6 ms·

There are a lot of people hacking on insulin pumps and they are lightyears ahead of commerce. If you want a very interesting rabbit hole to dive into try 'artif

by jacquesm 11mo ago

There are a lot of people hacking on insulin pumps and they are lightyears ahead of commerce. If you want a very interesting rabbit hole to dive into try 'artificial pancreas hacking' as google feed. One interesting link: https://www.drugtopics.com/view/hacking-diabetes-the-diy-bionic-pancreas-is-here-to-stay https://www.drugtopics.com/view/hacking-diabetes-the-diy-bio... I would trust the people that hack on these systems to be even more motivated than the manufacturers to make sure they don't fuck up, it's the equivalent of flying a plane you built yourself.

bitmasher9 11mo ago
> it's the equivalent of flying a plane you built yourself A great analogy because people die that way. I personally would never push code to another person’s insulin pump (or advertise code as being used for an insulin pump) because I couldn’t live with the guilt if my bug got someone else killed.
- jacquesm 11mo ago
  I know people die that way (GA). But someone is working for the companies that make insulin pumps and they are not as a rule equally motivated so I would expect them to do worse, not better. And to the best of my knowledge none of the closed-loop people have died as a result of their work and they are very good at peer reviewing each others work to make sure it stays that way. And I'd trust my life to open source in such a setting long before I'd do it to closed source. At least I'd have a chance to see what the quality of the code is, which in the embedded space ranges from 'wow' all the way to 'no way they did that'.
  - chii 11mo ago
    > I would expect them to do worse, not better. which is why lots of systems and processes (sometimes called red tape) exist to try and prevent the undesired outcome, and dont rely on the competency of a single person as the weak link!
    - firtoz 11mo ago
      There are more financial reasons to violate and cheat the red tape than there are incompetent open source hackers in the world.
- horsawlarway 11mo ago
  And yet someone IS pushing code to these devices. Every single one. So the question really becomes - Are these people working on their own pumps with open source more or less invested than the random programmers hired by a company that pretty clearly can't get details right around licensing, and is operating with a profit motive? More reckless as well? Perhaps. But at least motivated by the correct incentives.
  - dullcrisp 11mo ago
    So flying in a plane you built yourself is in fact safer than flying commercial because the motivations line up. Got it.
    - mindslight 11mo ago
      Flying in a plane you built yourself is likely safer than flying in the same model of plane built by a company that assembled it for you using lowest-bid labor while making you sign a twenty page lawyer barf disclaiming liability.
      - amrocha 11mo ago
        You can’t honestly believe that or you wouldn’t be able to function in society.
        mindslight 11mo ago
        My comment rests on the fact that the types of planes you can build yourself are completely different models than the fully assembled models from the likes of Boeing etc. I do agree that a kit 737, if such a thing existed, would be less safe than one off the line.
        amrocha 11mo ago
        I would still trust a cessna way more than any plane built or modified by a single person.
- f1shy 11mo ago
  Anytime anybody does something himself, there is a risk. People die because of welding parts cleaned with break-cleaner, people die driving, diving, sky-diving, doing bungee jumping... Advertising that code, IMHO would be as showing of you doing extreme sports, for example. I do not think is any bad. A good disclaimer should be enough to take away any guilt.
- RobotToaster 11mo ago
  I'm not aware of any deaths attributed to open source artificial pancreas systems. Meanwhile there have been multiple attributed to closed source glucose monitors.
  - croemer 11mo ago
    Not attributed to. The FDA wording says "associated with" which is much weaker causally.
    - UomoNeroNero 11mo ago
      I can guarantee you, from my personal experience of being diabetic for 30 years, that every day—and in the most incredible ways—I have managed to “almost kill myself.” Whether when I used finger-prick testing, sensors, injecting insulin with pens, or managing insulin with a pump. Our life is always a delicate balancing act between too little, too much, and way too much—the kind where this time I really kick the bucket By personal choice I use a commercial CGM (if I could “touch it,” I’d be firmly on the side of certainty about killing myself through sheer stupidity), but reading something like “associated with” really makes me angry. Before making such subtle insinuations about the open-source world (the source of the revolution of the last 10 years in this field), regulatory bodies should open their eyes to what is actually happening with the quality of current sensors and the real problems they are causing.
      - jacquesm 11mo ago
        Thank you. And strength to you. I had a business partner for some time that was much like you and every time he'd be 10 minutes late for an appointment I'd get nervous and if it was more than an hour I'd be on the phone to his family to check up on him.
- fsflover 11mo ago
  https://news.ycombinator.com/item?id=46398414 https://news.ycombinator.com/item?id=46398414
socalgal2 11mo ago
> I would trust the people that hack on these systems to be even more motivated than the manufacturers to make sure they don't fuck up I would think it's the opposite. People that hack on this only risk their own life. Companies risk many people's lives and will get sued. Of course the person doing the hacking doesn't want to die but they're also willing to take the risk.
- wpm 11mo ago
  > People that hack on this only risk their own life. Provided they do not risk anyone elses, that is entirely their right.
- array_key_first 11mo ago
  Right, but getting sued is basically the least risky activity ever. Okay, a little dramatic but: you won't go to jail, and if you're rich and become less rich you're still better off than most people. In pure absolutionist terms, being a business owner is basically always less risky than being labor.
- tavavex 11mo ago
  The absolute worst-case scenario of messing this up as a company is that you get sued and they win, or you're forced to settle. You pay out some money, post a public apology, whatever. If things get really bad, the company goes under. But you're likely still far richer than the average person, and the blame is distributed enough that no one gets a criminal sentence - not that it was a realistic option to begin with. The baseline worst-case scenario of messing this up on yourself is that you die.
- Dilettante_ 11mo ago
  >People that hack on this only risk their own life Yeah, only their own life, yknow, something not particularly valuable or motivating to conserve for them, as opposed to the companies financials!
- rkomorn 11mo ago
  A lot of the other responses say something along the lines of "of course people have more incentive not to mess up, they care about their own lives more than corporations care about getting sued" and sure, that's true in general, but: - people try to wingsuit through narrow obstacles and miss - people try to build their own planes and helicopters and die - people try to build submersible vehicles to go see the titanic and, uh, don't have a 100% success rate - people try to build steam-powered rockets and die "It's their life, they won't fuck it up" doesn't exactly cover a lot of behaviors. I'd argue home-rolling your own medical device firmware is closer to daredevil/"hold my beer" behavior than normal.

bitmasher9 11mo ago

> it's the equivalent of flying a plane you built yourself A great analogy because people die that way. I personally would never push code to another person’s insulin pump (or advertise code as being used for an insulin pump) because I couldn’t live with the guilt if my bug got someone else killed.

jacquesm 11mo ago
I know people die that way (GA). But someone is working for the companies that make insulin pumps and they are not as a rule equally motivated so I would expect them to do worse, not better. And to the best of my knowledge none of the closed-loop people have died as a result of their work and they are very good at peer reviewing each others work to make sure it stays that way. And I'd trust my life to open source in such a setting long before I'd do it to closed source. At least I'd have a chance to see what the quality of the code is, which in the embedded space ranges from 'wow' all the way to 'no way they did that'.
- chii 11mo ago
  > I would expect them to do worse, not better. which is why lots of systems and processes (sometimes called red tape) exist to try and prevent the undesired outcome, and dont rely on the competency of a single person as the weak link!
  - firtoz 11mo ago
    There are more financial reasons to violate and cheat the red tape than there are incompetent open source hackers in the world.
horsawlarway 11mo ago
And yet someone IS pushing code to these devices. Every single one. So the question really becomes - Are these people working on their own pumps with open source more or less invested than the random programmers hired by a company that pretty clearly can't get details right around licensing, and is operating with a profit motive? More reckless as well? Perhaps. But at least motivated by the correct incentives.
- dullcrisp 11mo ago
  So flying in a plane you built yourself is in fact safer than flying commercial because the motivations line up. Got it.
  - mindslight 11mo ago
    Flying in a plane you built yourself is likely safer than flying in the same model of plane built by a company that assembled it for you using lowest-bid labor while making you sign a twenty page lawyer barf disclaiming liability.
    - amrocha 11mo ago
      You can’t honestly believe that or you wouldn’t be able to function in society.
      - mindslight 11mo ago
        My comment rests on the fact that the types of planes you can build yourself are completely different models than the fully assembled models from the likes of Boeing etc. I do agree that a kit 737, if such a thing existed, would be less safe than one off the line.
        amrocha 11mo ago
        I would still trust a cessna way more than any plane built or modified by a single person.
f1shy 11mo ago
Anytime anybody does something himself, there is a risk. People die because of welding parts cleaned with break-cleaner, people die driving, diving, sky-diving, doing bungee jumping... Advertising that code, IMHO would be as showing of you doing extreme sports, for example. I do not think is any bad. A good disclaimer should be enough to take away any guilt.
RobotToaster 11mo ago
I'm not aware of any deaths attributed to open source artificial pancreas systems. Meanwhile there have been multiple attributed to closed source glucose monitors.
- croemer 11mo ago
  Not attributed to. The FDA wording says "associated with" which is much weaker causally.
  - UomoNeroNero 11mo ago
    I can guarantee you, from my personal experience of being diabetic for 30 years, that every day—and in the most incredible ways—I have managed to “almost kill myself.” Whether when I used finger-prick testing, sensors, injecting insulin with pens, or managing insulin with a pump. Our life is always a delicate balancing act between too little, too much, and way too much—the kind where this time I really kick the bucket By personal choice I use a commercial CGM (if I could “touch it,” I’d be firmly on the side of certainty about killing myself through sheer stupidity), but reading something like “associated with” really makes me angry. Before making such subtle insinuations about the open-source world (the source of the revolution of the last 10 years in this field), regulatory bodies should open their eyes to what is actually happening with the quality of current sensors and the real problems they are causing.
    - jacquesm 11mo ago
      Thank you. And strength to you. I had a business partner for some time that was much like you and every time he'd be 10 minutes late for an appointment I'd get nervous and if it was more than an hour I'd be on the phone to his family to check up on him.
fsflover 11mo ago
https://news.ycombinator.com/item?id=46398414 https://news.ycombinator.com/item?id=46398414

socalgal2 11mo ago

> I would trust the people that hack on these systems to be even more motivated than the manufacturers to make sure they don't fuck up I would think it's the opposite. People that hack on this only risk their own life. Companies risk many people's lives and will get sued. Of course the person doing the hacking doesn't want to die but they're also willing to take the risk.

wpm 11mo ago
> People that hack on this only risk their own life. Provided they do not risk anyone elses, that is entirely their right.
array_key_first 11mo ago
Right, but getting sued is basically the least risky activity ever. Okay, a little dramatic but: you won't go to jail, and if you're rich and become less rich you're still better off than most people. In pure absolutionist terms, being a business owner is basically always less risky than being labor.
tavavex 11mo ago
The absolute worst-case scenario of messing this up as a company is that you get sued and they win, or you're forced to settle. You pay out some money, post a public apology, whatever. If things get really bad, the company goes under. But you're likely still far richer than the average person, and the blame is distributed enough that no one gets a criminal sentence - not that it was a realistic option to begin with. The baseline worst-case scenario of messing this up on yourself is that you die.
Dilettante_ 11mo ago
>People that hack on this only risk their own life Yeah, only their own life, yknow, something not particularly valuable or motivating to conserve for them, as opposed to the companies financials!
rkomorn 11mo ago
A lot of the other responses say something along the lines of "of course people have more incentive not to mess up, they care about their own lives more than corporations care about getting sued" and sure, that's true in general, but: - people try to wingsuit through narrow obstacles and miss - people try to build their own planes and helicopters and die - people try to build submersible vehicles to go see the titanic and, uh, don't have a 100% success rate - people try to build steam-powered rockets and die "It's their life, they won't fuck it up" doesn't exactly cover a lot of behaviors. I'd argue home-rolling your own medical device firmware is closer to daredevil/"hold my beer" behavior than normal.