Section 4.7. Asylum

4.7. Asylum

Do we really want to go there? This is a question we must continue to ask as we intertwingle ourselves into a future with exciting benefits but cloudy costs. Though subdermal RFID chips were approved on the basis of their lifesaving potential, the FDA raised serious questions about their safety including electrical hazards, MRI incompatibility, adverse tissue reaction, and migration of the implanted transponder. In their guidance document, the FDA also detailed the risks of compromised information security, noting that transmissions of medical and financial data could be intercepted, and that the devices could be used to track an individual's movements and location. I don't know about you, but I plan to wait out the beta test.

But even as we spurn the bleeding edge, these technologies seep into every nook and cranny of our lives. I recently stumbled across a telling story about ubiquitous computing at a leading psychiatric hospital in Manhattan.[*] Based on the belief that allowing patients to talk on the phone may speed their recovery from depression or hasten their emergence from psychosis, doctors had approved the use of cell phones and other wireless devices. The patients loved this new freedom, and the ward was soon bustling with cell phones, laptops, Palm Pilots, and BlackBerries. As you might suspect, the results were mixed. The enhanced personal communication appeared to have real clinical benefit for many patients, but on the other hand, nurses found themselves constantly recharging batteries. In a place where people may use power cords to hang themselves, wireless has special meaning. However, the most serious problem was disruption. As one doctor noted:

[*] "In a Mental Institute, the Call of the Outside" by David Hellerstein, M.D. New York Times, January 27, 2004.

There was a constant ringing on the unit. All these different ring tones. Some people would put them on vibrate mode and sneak them into group and then want to walk out to answer their calls. Or they would be talking to their friends and would ignore the nurses.

The final straw was the new camera phones, which threatened to eliminate any semblance of privacy. The intertwingling of inside and outside had spiraled out of control. The very essence of the asylum as a save haven and protective shelter was under attack. The decision was made. Laptops and Palm Pilots were permitted, but no more cell phones. At first, there were protests as patients argued their right to communicate, but eventually the right to privacy and the virtues of peaceful sanctuary prevailed. Of course, as the lines between cell phones and Palm Pilots blur, the debate may be revisited. Said one doctor:

Is it over? I don't know. Here at the institute, our enthusiasm for wireless connectivity has been tempered by reality. We have reclaimed a fragment of asylum. But my guess is that we will face a next challenge by the wireless world, and that we will continually have to work to define our relation to it. My guess is that the battle has just begun.

This story resonates in the outside world. We love our cell phones but not the disruption. We love our email but not the spam. Our enthusiasm for ubiquitous computing will undoubtedly be tempered by reality. Our future will be at least as messy as our present. But we will muddle through as usual, satisficing under conditions of bounded rationality. And if we are lucky, and if we make good decisions about how to intertwingle our lives with technology, perhaps we too can reclaim a fragment of asylum.