Their Bionic Eyes Are Now Obsolete and Unsupported
These early adopters found out what happened when a cutting-edge marvel became an obsolete gadget... inside their bodies.
These early adopters found out what happened when a cutting-edge marvel became an obsolete gadget... inside their bodies.
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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.
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.
You are not doing an accurate comparison here.
You are ignoring all the stuff that died early (survivor bias). You are ignoring the maintenance crews that keep that stuff going which you know isn't the same as performing surgery. You are ignoring replacement parts. You are ignoring the conditions of operations, the human body is wet. You are ignoring the changes of electronics that made them less reliable but not prone to giving people lead and mercury poisoning. You are ignoring the amount of work being asked to perform from the electronics.
Also Voyager was not designed to last 5 years the engineers involved admitted that. They planned for it to last much longer but NASA management didn't want to oversell it.
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.
I get it. Most days I would love to get out of tech. Any given project I got half a dozen sales people and PEs who want to trash my software/electrical designs. It is commonplace for me to downgrade my work. Giving customers a less reliable more expensive system. Given how much of my work is for the government there is zero mystery where cost disease is coming from.
I just worry that if I walk away no one will stop them.
One of the jobs I worked, there was an older programmer, who had been their since the company was created, or very soon afterward. He survived Vietnam, learned COBOL via the GI Bill at a college, programmed the system underlying the /entire/ financial data system(s) of the company, from paying employees to receiving vendor payments to intracomapany finances... everything.
Before I left that job, we would talk often. He told me that his whole career, not a single VP or manager /ever/ listened to his constructive criticism or concerns about requests to make the system do something that would cause a problem later on down the line, that would be incompatible with other systems his stuff integrated with, either internal or external to the company, or often just asks to design totally useless features or even design things according to a manager of VPs specs, even though he explained to them that their design was fundamentally flawed from a programming perspective and not actually ever be able to work at even a test use case at all, because the higher ups think they know how to write code, but actually do not.
He explained to me that he had been telling them for 3 years he was going to retire, and that they needed to find a replacement programmer who knows COBOL, as the way the company's systems have culture have evolved will mean that his code his systems, will /need/ constant updates and tweaks to keep utter chaos from ensuing in his absence.
He then further explained to me that he knew they would not do this because of ignorance and arrogance... and that within a year of him departing he expected to be billing them 3x his current hourly rate as a contractor.
Management seema to have assumed they could hire 2 to 3 programmers similar to me, a young relatively novice programmer at the time, to replace him with a few 'Junior COBOL Programmers' for a total of maybe 2/3 of his current wages.
They did not understand that COBOL is a dead programming language that hasnt been taught in Computer Science courses at basically any American University since, at best, the early 90s... and that anyone who actually knows COBOL would by definition be a very senior programmer, and literally laugh at the pitiful wage they were offering to non existent 'Junior COBOL Programmers'.
And so, he left, within 3 months other systems in the company evolved until they broke the underlying COBOL system. Cue 3 months of 'make everything reliant on the COBOL code work witbout touching rhe COBOL code' for me, which is of course impossible because the parts of it some of my reports drew from were now outputting either nothing, or an error code.
Meanwhile, many other departments are having similar problems, everyone is overworked tryi g to come up with bandaid workarounds for their particular systems in a hurry, without documenting what they are doing, and I have to keep up with all of this to produce my more top level, big picture reports that add all the little details together.
I leave because the stress is too much, and within another 3 months, he is being contracted to fix the mess he told them would happen if ttheydid not do what he suggested.
This all happened because Managers and VPs are full of themselves, think they understand everything, focus on trimming the fat instead of making sustainable long term decisions, and of course are mainly focused soley on next quarter profits.
The amount of money that the company lost because of the chaos that ensued was at least one order of magnitude, possibly nearly two by the time the elder COBOL wizard was hired back on as a contractor... nearly 2 orders of magnitude greater than if they had just hired his replacement at roughly similar wages as him.
And I would know those numbers, because my job included making the monthly reports on the profitability of every single department of the business before handing those off to my boss, who presented them to the VPs and the CEO in the main executive conference room roughly 25 feet from my cubicle on the top floor of the building.
What I learned from that job is that VPs and CEOs are the most expensive employees to pay wages to at a company, and at best are barely more useful to the company than if I had simply tied my own executive level reports into a fairly simple decision tree program to output business leadership position decisions. Oh. That and they rolodexes of other people to wheel and deal with in the industry.
VPs and CEOs barely do any actual work, the 'work' they actually do is easy enough to codify into maybe a couple hundred lines of computer code and then automate... oh right, and hook up to a rolodex to deliver barely ever reworded emails to various people.
But we will figure out how to fully automate McDonalds employees before we automate CEOs.
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.
Wow what the actual rollercoaster.
As a fellow autist i am not sure if i would handle such a chain of events so well as you did.
I actually have some context for autism-schizophrenia.
Both medical disorders as well as adhd/add/ocd/dislexia/bipolar are all part of the neurodivergent family,
Therefor its common for overlap between these conditions and for different medical diagnoses to be more common in a single family tree. You may have (had) a schizofrenic family member and to some your autism resembles parts of it.
None of that matters to how your family treated you because even if you did have dillusions or psychotic feelings they are still no reason for forced therapy. These conditions, are very misunderstood and the only person that can truly know if they need help is the neurodivergent person themselves except maybe if they cause proven major harm.
I appreciate you saying that.
I have studied up a lot on neurodiversity and mental illnesses.
My family just gaslights me constantly. Anytime I display any emotion other than basically nodding and agreeing, I find out later they are describing it as a manic episode to their friends and the rest of the family.
A manic episode is ... you know, an episode, as in a sustained period of time with very very heightened emotions, where the subject does not seem to be aware of or able to control their emotions.
I would get excited for a few minutes, describing a breakthrough in coding I made at work... or maybe angry for a few minutes while describing all the apathy I see in society toward the homeless, if not outright hate.
Then back to normal conversation.
But things like that, to them, are manic episodes.
I do not care for them any more.
My dad was a drunk, has always been extremely right wing, is generally unlikeable due to always arguing and never being able to consider that he might be wrong about something, believes in Q Anon insanity, and manufactures firearms in a way he took pride in explaining to me is 'untraceable'.
My mother does have a neurological condition, and has the emotional maturity and intellectual capacity of an 8 year old.
My brother was a rave kiddie burn out who gave himself serotonin shock syndrome before he turned 21 via waaaay too much MDMA and Ecstasy. He believes shadow people are real, and was constantly trying to force me use hallucinogenic mushrooms while living with him. Oh, and he explained to me how its 'funny' to him to joke around with his actually schizophrenic girlfriend by just telling her that the past 30 minutes of events /did not actually happen/ and that she was having a delusion or hallucination. Then he says 'ah just kidding, love ya babe!'
Me on the other hand got nearly straight As in highschool, went to Uni and got two Bachelor's Degrees in the time it took 1/3 of my classmates to drop out with nothing. Ive since worked for a large tech firm, a logistics company and that nonprofit, doing data analytics/programming, etc.
So yeah my family are just bad people, and I have no problem with them just assuming I am dead.
What you describe is why I don’t think electronics should be in implants. “Dumb” implants already have issues; adding electronics will only increase the issues.
You can't hold complex electronics to the same lifespan as a wrench, or replacement hip, no matter how well built they are.
Exactly why it’s not going in my body.
Considering the already existing issues with inactive implants, maybe electronics shouldn’t be allowed in implants until they can demonstrate reliability.
if someone is willing to pay $150k to see blurry grey dots I don't see how it's anyone's business but there's to ban that.
This is a pretty wild take you're making here. You're essentially telling anyone who has received a deep-brain implant for Parkinson's to go kick rocks.
Just a thought, but with deep brain implants aren't the electronics separate from the electrodes that actually go in the brain? That would make them a little more accessible without needing to do brain surgery every time.
Maybe that's the middle ground for this situation at this moment in time: make the sensors/electrodes/static components needed for the health issue follow the same life+20 years and separate the processing pieces into a container that could still be surgically stored under the skin, but more easily accessed for maintenance, repair, replacement.
Theoretically, this could allow 3rd parties to come in and leverage existing installations by leaving the lifetime components in place and replacing the processing unit.
This could be the beginning of human device engineering standards similar to what IEEE does for computers and technology.
It’s not about designed to function lifetimes. It’s about product support, and there’s no reason why the electronics can’t be supported the same as “inactive pieces of metal.” We’re not talking about surgery to replace a broken component that’s now unobtanium.
I have a family member with an artificial heart and that is a worry of mine, that one day such implants will need you to agree to ToS in order to ensure continued operation.
They likely already signed the ToS while going through the surgery paperwork.
Yeah, until the ToS changes and the manufacturer bricks the heart because they missed a payment. Or said something online they don't agree with, or joined a group they don't like or any one of 100 other things.
If your internal hardware is connected to an active internet connection, that’s kinda on you…
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.
USA and insulin issue be like
I deal with electrical stuff and it is a different animal. We know our stuff can't last for decades. All we can do is document it so freaken well that the person who deals with it 20 years later has a shot at it. And unlike mechanical we can't just tell people to have a bunch of spare on hand because that stuff will rot on the shelf.
If something needs updates and repairs then they should be designed as such. Interchangeable parts, standard interfaces, safe shutdown and removal procedures. Planned upgrade cycles. Etc.
You mean the way industrial controls have been done since the 19th century? This stuff doesn't just happen, it takes work to make it like this.
Oh for sure! Engineering and standard creation is no easy feat for sure.
Would it not make more sense for a certain standard deviation away from the mean failure time to still meet the lifespan of the longest living patient? Why a flat 20 years?
Like if your product lasts an average of 40 years with a 2 year standard deviation on failure, if your longest living patient uses it for 34 years then you've effectively guaranteed it will last for life for over 99.7% of users, even if very few will ever last for 54 years.
