It’s pretty simple. Medical devices should have certain expectations for time and support. This happens in other industries all the time. Product support has to be guaranteed. And if you can’t guarantee product support, make your software open source. That’s not a law, just a “I’m not an asshole” placeholder. Open source schematics and software won’t fix everything, but it shows good faith effort to help people fucking not go blind.
What’s so messed up to me is that the implants I design, inactive pieces of metal, are required to be operable for the life of our longest living patient PLUS 20 YEARS. Yet somehow as soon as electronics are involved they can get away with this. How long until pacemakers or insulin pumps need a license to continue functioning?
This is why I have an issue with privatized medicine.
I agree with your sentiment, and maybe this is a minor quibble, but I don’t see how complex electronic implants can be designed to function on the same timelines as “inactive pieces of metal”.
I do think that your bashing of privatized medicine is on the right track though. There needs to be some sort of regulatory framework, and possibly public funding, to maintain warranty and replacement stockpiles for implants that are too dangerous, or complex to remove, or unique in the medical niche they fill.
However, I’m just spitballing out of my ass and depth here, so there’s a real possibility that everything I just said is nonviable, or otherwise idiotic.
I don’t see how complex electronic implants can be designed to function on the same timelines as “inactive pieces of metal”.
Considering the already existing issues with inactive implants, maybe electronics shouldn’t be allowed in implants until they can demonstrate reliability.
I don’t disagree with holding those implants to high standards and reliability, but think of it this way:
My iPod is great, and has worked great for over a decade and it’s still going strong. However, I don’t think it’ll be around long enough to get passed down to my grandkids, but my wrench set probably will.
That’s my point. You can’t hold complex electronics to the same lifespan as a wrench, or replacement hip, no matter how well built they are.
Which goes back to my original comment about mandating sufficient warranty and replacement inventory being required for all existing patients.
Unless you think a better alternative is just to tell patients that’s instead of doing something within our technical grasp, with a legal safety net, they’ll have to wait until we develop artificial eyes that can last 80+ years, which may, or may not, happen within this century.
I think if you look around hospitals and science labs you will find there is some old electrical equipment that is still used because of how reliable it is.
Other examples include bakelite Telephones from the 30s and Radios from even earlier still being fully operational.
Incorporating electrical equipment in implant and prosthesis should be just fine, but it should come ready out of the box with no need for updates whatsoever and the software that is prevalent open source so you don’t need to rely on a for profit company to maintain your health post surgery.
Developing things that are too robust and reliable means you run the risk of saturating your market and then going out of business.
Developing things that are intended to break down or fail only requires a competent enough legal team to ensure that your company is not liable for that happening approximately sooner than when your disclaimer no one reads states the customer may expect that to happen by.
Developing software that is bug free, ie, robust, violates both of the proceeding rules of private enterprise in a ‘free market’ capitalist society.
You want people to be dependent on software updates so maybe you can earn a subscription fee of some kind, or have the ability to remove pre-existing features in the future and then offer their return for a one time or recurring purchase.
Also, developing robust code that does not fail requires testing and sometimes extensive redevelopment, which is expensive, requires paying competent programmers good salaries, and cuts into the impossibly fast initial development timeframe the idiot manager with a business degree promised to the VP.
After years working various programming and data analytics jobs for various tech firms, I can tell you that no one cares about making a good product or delivering a good service, maybe other than the actual people designing it. Everyone else only cares about whether it either makes money or earns them social status of some kind.
Capitalism is not compatible with sound programming practices.
On a personal note:
I am 34 and am now far too jaded to ever attempt to work any tech job as an employee ever again. The number of times I have explained to managers with no background in computer technology that no, that is a bad idea for all these reasons, then one of those reasons massively delays a project, forces another team to make their project compatible with mine due to absurd imposed design limitations, or outright makes the whole project fail… and then all the blame is pinned on me for a failure I told them would happen if I listened to ‘their idea’, is so vast that I am just going to make my own video game now.
I have never met an experienced programmer who has not had this happen to them countless times.
Yup sounds look one of the good reasons to hate on capitalism. The guys able to create reliable long living stuff should be praised to the highest degree. Its why I believe job/career should not be attached to survival income.
So much energy gets wasted because stuff is designed to break. So much talent is wasted because too nice things are not profitable
I got lucky and work at the internal IT for a nonprofit, things aint brilliant either but at least its discussable stupidity and not intentional malice
My last job was as a data analyst, database admin, programmer, IT support, and internal auditor for a non profit.
You will note that my actual job title was Data Analyst. And that I was doing the work of at least 5 different job descriptions, while only earning the wages of one.
VP level managers were beyond incompetent. They were actively harmful to the mission of the organization, wasting absurd amounts of money on proprietary software for tasks that could easily be done with a simple HTML 5 website, paying outside contracting firms for translations you could use Google Translate for just fine, oh, and requiring the databases my team managed to interface with the accounting team’s database for a new service we were going to provide with a newly received grant.
But they did not realize that we would need access to the accounting database. Even though they asked us to interface with it.
Then we explained that we would … you know, actually need access to the accounting database, as the whole point was to make sure that we were doling out charity money for individuals in a way that followed internal standards to make sure we were not not being defrauded.
So we run some analysis with the data we do have access to, as the accounting database is only fully accessible by the head of accounting, and they are busy or on vacation all the time.
We notice significant discrepancies between what our system, the one that basically the entire org uses to manage clients, including disbursements, and what accounting says has actually been disbursed.
Then, personal life happens to me. After 3 years of seeing therapists and psychologists at the best medical organization in the state, they tell me that I am likely Autistic.
I tell my family this.
My family attempts to send me to a long term mental institution far away from any major city, as they believe I am actually schizophrenic. You know, while holding down an 80k a year job, making more money than any other member of my family, having no delusions, not wandering through the streets screaming at things that arent there. My brother’s girlfriend does that, but thats uh, fine apparently.
So, I grab all my stuff and put it in my car, and stay at a motel for a while… Because I am sharing an apartment with my brother and his gf, and they both think I need to be sent to a mental institution for reasons they are not able to actually explain.
In this time, my brother removes me as an authorized user on our shared phone plan, and uses the parental control feature to stalk me on foot and in his car.
I am preeetty good with computers, and manage to replace nearly all unnecessary Google parts of Android with open source stuff, thus disabling the parental control and tracking my brother is able to do.
He cancels my phone plan and disables my phone number within 45 seconds of me completely removing all Google related bs.
I get a new SIM card.
Ok good! The phone is successfully de-googled Android, and works with a new SIM card. Great!
Problem: All of my online accounts, including banking, require 2FA linked to a phone number that is now disabled.
Then, my car gets stolen and I get the shit beat out of me, wallet and phone stolen.
Homeless for a while.
Eventually manage to get a phone. Call the non profit I used to work for. They help homeless people after all.
The project my boss and I were working on, to rectify database discrepancies between the main system we maintain that the whole org uses, and accounting’s database? Well the point if this project was to have the underlying digital framework to be able to help people who are in exactly the situation I am now in.
But, because I lost my job, the project was cancelled.
Also the head of accounting quit right before my life turned upside down, you know just about a week after my boss and I ran the comparison audit. I am sure there was no financial fraud going on though. Mhm, yep.
So I have now been basically homeless for a year.
Good thing I qualify for SSDI (hooray Autism?), other wise I would have starved or frozen to death months ago.
Healthcare and profit motive should never, ever be allowed to mingle. That’s how you’re going to wind up with a pacemaker that requires a monthly subscription or even a prescription - meaning if you don’t see an authorized doctor, you can’t keep your pacemaker running. If someone like United Healthcare could do this, they absolutely would.
It’s pretty simple. Medical devices should have certain expectations for time and support. This happens in other industries all the time. Product support has to be guaranteed. And if you can’t guarantee product support, make your software open source. That’s not a law, just a “I’m not an asshole” placeholder. Open source schematics and software won’t fix everything, but it shows good faith effort to help people fucking not go blind.
What’s so messed up to me is that the implants I design, inactive pieces of metal, are required to be operable for the life of our longest living patient PLUS 20 YEARS. Yet somehow as soon as electronics are involved they can get away with this. How long until pacemakers or insulin pumps need a license to continue functioning?
This is why I have an issue with privatized medicine.
I agree with your sentiment, and maybe this is a minor quibble, but I don’t see how complex electronic implants can be designed to function on the same timelines as “inactive pieces of metal”.
I do think that your bashing of privatized medicine is on the right track though. There needs to be some sort of regulatory framework, and possibly public funding, to maintain warranty and replacement stockpiles for implants that are too dangerous, or complex to remove, or unique in the medical niche they fill.
However, I’m just spitballing out of my ass and depth here, so there’s a real possibility that everything I just said is nonviable, or otherwise idiotic.
Considering the already existing issues with inactive implants, maybe electronics shouldn’t be allowed in implants until they can demonstrate reliability.
I don’t disagree with holding those implants to high standards and reliability, but think of it this way:
My iPod is great, and has worked great for over a decade and it’s still going strong. However, I don’t think it’ll be around long enough to get passed down to my grandkids, but my wrench set probably will.
That’s my point. You can’t hold complex electronics to the same lifespan as a wrench, or replacement hip, no matter how well built they are.
Which goes back to my original comment about mandating sufficient warranty and replacement inventory being required for all existing patients.
Unless you think a better alternative is just to tell patients that’s instead of doing something within our technical grasp, with a legal safety net, they’ll have to wait until we develop artificial eyes that can last 80+ years, which may, or may not, happen within this century.
I think if you look around hospitals and science labs you will find there is some old electrical equipment that is still used because of how reliable it is.
When we want we can make lighbulbs that last a century
Space probe Voyager 1 (1977) is still communicating with earth from beyond the solar system, Space tech is a good general example of advanced technology that is designed to keep functioning, EDIT: After 46 years it had a computer glitch just today. It was designed to last only 5 years.
Other examples include bakelite Telephones from the 30s and Radios from even earlier still being fully operational.
Incorporating electrical equipment in implant and prosthesis should be just fine, but it should come ready out of the box with no need for updates whatsoever and the software that is prevalent open source so you don’t need to rely on a for profit company to maintain your health post surgery.
Developing things that are too robust and reliable means you run the risk of saturating your market and then going out of business.
Developing things that are intended to break down or fail only requires a competent enough legal team to ensure that your company is not liable for that happening approximately sooner than when your disclaimer no one reads states the customer may expect that to happen by.
Developing software that is bug free, ie, robust, violates both of the proceeding rules of private enterprise in a ‘free market’ capitalist society.
You want people to be dependent on software updates so maybe you can earn a subscription fee of some kind, or have the ability to remove pre-existing features in the future and then offer their return for a one time or recurring purchase.
Also, developing robust code that does not fail requires testing and sometimes extensive redevelopment, which is expensive, requires paying competent programmers good salaries, and cuts into the impossibly fast initial development timeframe the idiot manager with a business degree promised to the VP.
After years working various programming and data analytics jobs for various tech firms, I can tell you that no one cares about making a good product or delivering a good service, maybe other than the actual people designing it. Everyone else only cares about whether it either makes money or earns them social status of some kind.
Capitalism is not compatible with sound programming practices.
On a personal note:
I am 34 and am now far too jaded to ever attempt to work any tech job as an employee ever again. The number of times I have explained to managers with no background in computer technology that no, that is a bad idea for all these reasons, then one of those reasons massively delays a project, forces another team to make their project compatible with mine due to absurd imposed design limitations, or outright makes the whole project fail… and then all the blame is pinned on me for a failure I told them would happen if I listened to ‘their idea’, is so vast that I am just going to make my own video game now.
I have never met an experienced programmer who has not had this happen to them countless times.
Yup sounds look one of the good reasons to hate on capitalism. The guys able to create reliable long living stuff should be praised to the highest degree. Its why I believe job/career should not be attached to survival income. So much energy gets wasted because stuff is designed to break. So much talent is wasted because too nice things are not profitable
I got lucky and work at the internal IT for a nonprofit, things aint brilliant either but at least its discussable stupidity and not intentional malice
My last job was as a data analyst, database admin, programmer, IT support, and internal auditor for a non profit.
You will note that my actual job title was Data Analyst. And that I was doing the work of at least 5 different job descriptions, while only earning the wages of one.
VP level managers were beyond incompetent. They were actively harmful to the mission of the organization, wasting absurd amounts of money on proprietary software for tasks that could easily be done with a simple HTML 5 website, paying outside contracting firms for translations you could use Google Translate for just fine, oh, and requiring the databases my team managed to interface with the accounting team’s database for a new service we were going to provide with a newly received grant.
But they did not realize that we would need access to the accounting database. Even though they asked us to interface with it.
Then we explained that we would … you know, actually need access to the accounting database, as the whole point was to make sure that we were doling out charity money for individuals in a way that followed internal standards to make sure we were not not being defrauded.
So we run some analysis with the data we do have access to, as the accounting database is only fully accessible by the head of accounting, and they are busy or on vacation all the time.
We notice significant discrepancies between what our system, the one that basically the entire org uses to manage clients, including disbursements, and what accounting says has actually been disbursed.
Then, personal life happens to me. After 3 years of seeing therapists and psychologists at the best medical organization in the state, they tell me that I am likely Autistic.
I tell my family this.
My family attempts to send me to a long term mental institution far away from any major city, as they believe I am actually schizophrenic. You know, while holding down an 80k a year job, making more money than any other member of my family, having no delusions, not wandering through the streets screaming at things that arent there. My brother’s girlfriend does that, but thats uh, fine apparently.
So, I grab all my stuff and put it in my car, and stay at a motel for a while… Because I am sharing an apartment with my brother and his gf, and they both think I need to be sent to a mental institution for reasons they are not able to actually explain.
In this time, my brother removes me as an authorized user on our shared phone plan, and uses the parental control feature to stalk me on foot and in his car.
I am preeetty good with computers, and manage to replace nearly all unnecessary Google parts of Android with open source stuff, thus disabling the parental control and tracking my brother is able to do.
He cancels my phone plan and disables my phone number within 45 seconds of me completely removing all Google related bs.
I get a new SIM card.
Ok good! The phone is successfully de-googled Android, and works with a new SIM card. Great!
Problem: All of my online accounts, including banking, require 2FA linked to a phone number that is now disabled.
Then, my car gets stolen and I get the shit beat out of me, wallet and phone stolen.
Homeless for a while.
Eventually manage to get a phone. Call the non profit I used to work for. They help homeless people after all.
The project my boss and I were working on, to rectify database discrepancies between the main system we maintain that the whole org uses, and accounting’s database? Well the point if this project was to have the underlying digital framework to be able to help people who are in exactly the situation I am now in.
But, because I lost my job, the project was cancelled.
Also the head of accounting quit right before my life turned upside down, you know just about a week after my boss and I ran the comparison audit. I am sure there was no financial fraud going on though. Mhm, yep.
So I have now been basically homeless for a year.
Good thing I qualify for SSDI (hooray Autism?), other wise I would have starved or frozen to death months ago.
Healthcare and profit motive should never, ever be allowed to mingle. That’s how you’re going to wind up with a pacemaker that requires a monthly subscription or even a prescription - meaning if you don’t see an authorized doctor, you can’t keep your pacemaker running. If someone like United Healthcare could do this, they absolutely would.