Ethical Considerations Behind Brain-Computer Interface Research
Emergent neurotechnologies such as brain-computer interface (BCI) systems provide exciting opportunities for repairing, enhancing, and understanding the brain and the body. Specifically, rapid advances in neural-interface science and robotics technology have made it possible to communicate bi-directionally with the brain. During the last decade, there have been remarkable developments in the creation of algorithms that decipher neural activity and the use of those algorithms in BCI systems to reconstitute motor function. These developments promise to reduce the burden of disability after accident, injury, or illness. Ethical questions arise, however, because these profound advances are happening quickly and these neuro-robotic technologies have the potential to alter humanity as we know it.
BCI systems now allow people with mobility impairments such as tetraplegia to operate prosthetic devices with just their thoughts. Invasive BCI systems acquire neural signals with intracranial or subdural penetrating electrodes, while non-invasive BCI systems acquire neural signals outside the head with scalp electroencephalography. Current BCI systems utilize neurophysiological or metabolic signals originating in the brain to control external devices or computers. These signals are fed into a decoding algorithm that transforms them into functional outputs to control robotic limbs or screen cursors. A closed control loop is normally established via the user's visual feedback of the prosthetic limb's or robotic orthosis' movement. In the case of BCI robotic orthoses, there is transfer of both power and information signals from the human to the robot and vice-versa. These "co-robots" work with people and enhance human capabilities, performance, and safety.
A growing number of implantable brain-interfacing devices designed for the treatment of movement disabilities and disorders of mood, behavior, and thought are currently in use. The development of BCI systems to reduce the burden of disability is not only ethically permissible, but it is also a highly respected scientific and clinical human endeavor. Clearly, the balance of the predictable benefits to the patient against the expected risks imposed by the intervention must be carefully examined on an individual basis and disclosed to the potential patient. Jens Clausen, PD, Dr med, Department of Medical Ethics, University of Tübingen, Germany, identifies questions of personality and identity with respect to unwanted alterations in behavior that could be triggered by BCI use that may affect cognition, perception, and well-being. For example, fatigue is common following deep brain stimulation (DBS) surgery for the treatment of tremor in Parkinson's disease and significantly impacts the quality of life of those patients.
Moreover, understanding patients' and caregivers' conceptions of personal identity and agency (assignment of responsibility for our own actions) when deploying BCI systems is important not only for the informed consent process, but also for questions of public policy and legal issues regarding the attribution of human behavior to algorithms. This is particularly difficult to assess in the case of co-robots given the information exchange between the human brain and the robot.
The use of BCI systems for enhancing the brain or the body presents a far more complicated scenario not only in terms of the consent process and deciding whether the benefits of using the system outweigh the risks but also the potential impact to society at large. We have already experienced the debate on whether, for example, a sprinter fitted with high-tech prosthetic legs should be allowed to compete with able-bodied athletes in sanctioned competitions. The same considerations could potentially apply to persons who are "fitted" with BCI systems for the purposes of enhancing cognition, perception, and action. As these neurotechnologies continue to advance, it will be increasingly important to assess the neuroethical ramifications of their deployment in society.
Josè L. Contreras-Vidal, PhD, is the director of the Laboratory for Noninvasive Brain-Machine Interface Systems and a professor in the Department of Electrical and Computer Engineering, University of Houston, Texas. He can be reached at firstname.lastname@example.org