Smart Pill
This brick is concerned with “Intelligent pills” (also known as “smart pills” or “robot pills” or “electronic pills”).
These are a combination of a drug and a device, which can be described as “an oral tablet that incorporates some type of medical device, such as a microchip, that, for example, controls the release of the active pharmaceutical ingredient after ingestion” (Avery and Liu, 2011).
This educational unit contains:
- A teaching plan to get students involved in a debate with a journalist
Learning Outcomes
- The computing learning objectives is to learn how to read documentation of IoT devices and evaluate whether there is coherency between natural language descriptions, formal technical specifications and the hardware.
- The ethical learning objectives are:
- To consider who is responsible for the privacy of the device-generated data
- To understand the implications of the device being faulty/buggy
- To learn how to protect devices against attacks.
- The transverse learning objectives are to develop communication skills and learn how to interact with the media.
Prerequisites
The pre-requisites are foundational knowledge of software engineering and networked/distributed system architectures. This implementation of the educational brick is aimed at 3rd/4th year engineering students who have chosen to specialise in information system management and development. As such, they participate in a module concerned with the architecture of complex systems, and apply their learning to developing a prototype system with a real industrial client, as part of a significant team project. In recent years, many of the team projects have incorporated technologies from the Internet-of-Things (IoT). Furthermore, the system requirements have become more and more demanding with respect to data protection and privacy (related to the GDPR in Europe). Finally, the students are becoming increasingly aware of the problem of such systems malfunctioning and the impact on the users when they fail because of internal bugs or because of unexpected attacks from the exterior.
Should I teach this?
- Suitable for teaching in Computer Science, Software Engineering, and Other courses
- Domain: Health Care
- Disciplines: Electronics, Journalism, Biology
Suggested teaching and assessment approaches
The delivery mechanism/teaching approach is based upon students being involved in a debate with a journalist concerning whether the technical and ethical issues have been well-addressed in the general media. This will involve role-playing, following the advice from Diana Adela Martin et al. (2019) . The evaluation is indirect – the students are evaluated through their project work, and one of the criteria is whether they have adequately considered the ethical issues.
- Step 1 – introductory reading (3 hours outside class) – the students are introduced to published research on general digital ethics (Stahl, B.C., Timmermans J., and Mittelstadt, B.D., 2016), ethics in IOT (AboBakr, A. and Azer, M., 2017), ethics in IOT health (Cerf, V., 2020) and, finally, smart pills (Avery, M. and Liu, D., 2011) ).
- Step 2.1 – class discussion (1.5 hours – small class room) – facts v opinions, legal v moral v ethical. The students are asked to use what they have learned from reading and discussing the published articles to analyse a report in the general media: Gut feeling: the swallowable gut sensor that could replace a colonoscopy. By Buffy Gorrilla, January 2017, The Sydney Morning Herald.(Web archive).
- Step 2.2 – search for new material (1.5 hours – small class room) – how to search/filter/categorise
- Step 3 – analysis (and comparison) of device specifications, manufacturer claims, media commentary (3 hours outside class) – provide the material only if the students fail to find it themselves
- Step 4.1 – class discussion (1 hour – small class room) – identify the different roles in the provided case study and their ethical responsibilities
- Step 4.2 – preparation for media panel role-playing (2 hours – small class room) – students decide on the structure and composition of panel debate
- Step 5 – preparation for media panel role-playing (3 hours outside class)
- Step 6.1 – media panel debate (1 hour – multi-media laboratory with video-conference and recording facilities) – with the assitance of a journalist who is specialist in digital ethics and/or smart-pills, there will be a panel discussion where students play various role (as identified earlier) and answer various questions (as identified during the preparation). The audio will be recorded for further analysis.
- Step 6.2 – panel debate review, evaluation and concluding discussion (2 hours – small class room) – Did the brick meet the learning objectives (technical and ethical)? The evaluation at this step is purely formative.
Resources

Further reading
Papers
Ethical issues (general)
- The ethics of computing: A survey of the computing-oriented literature. Stahl, Bernd Carsten, Job Timmermans, and Brent Daniel Mittelstadt. ACM Computing Surveys (CSUR) 48.4 (2016): 1-38.
Ethical issues (privacy)
- What must we hide: The ethics of privacy and the ethos of disclosure. Anita L Allen, St. Thomas Law Review, 25(1):1, 2012.
- Privacy by design: The 7 foundational principles. Ann Cavoukian et al., Information and Privacy Commissioner of Ontario, Canada, 5, 2009.
- Privacy issues and data protection in big data: A case study analysis under GDPR. Nils Gruschka, Vasileios Mavroeidis, Kamer Vishi, and Meiko Jensen. In 2018 IEEE International Conference on Big Data, pages 5027 – 5033. IEEE, 2018.
Ethical issues (safety and security)
- Are you sure your software will not kill anyone? Nancy Leveson. Communications of the ACM, 63(2):25–28, 2020.
Computing issues (IoT)
- IoT ethics challenges and legal issues. Ahmed AboBakr and Marianne A Azer. In 2017 12th International Conference on Computer Engineering and Systems (ICCES), pages 233–237. IEEE, 2017.
- Case study: The internet of things and ethics. Josephina Antoniou and Andreas Andreou. The Orbit Journal, 2(2), 2019.
Problem Domain (Health)
- Bringing smart pills to market: FDA regulation of ingestible drug/device combination products. Avery, M. and Liu, D. (2011), Food and Drug Law Journal, 66(3), pp.329-352.
- On the internet of medical things. Vinton G. Cerf. Commun. ACM, 63(8):5, July 2020.
- Ethics of the health-related internet of things: a narrative review. Brent Mittelstadt. Ethics and Information Technology9(3):157 – 175, 2017.
- Ethics in public health research – privacy and public health at risk: public health confidentiality in the digital age. Julie Myers, Thomas R Frieden, Kamal M Bherwani, and Kelly J Henning. American Journal of public health, 98(5):793 – 801, 2008.
- Cleartext data transmissions in consumer IOT medical devices. Daniel Wood, Noah Apthorpe, and Nick Feamster. In Proceedings of the 2017 Workshop on Internet of Things Security and Privacy, pages 7 – 12, 2017.
Books
- The public and the private realm. In The human condition, Hannah Arendt, chapter B, pages 22-78. University of Chicago Press, 1998.
Code of Ethics
Teaching Guidelines
- What Do We Teach When We Teach Tech Ethics? A Syllabi Analysis Proceedings of the 51st ACM Technical Symposium on Computer Science Education. 2020.
- The role of role-play in student awareness of the social dimension of the engineering profession. Martin, Diana Adela, Eddie Conlon, and Brian Bowe. European Journal of Engineering Education 44.6 (2019): 882-905.
Other resources
- Oxford Digital Ethics Lab
- Gut feeling: the swallowable gut sensor that could replace a colonoscopy. By Buffy Gorrilla, January 2017, The Sydney Morning Herald.(Web archive). KEYWORDs: IOT, Security, Health, smart-Pills
- FDA approves pill with sensor that digitally tracks if patients have ingested their medication . By Sandy Wash, US-FDA Press release, November 2017. (Web archive). KEYWORDs: IOT, Security, Health, smart-Pills
- The Potential and Perils of the IoT in Healthcare. . By Mark Stone, Security Intelligence, November 21, 2019. (Web archive). KEYWORDs: IOT, Security, Health
- Major Cyberattacks On Healthcare Grew 63% in 2016 ( Web archive.). By Kelly Sheridan, Darkreading, December 2016.(Web archive). KEYWORDs: Security, Health
- Hacked IV Pumps and Digital Smart Pens Can Lead to Data Breaches. By Dawn Kawamoto, DarkReading, April, 2017. (Web archive). KEYWORDs: IOT, Privacy, Health, Security
- St. Jude admits security vulnerabilities in cardiac devices. By Jessica Davis, January 2017, Healthcare news. (Web archive). KEYWORDs: IOT, Security, Health
- Bluetooth-Related Flaws Threaten Dozens of Medical Devices . By Lily Hay Newman, Wired, 20 Feb, 2020.(Web archive). KEYWORDs: IOT, Security, Health
- Smart locks opened with nothing more than a MAC address.. By Charlie Osborne, ZDNet, August 2020 . (Web archive). KEYWORDs: IOT, Security
- The health care blog (IOT)

Videos
Electronic pills can improve our health but create ethical and legal challenges – Rajamanickam Antonimuthu, Jan 2020
First digital pill approved by FDA – CBC News, Nov 2017
Bioethicists warn of first FDA approved digital pill – Al Jazeera, Nov 2017
Digital drugs will Transform Healthcare – Andrew Thompson, Health, WIRED, May 2014
Evaluate your Teaching
Don’t forget to evaluate your teaching! Did the students meet the learning objectives? You can ask the class to fill a questionnaire to collect both quantitative and qualitative data. The idea is that you can always improve your lectures and the resources based on the students’ feedback.
Let us know how we did
Do you think the resources can be ameliorated? Let us know how we can do better via email or leave a comment!