Should Your Employer Have Access to Your Fitbit Data?
The modern world today has become more dependent on technology than ever. We want to achieve maximal tasks with minimal human effort. And increasingly, we want our technology to go wherever we go.
Wearable devices operate by collecting massive amounts of personal information on unsuspecting users.
At work, we are leveraging the immense computing power of tablet computers. To supplement social interaction, we have turned to smartphones and social media. Lately, another novel and exciting technology is on the rise: wearable devices that track our personal data, like the FitBit and the Apple Watch. The interest and demand for these devices is soaring. CCS Insight, an organization that studies developments in digital markets, has reported that the market for wearables will be worth $25 billion by next year. By 2020, it is estimated that a staggering 411 million smart wearable devices will be sold.
Although wearables include smartwatches, fitness bands, and VR/AR headsets, devices that monitor and track health data are gaining most of the traction. Apple has announced the release of Apple Health Records, a new feature for their iOS operating system that will allow users to view and store medical records on their smart devices. Hospitals such as NYU Langone have started to use this feature on Apple Watch to send push notifications to ER doctors for vital lab results, so that they can review and respond immediately. Previously, Google partnered with Novartis to develop smart contact lens that can monitor blood glucose levels in diabetic patients, although the idea has been in limbo.
As these examples illustrate, these wearable devices present unique opportunities to address some of the most intractable problems in modern healthcare. At the same time, these devices operate by collecting massive personal information on unsuspecting users and pose unique ethical challenges regarding informed consent, user privacy, and health data security. If there is a lesson from the recent Facebook debacle, it is that big data applications, even those using anonymized data, are not immune from malicious third-party data-miners.
On consent: do users of wearable devices really know what they are getting into? There is very little evidence to support the claim that consent obtained on signing up can be considered 'informed.' A few months ago, researchers from Australia published an interesting study that surveyed users of wearable devices that monitor and track health data. The survey reported that users were "highly concerned" regarding issues of privacy and considered informed consent "very important" when asked about data sharing with third parties (for advertising or data analysis).
However, users were not aware of how privacy and informed consent were related. In essence, while they seemed to understand the abstract importance of privacy, they were unaware that clicking on the "I agree" dialog box entailed giving up control of their personal health information. This is not surprising, given that most user agreements for online applications or wearable devices are often in lengthy legalese.
Companies could theoretically use their employees' data to motivate desired behavior, throwing a modern wrench into the concept of work/life balance.
Privacy of health data is another unexamined ethical question. Although wearable devices have traditionally been used for promotion of healthy lifestyles (through fitness tracking) and ease of use (such as the call and message features on Apple Watch), increasing interest is coming from corporations. Tractica, a market research firm that studies trends in wearable devices, reports that corporate consumers will account for 17 percent of the market share in wearable devices by 2020 (current market share stands at 1 percent). This is because wearable devices, loaded with several sensors, provide unique insights to track workers' physical activity, stress levels, sleep, and health information. Companies could theoretically use this information to motivate desired behavior, throwing a modern wrench into the concept of work/life balance.
Since paying for employees' healthcare tends to be one of the largest expenses for employers, using wearable devices is seen as something that can boost the bottom line, while enhancing productivity. Even if one considers it reasonable to devise policies that promote productivity, we have yet to determine ethical frameworks that can prevent discrimination against those who may not be able-bodied, and to determine how much control employers ought to exert over the lifestyle of employees.
To be clear, wearable smart devices can address unique challenges in healthcare and elsewhere, but the focus needs to shift toward the user's needs. Data collection practices should also reflect this shift.
Privacy needs to be incorporated by design and not as an afterthought. If we were to read privacy policies properly, it could take some 180 to 300 hours per year per person. This needs to change. Privacy and consent policies ought to be in clear, simple language. If using your device means ultimately sharing your data with doctors, food manufacturers, insurers, companies, dating apps, or whoever might want access to it, then you should know that loud and clear.
The recent implementation of European Union's General Data Protection Regulation (GDPR) is also a move in the right direction. These protections include firm guidelines for consent, and an ability to withdraw consent; a right to access data, and to know what is being done with user's collected data; inherent privacy protections; notifications of security breach; and, strict penalties for companies that do not comply. For wearable devices in healthcare, collaborations with frontline providers would also reveal which areas can benefit from integrating wearable technology for maximum clinical benefit.
In our pursuit of advancement, we must not erode fundamental rights to privacy and security, and not infringe on the rights of the vulnerable and marginalized.
If current trends are any indication, wearable devices will play a central role in our future lives. In fact, the next generation of wearables will be implanted under our skin. This future is already visible when looking at the worrying rise in biohacking – or grinding, or cybernetic enhancement – where people attempt to enhance the physical capabilities of their bodies with do-it-yourself cybernetic devices (using hacker ethics to justify the practice).
Already, a company in Wisconsin called Three Square Market has become the first U.S. employer to provide rice-grained-sized radio-frequency identification (RFID) chips implanted under the skin between the thumb and forefinger of their employees. The company stated that these RFID chips (also available as wearable rings or bracelets) can be used to login to computers, open doors, or use the copy machines.
Humans have always used technology to push the boundaries of what we can do. But in our pursuit of advancement, we must not erode fundamental rights to privacy and security, and not infringe on the rights of the vulnerable and marginalized. The rise of powerful wearables will also necessitate a global discussion on moral questions such as: what are the boundaries for artificially enhancing the human body, and is hacking our bodies ethically acceptable? We should think long and hard before we answer.
Stronger psychedelics that rewire the brain, with Doug Drysdale
A promising development in science in recent years has been the use technology to optimize something natural. One-upping nature's wisdom isn't easy. In many cases, we haven't - and maybe we can't - figure it out. But today's episode features a fascinating example: using tech to optimize psychedelic mushrooms.
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These mushrooms have been used for religious, spiritual and medicinal purposes for thousands of years, but only in the past several decades have scientists brought psychedelics into the lab to enhance them and maximize their therapeutic value.
Today’s podcast guest, Doug Drysdale, is doing important work to lead this effort. Drysdale is the CEO of a company called Cybin that has figured out how to make psilocybin more potent, so it can be administered in smaller doses without side effects.
The natural form of psilocybin has been studied increasingly in the realm of mental health. Taking doses of these mushrooms appears to help people with anxiety and depression by spurring the development of connections in the brain, an example of neuroplasticity. The process basically shifts the adult brain from being fairly rigid like dried clay into a malleable substance like warm wax - the state of change that's constantly underway in the developing brains of children.
Neuroplasticity in adults seems to unlock some of our default ways of of thinking, the habitual thought patterns that’ve been associated with various mental health problems. Some promising research suggests that psilocybin causes a reset of sorts. It makes way for new, healthier thought patterns.
So what is Drysdale’s secret weapon to bring even more therapeutic value to psilocybin? It’s a process called deuteration. It focuses on the hydrogen atoms in psilocybin. These atoms are very light and don’t stick very well to carbon, which is another atom in psilocybin. As a result, our bodies can easily breaks down the bonds between the hydrogen and carbon atoms. For many people, that means psilocybin gets cleared from the body too quickly, before it can have a therapeutic benefit.
In deuteration, scientists do something simple but ingenious: they replace the hydrogen atoms with a molecule called deuterium. It’s twice as heavy as hydrogen and forms tighter bonds with the carbon. Because these pairs are so rock-steady, they slow down the rate at which psilocybin is metabolized, so it has more sustained effects on our brains.
Cybin isn’t Drysdale’s first go around at this - far from it. He has over 30 years of experience in the healthcare sector. During this time he’s raised around $4 billion of both public and private capital, and has been named Ernst and Young Entrepreneur of the Year. Before Cybin, he was the founding CEO of a pharmaceutical company called Alvogen, leading it from inception to around $500 million in revenues, across 35 countries. Drysdale has also been the head of mergers and acquisitions at Actavis Group, leading 15 corporate acquisitions across three continents.
In this episode, Drysdale walks us through the promising research of his current company, Cybin, and the different therapies he’s developing for anxiety and depression based not just on psilocybin but another psychedelic compound found in plants called DMT. He explains how they seem to have such powerful effects on the brain, as well as the potential for psychedelics to eventually support other use cases, including helping us strive toward higher levels of well-being. He goes on to discuss his views on mindfulness and lifestyle factors - such as optimal nutrition - that could help bring out hte best in psychedelics.
Show links:
Doug Drysdale full bio
Doug Drysdale twitter
Cybin website
Cybin development pipeline
Cybin's promising phase 2 research on depression
Johns Hopkins psychedelics research and psilocybin research
Mets owner Steve Cohen invests in psychedelic therapies
Doug Drysdale, CEO of Cybin
How the body's immune resilience affects our health and lifespan
Story by Big Think
It is a mystery why humans manifest vast differences in lifespan, health, and susceptibility to infectious diseases. However, a team of international scientists has revealed that the capacity to resist or recover from infections and inflammation (a trait they call “immune resilience”) is one of the major contributors to these differences.
Immune resilience involves controlling inflammation and preserving or rapidly restoring immune activity at any age, explained Weijing He, a study co-author. He and his colleagues discovered that people with the highest level of immune resilience were more likely to live longer, resist infection and recurrence of skin cancer, and survive COVID and sepsis.
Measuring immune resilience
The researchers measured immune resilience in two ways. The first is based on the relative quantities of two types of immune cells, CD4+ T cells and CD8+ T cells. CD4+ T cells coordinate the immune system’s response to pathogens and are often used to measure immune health (with higher levels typically suggesting a stronger immune system). However, in 2021, the researchers found that a low level of CD8+ T cells (which are responsible for killing damaged or infected cells) is also an important indicator of immune health. In fact, patients with high levels of CD4+ T cells and low levels of CD8+ T cells during SARS-CoV-2 and HIV infection were the least likely to develop severe COVID and AIDS.
Individuals with optimal levels of immune resilience were more likely to live longer.
In the same 2021 study, the researchers identified a second measure of immune resilience that involves two gene expression signatures correlated with an infected person’s risk of death. One of the signatures was linked to a higher risk of death; it includes genes related to inflammation — an essential process for jumpstarting the immune system but one that can cause considerable damage if left unbridled. The other signature was linked to a greater chance of survival; it includes genes related to keeping inflammation in check. These genes help the immune system mount a balanced immune response during infection and taper down the response after the threat is gone. The researchers found that participants who expressed the optimal combination of genes lived longer.
Immune resilience and longevity
The researchers assessed levels of immune resilience in nearly 50,000 participants of different ages and with various types of challenges to their immune systems, including acute infections, chronic diseases, and cancers. Their evaluation demonstrated that individuals with optimal levels of immune resilience were more likely to live longer, resist HIV and influenza infections, resist recurrence of skin cancer after kidney transplant, survive COVID infection, and survive sepsis.
However, a person’s immune resilience fluctuates all the time. Study participants who had optimal immune resilience before common symptomatic viral infections like a cold or the flu experienced a shift in their gene expression to poor immune resilience within 48 hours of symptom onset. As these people recovered from their infection, many gradually returned to the more favorable gene expression levels they had before. However, nearly 30% who once had optimal immune resilience did not fully regain that survival-associated profile by the end of the cold and flu season, even though they had recovered from their illness.
Intriguingly, some people who are 90+ years old still have optimal immune resilience, suggesting that these individuals’ immune systems have an exceptional capacity to control inflammation and rapidly restore proper immune balance.
This could suggest that the recovery phase varies among people and diseases. For example, young female sex workers who had many clients and did not use condoms — and thus were repeatedly exposed to sexually transmitted pathogens — had very low immune resilience. However, most of the sex workers who began reducing their exposure to sexually transmitted pathogens by using condoms and decreasing their number of sex partners experienced an improvement in immune resilience over the next 10 years.
Immune resilience and aging
The researchers found that the proportion of people with optimal immune resilience tended to be highest among the young and lowest among the elderly. The researchers suggest that, as people age, they are exposed to increasingly more health conditions (acute infections, chronic diseases, cancers, etc.) which challenge their immune systems to undergo a “respond-and-recover” cycle. During the response phase, CD8+ T cells and inflammatory gene expression increase, and during the recovery phase, they go back down.
However, over a lifetime of repeated challenges, the immune system is slower to recover, altering a person’s immune resilience. Intriguingly, some people who are 90+ years old still have optimal immune resilience, suggesting that these individuals’ immune systems have an exceptional capacity to control inflammation and rapidly restore proper immune balance despite the many respond-and-recover cycles that their immune systems have faced.
Public health ramifications could be significant. Immune cell and gene expression profile assessments are relatively simple to conduct, and being able to determine a person’s immune resilience can help identify whether someone is at greater risk for developing diseases, how they will respond to treatment, and whether, as well as to what extent, they will recover.