IEEE Spectrum March, 2007 - 23

28 IEEE Spectrum | March 2007 | NA

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oRAN bARbER/bEth ISRAEl dEAcoNESS MEdIcAl cENtER

Tattoos, an ID technology that is at least
4000 years old, share some key qualities with
implanted RFID tags. Both could be used for
the same purposes and are intended to be permanent-they can be removed, but only with
some difficulty and not without assistance.
The only differences are that, compared with a
tattoo, an RFID chip is invisible, may be easier
to read surreptitiously, and is a little more difficult to duplicate. Yet we suspect most people, regardless of their feelings toward being
chipped, would balk at the idea of accepting a
machine-readable tattoo as a means of identification, even if such an indelible marking had
some personal or societal benefit.
If there were a societal benefit, could a govtest Case: Dr. John
ernment require individuals to modify their
halamka [right] got
bodies? For public health purposes, the answer
chipped. he later helped
expose a weakness in
is yes. In the United States, for example, stuVeriChip's security.
dents must have certain immunizations before
attending public school. But this example is
but the situation would certainly be different for those pursuing the only instance we can think of. Could a health care-related
temporary minimum-wage jobs in a foreign country.
implant such as the VeriChip tag become a public health imperaSilverman made his proposal, that immigrants and guest tive? Would that use lead down a slippery slope toward universal
workers be implanted with RFID chips, amid a national debate chipping? It seems unlikely.
in the United States about illegal immigration, focusing on
VeriChip Corp. does not, in fact, advocate universal chipping
impoverished Latin Americans in search of work. But might for medical purposes. The company's vice president of mediSilverman's proposition apply as well to electrical engineers or cal applications, Richard Seelig, estimates a U.S. market for
doctors, or other high-status individuals coming into the coun- VeriMed of 43 million to 45 million people-less than one-sixth
try for work? Who decides?
of the population. This group is made up of people who are more
Mandating guest workers to have RFID chips implanted in likely than others to wind up in the emergency room. These
their bodies for identification purposes strikes us as coercive and include cancer patients undergoing chemotherapy; people with
opportunistic. That approach makes the RFID chip a branding pacemakers or other medical implants; and those who might
device similar to what a cowboy uses when he sears the haunches be suffering some sort of cognitive impairment or loss of conof his cattle or the tattoos that the Nazis forced on their victims sciousness due to epilepsy, diabetes, or Alzheimer's disease.
in concentration camps. It goes against the widely held belief
We believe that even Seelig's estimates of the potential size
in basic human rights and might even be interpreted as a viola- of the market for patient identification are grossly exaggerated.
tion of Article 3 of the United Nations' Universal Declaration of "For certain subpopulations-Alzheimer's patients, the mentally
Human Rights, which affirms everybody's right to "life, liberty, ill, people with communication difficulties-having an implanted
and security of person."
identifier makes great sense," says John Halamka, a former emerSocial researchers are just beginning to study people's atti- gency physician and now CIO at Beth Israel Deaconess Medical
tudes to implanted RFID. Christine Perakslis and Robert Wolk Center, in Boston. "Others can just carry a card in their wallet, a
at Bridgewater State University, in Massachusetts, questioned medic-alert bracelet, or a USB drive with their personal health
141 college students on their feelings about implanted RFID. records. There is no clear medical or business justification for chipRespondents were asked if they would be willing to have an ping large populations of healthy people."
implant to prevent ID theft, to combat terrorism, for other
In fact, so far there is no clear evidence that the VeriChip will
national security reasons, as a life-saving device, or to ensure help patients facing medical emergencies. The first study designed
the safety of themselves and their families. About a third of the to determine whether patients, physicians, and insurers benefit at
respondents were willing to be implanted, while less than half all from VeriChip began only last fall, in New Jersey.
of them were not. Wolk and Perakslis's subjects were the least
Other nonimplanted technologies based on RFIDs may soon
comfortable with chipping as a cure for ID theft. The reasons provide some of the benefits to the patient VeriChip hopes for. For
that garnered the most support for getting chipped were to save instance, nonprofit health care informatics organization MedicAlert
their lives or to ensure the safety of their family.
is researching RFID-enabled bracelets that would link to a personal
Another small survey in 2003 by Starr Roxanne Hiltz, professor health care record. However, as with VeriChip, a key question is
of information systems at the New Jersey Institute of Technology, how to ensure the privacy of the information in the databases,
in Newark, and her colleagues found that 18 out of 23 people ques- while at the same time providing easy access to the database by
tioned objected to the idea of implantable chips as identification.
caregivers in emergency situations.
Some of the resistance has to do with feelings about modification to one's body. "If they are putting something inside of you," a RIght to PRIVaCy is at the heart of some of the questions
one respondent replied, "it's like you're changing yourself. It's not raised by implanted RFID tags. In agreeing to be chipped for
right." As the wide variety of acceptable and unacceptable pierc- medical purposes, the patient gives up a measure of privacy
ings and tattoos found around the world attests, people of different for his or her own potential benefit. But when chipping is
backgrounds vary in their attitudes toward "changing yourself."
used for other reasons, difficult confidentiality issues can arise.

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Table of Contents for the Digital Edition of IEEE Spectrum March, 2007