheimers and bipolar disorder. It was the scariest few hours of my life.

A similar thing happened to my high school girlfriend's grandfather and we had to drive around for like 6 hours looking for him. He ended up on a park bench like 2 towns away.

I dunno how I feel about this, though. Any sort of tracking chip technology sounds a bit too much like "1984" for me to be comfortable.

[Autumn Dusk]

I wouldn't go as far as a chip, but an RFID tag can be made as a sticker but lighter and smaller. An Althimere's patitent could wear one like a nicotine patch. I could be placed where they couldn't tug it off, but it would be possible for someone to remove.

[picchick]

[quote name='Alycin' post='1591633' date='Jul 4 2008, 09:34 PM']I would partially agree that it is infinitely more important to not risk it when it comes to human life, but at the same time, slippery slope works against us, too.

For instance, we use adult stem cell research and it is turning out a lot of great results. One of the arguments against stem cell research (that used to be used because of the embryonic argument) was that it could lead to furthering the science for human cloning.

Now, we should not throw out everything just because of that fact, right?

Another example of slippery slope argument is that we cannot outlaw pornography because before you know it, censorship will be out of control and it will be back to the days of burning books. Obviously this isn't actually true. Lines are drawn all the time in everyday life with rules and laws. Even within the Church, lines are drawn and we don't rely on absolute either/or theory... like with the death penalty.[/quote]
The issues that you bring up are complicated. Stem cell research is fine as long as it is not using embryos.

However, if you take the issue of abortion and fertility and you look back where we were and where we are now and the possibilities in the future, then yes, I believe that a slippery slope is very applicable.

But I understand what you are saying.

[quote name='Autumn Dusk' post='1591662' date='Jul 4 2008, 10:06 PM']I wouldn't go as far as a chip, but an RFID tag can be made as a sticker but lighter and smaller. An Althimere's patitent could wear one like a nicotine patch. I could be placed where they couldn't tug it off, but it would be possible for someone to remove.[/quote]

The problem with something like a nicotine patch is skin integrity and sores. Maybe if we were to put it on the clothing. The problem with elderly people is that their skin is so fragile and it can tear so easily. Something to stick to their skin could be very bad for them.

Meg

[CatherineM]

It might make a real difference in a place like this where in winter an elderly person can die really quickly. I don't think implantation is necessary, but there has to be something better than ankle bracelets. Parolees get those off all the time, plus with the elderly, you always have to worry about them developing skin ulcers.

[Autumn Dusk]

there are different and lighter glues that can be used.

I think a patch is much better than a chip. I'd rather encourage development of a patch. At least the patch can be removed without *too* much pain. A chip thats in the bloodstream...not so much.

[picchick]

[quote name='Autumn Dusk' post='1591872' date='Jul 5 2008, 08:53 AM']there are different and lighter glues that can be used.

I think a patch is much better than a chip. I'd rather encourage development of a patch. At least the patch can be removed without *too* much pain. A chip thats in the bloodstream...not so much.[/quote]

When something is stuck on the skin it can cause sores for some people. I think that maybe if they tried to sew the chip in clothing or something like that it might work better. However, I it still is similar to me like a dog tag so I am still going back and forth with it as far as the privacy.

The chip, just for clarification would not be in the blood stream. It would be under the skin like a sliver.