Wireless drug delivery computer chips: Will telemedicine take away patient choice?

I’m not sure if I’m a fan of telemedicine -- health care from a distance.

When I first heard of the successful test of a wirelessly controlled drug delivery computer chip, I couldn’t help but visualize a doctor lounging on the golf course, with a martini in one hand and an iphone in the other. With a quick push of the button on his phone he can inject you with your medication or the newest vaccine, before returning to his game. I mean, do we really need another excuse for doctors to further limit their time with patients?

Obviously, I am being a little facetious and it is true that such a computer chip can definitely revolutionize health care. The ability of a pharmacist (I’d trust a pharmacist way before I’d ever trust a doctor to correctly manage my medication) to properly control and manage a complicated drug regimen, could greatly decrease drug error and unwanted adverse reactions; however, this type of chip could also take away a patients accountability for their health, as they become increasingly passive regarding the medicines they take, when they take them, and why. It is much easier to simply rely on a computer chip to give you your meds without a second thought, right? But who controls this choice?

The press release announcing the successful trial describes the importance of this medical technology as a means to keep a patient compliant on a drug regimen. It is true, a big problem with successful medical therapy, is that not all patients follow a drug regimen exactly and finding ways to improve this shortcoming can be incredibly helpful. But, the word compliance is no longer a word that should be used in health care. The word compliance invokes a sense of “falling in line” or “not breaking the rules,” unless you want to get into trouble. The use of compliance is actually a tad snotty. It is not the job of a patient to be compliant with a doctor’s orders. A patient’s health care choices are exactly that, their choice. Patients are partners with their doctors, and instead they choose to adhere to a drug regimen, not comply.

While this may be considered semantics, and obviously not the intent of the creators of the microchip, there has been a concerted effort to remove the use of the term compliance from health care in replacement with adherence. Language can be powerful, and at the very least, it can invoke important questions.

Who will control the chip? Will a patient have a choice to stop a drug course (they may have their reasons) or will it be strictly up to their doctor? This may seem to be a bit like a conspiracy theory. It is doubtful that a doctor would necessarily try to control your health choices, and give you medication that you may not want, but then again there are several historical and recent examples that indicate the contrary.

A wireless chip for the safe and effective injection of medication is an incredible leap forward for health care and the improvement of medicine-based therapies. With every innovation; however, there are also potential logistical and philosophical conundrums that must be addressed.