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Do implanted medical devices have a place in the military?

It’s something that could be really useful, but an ethical nightmare. I’m happy to be “tagged” (I currently have a magnet in a finger, I’ve previously had an NFC chip in the webbing between my thumb/fore finger and am interested in other things), but most people are not. Can we trust the safety of these devices? Can we trust that they will only be used for good? Who knows.

I think that in the future, implantable devices will become a lot more common place within the general population, stimulating their use within the military domain. These devices largely exist for medical purposes, but they can also have other uses. In this essay I will talk about how implantable devices are currently used within the medical domain, I will make suggestions as to how these types of devices could be used to augment future soldiers, and I will touch on the security issues associated with such devices.

The medical applications of implantable devices are becoming fairly well known. Pacemakers are tiny devices, weighing in the region of 20-50g, sending small electrical shocks in to the heart to regulate beating. The devices feature small sensors to detect if the heart is beating incorrectly, so that a correcting impulse can be sent. The responses of these devices are programmable, with updates being provided over RF transmission. These RF transmissions are provided by Pacemaker Programmer units. These used to be low range with the use of a “telemetry wand” to affect the device, but now they often just spit out RF from a distance in addition to the use of a small wand.

Another device is the implantable insulin pump. There are two types of devices here. The traditional device delivers a programmable amount of insulin slowly throughout the day, providing an additional bolus on command. In newer devices, the system monitors the user’s blood glucose levels continuously throughout the day, providing precise doses as required. Although the traditional insulin pumps are becoming more common place, automatic ones are still in their infancy. The US’s FDA only approved them for human use in 2016, and they do not appear to be available on the NHS over here in the UK. People known as biohackers have begun modifying their existing devices to become automatic, but these are in the minority.

Brain stimulation is another target for implantable devices, with the technology becoming more sophisticated over time. Deep Brain Stimulation, a technology where nodes are inserted in the brain and electrically stimulated, has been used successfully to help sufferers of Parkinson’s for the past 30+ years. This treatment previously required invasive surgical intervention for every session, but now the implanted nodes can be connected to a device similar to a pacemaker which is suitable for continuous shocks. Similar systems can also be used to treat other conditions such as epilepsy, and it has been proposed as treatment for severe depression and other mental disorders.
I alluded to the field of biohacking when talking about the modification of automatic insulin pumps. Biohacking is a field where people seek to, as the name suggests, hack their biology. This includes modifying medical devices, implanting other devices, and even modifying ones’ own genes through the use of CRISPR. Biohacking is generally done by hobbyists, leading to mixed levels of success. The CRISPR hacking for instance, to my knowledge, has not led to the superhumans that some promised, or the cure to herpes as a proponent of CRISPR recently declared that he had invented. Some success can be had in the area of small implantable devices. I have a magnet in my finger which allows me to enjoy the novelty of being able to “feel” electrical fields. It’s not the most useful of devices, but it demonstrates that implantable devices are not only viable, but available. Implantable RFID and NFC chips are available online, coming pre-loaded in to heavy gauge syringes for easier insertion.

So, what are the impacts of these technologies on the future battlespace? I think that there are two potential strands: enhancing the soldier, and taking better care of the soldier. Technologies such as CRISPR are still in their infancy, and I don’t think that within the next 10 years it will reach a level of success whereby Captain America can be created. However, I think that single use capabilities will be possible. Various drugs have been tested on soldiers in pursuit of the super soldier. What if soldiers could have an implantable capsule which when pierced via a hit (self-inflicted or otherwise), adrenaline or other chemicals could be dumped in to the soldiers system. Perhaps small electronic devices could be implanted in to soldiers, which could provide them with discreet information through vibrations. Perhaps Deep Brain Stimulation systems could be implanted to stimulate better decision making in soldiers during combat situations.
Less within the sci-fi domain, and with less ethical issues, is the use of implantable devices to better take care or soldiers. Wearable tech such as Fitbits can give us some information on the health of their wearers, such as movement, sleep, and heart rate statistics. In the future, could this sort of information be collected via implantable devices? Perhaps implantable devices would be more accurate, and could collect additional information such as blood pressure. If a soldier had a small implanted device which collected and stored such information, it could be offloaded to a server for analysis at the end of each day. This system could analyse data to assess the health of soldiers, and potentially detect the presence of underlying medical issues before they become a major issue to the soldier.

I once attended a talk where the speaker said that if exercise could be put in to a pill, everyone would take it. This is because of the effect it has on one’s health, as well as the potential for the extension of lifespan. Unfortunately, it is not available in a pill and so a lot of people don’t have the time for it. It is unlikely that it will be for a very long time. There is something that can expand the lifespan of humans right now however: monitoring of blood glucose levels. By keeping blood glucose within optimal bounds, one can expect to live longer. Diabetes sufferers tend to have shorter lifespans, in large due to the associated issues with blood glucose level regulation. Devices are available off the shelf which can automatically monitor blood glucose levels and ping the user if they go outside certain ranges. This information can be actioned upon by a diabetic person by altering them to take insulin or eat something, but it could also be used by non-diabetics in the alteration of behaviour. If you could see that after eating something it causes a massive spike, perhaps that would make the negative implications of your action seem more “real”, acting as more of a deterrent. Through devices such as this, perhaps the general health of soldiers could be improved.

As with many technologies which start out in the consumer world, the security of them would need a lot of work. Devices targeted towards the general population tend to have poor security as it makes them easier to use, even devices that could cause serious harm to users. At Black Hat I attended a talk on the security of insulin pumps and pacemakers. It turns out that standard practices aren’t being observed, such as the use of nonce values which a user wirelessly signals to their pump to deliver a bolus- a replay attack could allow one to dump lethal amounts of insulin in to a person’s bloodstream. The devices used to push updates to devices, generally owned by a doctor, sometimes don’t even need a username or password to gain access to. These devices pull unsigned firmware updates from the web over HTTP, from Windows XP based servers. The speakers at the Black Hat talk found that generally companies take it fairly well when they are alerted to the myriad of issues within their devices and do aim to fix them, but some see it as an attack on them personally and refuse to act.

Within the 10 years, I think that we will see the adaption of commercially available products such as the ones that I have mentioned today for use within the military. I also think that the use of implantable devices to augment future soldiers will also be more heavily considered, with novel technologies emerging and being investigated.

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