> 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.
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'.
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!
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.
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.
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.
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.
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.
You, an engineer at a major aircraft manufacturer that isn't Boeing, have been working after hours with some of your colleagues on a hobby project to add some modern safety features to an older model of small private plane, because you regard it as unsafe even though it still has a government certification and you got into this field because you want to save lives.
Your "prototype" is a plane from the original manufacturer with no physical modifications but a software patch to use data from sensors the plane already had to prevent the computer from getting confused under high wind conditions in a way that has already caused two fatal crashes.
Now you have to fly somewhere and your options for a plane are the one with the history of fatal crashes or the same one with your modifications, and it's windy today. Which plane are you getting on?
Are you kidding me? How many times have you unwillingly introduced bugs into a code base you didn’t fully understand? That’s basically table stakes for software engineering.
> Definitely not the untested code I wrote myself!
Nobody said it was untested.
> How many times have you unwillingly introduced bugs into a code base you didn’t fully understand? That’s basically table stakes for software engineering.
Which applies just the same to the people the company hired to do it, and now we're back to "the people with a stronger incentive to get it right are the people who die if it goes wrong".
I can’t tell if you seriously think a random person writing code in their basement is equivalent to a company that has access to API docs, design specs, actual test hardware, the expertise of a ton of engineers that have worked on the project and understand how it can go wrong, not to mention all the regulations and verifications they’re subject to.
But if you do then wow. That really puts in perspective the kind of people that use hacker news. I’m gonna be more selective about who I bother replying to going forward.
> I can’t tell if you seriously think a random person writing code in their basement is equivalent to a company that has access to API docs, design specs
Are you saying not having those things is dangerous? They should be required to publish all of that for safety-critical devices then.
> actual test hardware
Why would arbitrary people be unable to buy test hardware? Again something to be addressed if true rather than used as an excuse.
> the expertise of a ton of engineers that have worked on the project and understand how it can go wrong
Do they not have internet access? If they don't even work for the company anymore then that could be the only way to access that information.
Literally something which is happening on the linked Reddit page.
> not to mention all the regulations and verifications they’re subject to.
Regulations are for preventing someone else from harming you. You don't need a government incentive to protect you from yourself, you already come with that incentive.
Tested how? With 100% "unit test" coverage? I can certainly see how a random person on the internet might be highly motivated and actually talented enough to contribute to these sorts of projects. But they don't have the budget and resources that commercial entities have. They don't have the same due diligence requirements. They don't have the same liability. If I use a commercial device unaltered, it's the company's fault if the device fucks up or is defective and causes harm. If I install random internet software on my medical device and it fucks up and causes harm, it's my fault.
I say this as someone who might modify my own medical devices because I'm so fucking jaded over the capitalist march towards enshitification and maximizing profit over human lives. There is simply no way random folks on the internet can test these types of systems to any reliable degree. It requires rigorous testing across hundreds to thousands of test cases. They at best can give you the recipe that works well for them and the few people that have voluntarily tried their version. That doesn't scale and certainly isn't any safer than corporate solutions.
Why do people think constantly something made by some random company is automatically better than something made "DIY".
I totally understand, that because of liability and some more availability of resources, you would expect a company product to be "safe". BUT: if it is your butt that is going to be in the line, then I bet you: you will be much more careful that a random engineer in some random company. About the resources available in a big company, they are usually more directed to marketing, legal (including lobbing to avoid right to repair) and oder areas to maximize revenue, and not exactly in quality.
I worked in 2 different big companies which worked in "mission critical systems" and boy! I can tell you some stories about how unsafe is what they do, and how much money is invested in "cover your ass" instead of making products better/safer.
I thought I explained it, but I'll break it down into smaller words. Medical software doesn't just have to solve one particular users's problems. It has to be generalized to the majority of folk seeking treatment for a particular problem. If one particular CPAP user is able to tweak their settings to work better for their particular lifestyle, it is not generalizeable to every CPAP user. A corporation offering a general solution is put under *far* more scrutiny than a random github repo is. A corporation can be sued for releasing a product that kills people, but good luck convincing a court that your family deserves restitution for you installing a random script you found on the internet into your insulin pump.
This has fuck all to do with how much corporations care about people. It has everything to do with liability laws and how victims can get restitution. It has everything to do with the actual risks of installing random internet scripts versus the corporations who have to jump through regulatory hoops. And it's not to say corporations get everything right. They fuck things up constantly. But they fuck things up constantly with oversight and regulation and you want me to believe random internet users will make a better product without it. It's nonsense.
I have explained it already in other comments, but let me break it down for you again:
The “liability”, “scrutiny”, “regulation” only generate “cover your ass” measures, bureaucracy, red tape, costs, and hardly any real measure to increase quality or safety. My work is in such a critical mission systems company, and they don’t give a shit about safety, just are interested in coming out clean or not waste too much money in settlement with dead people relatives.
> but good luck convincing a court that your family deserves restitution for you installing a random script you found on the internet into your insulin pump.
And good luck fighting a Pharma corporation for whatever did wrong. BTW, you bring the CPAP topic. Maybe you can read this at leisure [1] in this case, because it was a huge scandal, they pay. But 90% of the time, they don’t. And even if this case, with legal cost deducted, and divided by all people, is not a real compensation (spoiler alert: it never ever is!).
Please note in this case they DID KNOW about the issue, and did nothing. So much for liability and scrutiny.
This is fucking retarded. Liability isn't just CYA. It's real fucking consequences when someone dies. From your own fucking source:
> Philips Respironics agreed to a $1.1 billion settlement on April 29, 2024, to compensate people for financial damages related to the recall.
Which open source individual contributor will agree to a $1.1 billion dollar settlement because of wrongdoing? Not a single fucking one because those numbers don't make sense when random internet users are promising salvation if you just download their firmware. What a complete crock of shit you're suggesting here and you're just reinforcing my point. Did you even do the barest amount of critical thinking here?
random internet users are not promising salvation, nor or they taking profit.
they are saying: i made this and it worked for me in my specific case. you can look at it (or have a trusted knowledgable friend look at it), and use it, for zero payment; if you want to, if the paid solutions offered on the market are insufficient for your specific case.
they would never need to come up with 1.1 billion dollars because they're not making 10x that from selling things that still harm people despite the resources that that profit makes available.
> But they don't have the budget and resources that commercial entities have.
Everyone is standing on the shoulders of giants. You're not going from stone tools to jet engines in a month, but you could fix a bug in one in that time.
> They don't have the same due diligence requirements. They don't have the same liability.
Things that exist to try to mitigate the misalignment of incentives that comes from paying someone else to create something you depend on. Better for the incentives to align to begin with.
Notice also that these things are floors, not ceilings. The company is only required to do the minimum. You can exceed it by as much as you like.
> If I use a commercial device unaltered, it's the company's fault if the device fucks up or is defective and causes harm. If I install random internet software on my medical device and it fucks up and causes harm, it's my fault.
And then if the community version fixes a bug that would have killed you and you stick with the commercial version you can sue them for killing you. Except that you're dead.
> There is simply no way random folks on the internet can test these types of systems to any reliable degree.
Basically the entire population is on the internet, so the set of them includes all the people doing it for a corporation. Are they going to forget how to do their jobs when they go home, or when they or a member of their family gets issued another company's device and they want it to be right?
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.
See my other follow up comment ("same model"). Medical device software development feels much closer to homegrown (or worse) than aeronautical engineering.
Why do you think a random person, who is VERY passionate about something, as to invest all the free hours in life to do something, is less skilled that one who just does it because is needed to survive?
Sorry. I would be much more inclined to have something made by somebody passionate about it, as done by some guy that received hopefully some kind of instruction on how to do things and was then left alone.
In this context (GA) we are not comparing Airbus/Boeing with a garage build. We are comparing some small company making 2 seaters with your hangar and maybe 10 certified aircraft mechanics that will help you a lot on the process.
And why do you think pathos arguments are logical? Granted, they didn't cite them, but assuming it is true, empirical studies showing the accident rates are the logical point from which to draw conclusions. What you would like, how you and others feel about it, and what you would expect are meaningless.
You're also equivocating. They made it extremely clear they are referring to hobbyist and other such groups with vague or unknown qualifications; whereas, you go in and make stipulated claims about small businesses with certified mechanics, etc. These two are clearly not the same category, making your argument non-responsive. It's also contradictory in terms of discussed liabilities and such, as the small company, and its mechanics, that whoever worked with, would have liability as well, as opposed to the "random git repo".
You write that as if you have ample experience with codebases of medical devices and I'm going to take a stab at this and say that you don't. Prove me wrong.
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.
I think the Beechcraft Bonanza deserves special mention here. I'm sure all the people that worked on it were experts too!
The big problem with this analogy is that it conflates three very important things:
- GA is more dangerous, period. Doesn't matter whether you build the plane yourself or if you bought it ready made (hopefully new, hopefully very well maintained if second hand)
- GA craft tend to have less experienced pilots than airliners, but even airliner pilots tend to do worse as GA pilots than when they're at work. The reason for that is simple: the processes are what keeps commercial aviation (mostly) safe.
- GA craft tend to kill the pilots, because they are more often than not the only person on the plane.
- GA craft have malfunctions like larger aircraft, there is nothing special about them in that sense. But there is something that they don't have that larger aircraft do have: redundancy. In electronics systems, in the design of the mechanical bits, and finally in the people.
- GA craft that are designed and built by their operators are experimental class for a reason: they are untested and so more likely to fail than the ones that are certified. The design processes for commercial aircraft are nothing compared to the design processes employed by what we'll call hobbyists to distinguish them.
- And finally, even though it is a fun analogy I only meant it from a skin-in-the-game point of view, a GA hobbyist is still going to do his level best to make sure that he's not going to get killed. Boeing executives only care about the bottom line, safety is a distant second. And based on my experience with the difference between the guts of various bits and pieces of avionics and the software that they run on compared to my experience looking at medical devices, their guts and the software that they run on I would be more than happy to bet that the loop hackers know as much more more about the failure modes of these devices as the manufacturers do.
Cleanroom manufacturing under sterile conditions is the main differentiator here, and that just applies to the hardware, and it is an art that the medical industry understands very well. Electronics is already at a lower level of competence and their software knowledge tends to be terrible, not to mention the QA processes on said software.
Programmers working for corporations don't necessarily suddenly grow an extra quality brain when they do their work.
Now look at something like the Bede BD-5 and see how many of it's amatuer builders IT killed. Death rate on the first flight alone was something like 10%.
PS: AIrcraft aren't assembled in cleanrooms.
Frankly, you don't have a damn clue on and are getting basically everything wrong in the process
You can believe it and simultaneously function in society.
We aren't all building our own planes because it's worse, but because it's time consuming. I don't have 20,000 hours to burn learning about how planes work to make my own.
If we magically beamed the knowledge straight into people's heads and also had a matter fabricator, I'd imagine yes - everyone would build their own plane. And it might be safer, I don't know.
Point is, the ideas are not mutually exclusive. You can believe both and still resolve it internally and with the world
Not the original poster, but that was snark and not meant literally.
Also, building your own plane is absolutely worse, even if you do have expert-level knowledge. That's true for any complex design. Aircraft design, material sourcing, fabrication, assembly and quality control are all very different skill sets, but the real kicker is experience.
The reason why commercial aircraft are so safe is a lot of work goes into investigating and understanding the root causes of accidents, and even more work goes into implementing design fixes and crew training.
The problem is that the system incentivizes incompetence. The mechanics who are paid a skilled wage, take their time, and double check to make sure they are not missing anything show up as big red problems on the beancounters' spreadsheets and get optimized away.
The system can make up for this in other ways like repeatability of processes, redundancy, etc. Which is why commercial aviation is safer than general aviation, and also why I specifically worded my comment as being about the same model of plane - ie if instead of building your own experimental-class kit plane, you hired it out to a liability-limiting company hiring minimum-wage workers to follow the directions. I'm guessing such a thing is illegal per FAA regs, but that kind of proves my point.
For another example, have you experienced the medical system lately? Doctors are generally smart people, but that intelligence is squandered by having their attention smashed into 10 minute chunks, with the entire rest of the system revolving around blame passing - the end result is a lot of smart and well-meaning people ending up grossly incompetent through emergent effects. I would much rather be able to go to a doctor and trust whatever answers they gave me rather than having to do my own independent research and advocacy to drive the process. But that is not how the system we have works.
I don’t even disagree with you about the system incentives. I hate capitalism just as much as you!
But I still trust the institutions around me to keep me safe. Obviously that depends on where you live, I wouldn’t feel the same way if I still lived in Brazil.
Last time I went to a doctor was about 3 years ago. They diagnosed me in 5 minutes, and took another 10 to treat me and write me a prescription. It was great, I loved it.
Sounds like you have this trust issue with lots of different areas of your life, it might be worth reexamining your own perspective. Or maybe you just have to move to somewhere that you do trust.
I'm glad for you that you've had good experiences so far! "Diagnosed me in 5 minutes" doesn't sound like anywhere near a complex medical issue though.
I certainly keep trying to obtain good results from the system, ie extend trust, but situations routinely run aground. Can you really say it's a "trust issue" when the problem is that I dig into details of situations and repeatedly discover how so-called professionals abjectly drop key issues on the floor?
Latest example: I need a new dishwasher. I should be able to read some reviews, spend $1k, and get the problem solved, right? Guess again - first delivery, a dent (crease) in the tub from the thing being slammed so hard that its plastic frame deformed and pushed up into the metal tub. Second delivery - loud noise from wash motor. I try to engage with warranty service figuring I'd be fine with them swapping the whole pump assembly. Nope, the guy that comes can't even be assed to do his job either! "Oh that's normal so there is nothing to fix, this is a good model, you should keep it". Third try, wash motor sounds a little better but still has a problem. The third set of delivery guys didn't even take away unit #2 for the exchange (even though I even pushed back when they said someone else was going to come later). I had wanted to simply pay money to solve the problem, but instead I'm left with two noisy dishwashers and a big ole project in my court. (do I keep pushing this exchange button? do I just order a new pump assembly and fix it myself, considering the bonus dishwasher compensation for that? do I say fuck it to the whole brand and rethink the purchase decision?)
Sure, I could drop my standards here, check out, and stop caring about the details. The dented tub probably wouldn't leak a decade down the line, the loud motor isn't really that big of a deal if I only run it overnight, and if the motor needs replacing in a few years it's only a $200 repair. But should not giving in to this "best effort" service (after paying $1k) really be considered a "me" problem? It seems more like an economy problem, with me only being exceptional for noticing, having some expertise on how these things should function, and having the willingness to push back.
(although I am thankful that the thing in the front of my mind that I'm frustrated with is an appliance rather than dealing with the medical system again)
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.