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      The Case for a Hippocratic Oath for Connected Medical Devices: Viewpoint

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          Abstract

          Prior to graduating from medical school, soon-to-be physicians take the Hippocratic Oath, a symbolic declaration to provide care in the best interest of patients. As the medical community increasingly deploys connected devices to deliver patient care, a critical question emerges: should the manufacturers and adopters of these connected technologies be governed by the symbolic spirit of the Hippocratic Oath? In 2016, I Am The Cavalry, a grassroots initiative from the cybersecurity research community, published the first Hippocratic Oath for Connected Medical Devices (HOCMD), containing 5 principles. Over the past three years, the HOCMD has gained broad support and influenced regulatory policy. We introduce 5 case studies of the HOCMD in practice, illustrating how the 5 principles can lead to a safer and more effective adoption of connected medical technologies.

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          Most cited references 2

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          Factors Influencing the Decision to Proceed to Firmware Upgrades to Implanted Pacemakers for Cybersecurity Risk Mitigation

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            A controlled experiment with a medical student honor system.

            In 1984 the student body at a midwestern medical school created an honor code and student honor council which supplemented the school's proctoring system. In consideration of recommending that the proctoring system be replaced by an honor system, the authors conducted a controlled experiment in which one trimester's behavioral science midterm and final examinations were unproctored and the midterm and final examinations in physiology and neuroscience were proctored. Using anonymous questionnaires, the authors discovered that significantly more students cheated and observed others cheating in behavioral science than in physiology or neuroscience examinations. Of 17 students who observed cheating, only two reported it, and they did so without providing the offenders' names.
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              Author and article information

              Contributors
              Journal
              J Med Internet Res
              J. Med. Internet Res
              JMIR
              Journal of Medical Internet Research
              JMIR Publications (Toronto, Canada )
              1439-4456
              1438-8871
              March 2019
              19 March 2019
              : 21
              : 3
              Affiliations
              [1 ] I Am The Cavalry Washington, DC United States
              [2 ] Biohacking Village New York, NY United States
              [3 ] Atlantic Council Washington, DC United States
              [4 ] Elektra Labs Boston, MA United States
              [5 ] Harvard-MIT Center for Regulatory Science Harvard University Boston, MA United States
              [6 ] Digital Medicine (DiMe) Society New York, NY United States
              [7 ] Heinz College of Information Systems and Public Policy Carnegie Mellon University Pittsburgh, PA United States
              [8 ] PTC Needham, MA United States
              Author notes
              Corresponding Author: Andrea Coravos andrea@ 123456elektralabs.com
              Article
              v21i3e12568
              10.2196/12568
              6444210
              30888323
              ©Beau Woods, Andrea Coravos, Joshua David Corman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.03.2019.

              This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

              Categories
              Viewpoint
              Viewpoint

              Medicine

              connected devices, ethics, cybersecurity, information technology, delivery of health care

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