While medication compliance is important with these patients, and the current use of these pills is to simply assist physicians with providing their patients with better care (i.e. they can ask "why didn't you take your medications this week?" in order to perhaps determine something else they need to address), its not very hard to make the jump from "suggesting" to "mandating". One may foresee a world in which those with less stable mental health disorders are mandated to take medication, and have said usage tracked, with punishment for non-compliance. While it seems outlandish, look at the way mental health issues have recently been portrayed in the media during and after the mass shootings, even though the vast majority of individuals with mental health problems are much more often victims of violence rather than perpetrators (Desmarais, Van Dorn, Johnson, Grimm, Douglas, Swartz, 2014). While it is true that certain individuals are not capable of caring for themselves, I hesitate to say that the autonomy of all of these individuals to decide whether or not they want to take medication should be stripped, which I believe is a possibility with this technology.
What concerned me most about hearing this news story today was it reminded me immediately of the book The Giver, by Lois Lowry. Spoilers follow (even though the book came out in 1993. If you haven't read it, you should). The book follows a boy in a dystopian community, where everything is tightly regulated, and any deviation from the norm is punished. What I draw my parallel to is this: In the community, every member must take a pill every morning (which you eventually finds out dulls their perception of the world). Their ingestion of the pill is tracked. This is incredibly extreme, and I don't believe that we are suddenly on the verge of abusing this technology. I do, however, think it is a cautionary tale in exactly how far we should go with "tracking".
Sources:
Johnson, K. L., Desmarais, S. L., Dorn, R. A., & Grimm, K. J. (2014). A Typology of Community Violence Perpetration and Victimization Among Adults With Mental Illnesses. Journal of Interpersonal Violence, 30(3), 522-540. doi:10.1177/0886260514535102
Scutti, S. (2017, November 14). FDA OKs pill with digital tracking device. Retrieved November 14, 2017, from http://www.cnn.com/2017/11/14/health/fda-digital-pill-abilify/index.html
Scutti, S. (2017, November 14). FDA OKs pill with digital tracking device. Retrieved November 14, 2017, from http://www.cnn.com/2017/11/14/health/fda-digital-pill-abilify/index.htmlJohnson, K. L., Desmarais, S. L., Dorn, R. A., & Grimm, K. J. (2014). A Typology of Community Violence Perpetration and Victimization Among Adults With Mental Illnesses. Journal of Interpersonal Violence, 30(3), 522-540. doi:10.1177/0886260514535102Scutti, S. (2017, November 14). FDA OKs pill with digital tracking device. Retrieved November 14, 2017, from http://www.cnn.com/2017/11/14/health/fda-digital-pill-abilify/index.html
Johnson, K. L., Desmarais, S. L., Dorn, R. A., & Grimm, K. J. (2014). A Typology of Community Violence Perpetration and Victimization Among Adults With Mental Illnesses. Journal of Interpersonal Violence,30(3), 522-540. doi:10.1177/0886260514535102
Scutti, S. (2017, November 14). FDA OKs pill with digital tracking device. Retrieved November 14, 2017, from http://www.cnn.com/2017/11/14/health/fda-digital-pill-abilify/index.html
I read about this and was trying hard to vision a benefit for the patient. Why focus on schizophrenic patients? Even though taking medications consistently is a key to managing symptoms, how does tracking a pill lead to drug adherence? If a person's compliance depends on mood or personal reasons, there is no making the person do something that he/she doesn't want to do. On the other hand, it will be helpful for the physician to evaluate the symptoms and relate that to compliance with medications. Maybe, adjust the doses accordingly. Besides being a surveillance tool for the physicians, it is hard to see a point here. The mere sense of being monitored breaches one's privacy. Just like any other technologies are prone to being hacked, what are the guarantee that an app like this won't be.
ReplyDeleteThis is a really interesting concept that you bring up. I have two questions that came up while I was reading this. My first one is I wonder how accurate the chip is. Would there be any chance that someone who has taken their pill could have the chip not react with the patch and have it look as though they are non compliant. My other question is if something similar to this could maybe be used with people in developing nations to track if they take medications that have been given to them. There are a lot of issues regarding people not taking their medications and I wonder if there was a way to offer an incentive to take their medication and have it be tracked if it would improve the number of people who finish out a course of medicine.
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