Brain machine interface (BMI) technology makes direct communication between the brain and a machine possible by means of electrodes. This paper reviews the existing and emerging technologies in this field and offers a systematic inquiry into the relevant ethical problems that are likely to emerge in the following decades.

This paper examines the implications of brain–machine interfaces (BMIs) from a libertarian perspective, arguing that their widespread use necessitates careful scrutiny due to potential risks to individual autonomy, freedom, privacy, and dignity. BMIs, while offering significant technological advancements, pose severe threats by potentially undermining fundamental libertarian values. The paper discusses how BMIs could enable invasive surveillance, thought manipulation, and emotional control, drawing parallels to Robert Nozick’s Experience Machine thought experiment. Unlike the hypothetical machine, which offers simulated experiences, BMIs (...) could facilitate real-time control over individuals’ thoughts and emotions, leading to unprecedented forms of government overreach and coercion. The paper concludes that although libertarians advocate for minimal state intervention, the profound impact of BMIs on personal freedom and autonomy warrants a cautious approach, including potential restrictions on their use to safeguard against their misuse and to preserve individual self-ownership and dignity. (shrink)

This comment responds to Kevin Warwick’s article on predictability and responsibility with respect to brain-machine interfaces in action. It compares conventional responsibility for device use with the potential consequences of phenomenological human-machine integration which obscures the causal chain of an act. It explores two senses of “responsibility”: 1) when it is attributed to a person, suggesting the morally important way in which the person is a causal agent, and 2) when a person is accountable and, on the basis of (...) fairness about rewards and sanctions, has a duty to act responsibly and accept liability. The comment suggests that, in the absence of absolute knowledge and predictability, we continue to engage in practical forms of reasoning about the responsibility for BMI-use in ways which are inclusive of uncertainties about the liability of persons versus devices and those who create them. (shrink)

Physically enhancing brain–machine interfaces communicate elec­tronically with the patient’s mind in both directions. They present significant opportunities to improve a patient’s health and to restore his or her physical function, but they also present problems for the patient’s sense of agency and self. This is exacerbated by notions of extension and enhancement that are not grounded in an authentic human anthropology that describes the inherently dignified person as an integral union of body and soul.

The aim of this paper is to clarify specific aspects of the impact of the brain-machine interface on our understanding of subjectivity. The brain-machine interface is presented as a phase of cyborgization of humans. Some projects in the field of brain-machine interface are aimed at enabling consensual telepathy - communication without symbolic mediation. Consensual telepathy refers to one of potential ways of transmission of information within singularity. Therefore, consensual telepathy is an important aspect of singularity. Singularity or human-machine symbiosis shows (...) some similarities with child-mother unity. Therefore, the psychodynamic perspective might be considered useful in thinking about human-machine symbiosis. Knowledge from developmental psychodynamic psychology combined with insights by Slavoj Zizek and Jean Baudrillard provides an additional perspective looking at human-machine symbiosis. The paper claims that if consensual telepathy becomes another way of communication, it will have the potential to annihilate subjectivity making it schizophrenic. At the same time, we look at the possibility of an escape from our inner world through the prism of addictions. (shrink)

The ethical monitoring of brain-machine interfaces (BMIs) is discussed in connection with the potential impact of BMIs on distinguishing traits of persons, changes of personal identity, and threats to personal autonomy. It is pointed out that philosophical analyses of personhood are conducive to isolating an initial thematic framework for this ethical monitoring problem, but a contextual refinement of this initial framework depends on applied ethics analyses of current BMI models and empirical case-studies. The personal autonomy-monitoring problem is approached by (...) identifying various ways in which the inclusion of a robotic controller in the motor pathway of an output BMI may limit or jeopardize personal autonomy. (shrink)

The loss or absence of vision is probably one of the most incapacitating events that can befall a human being. The importance of vision for humans is also reflected in brain anatomy as approximately one third of the human brain is devoted to vision. It is therefore unsurprising that throughout history many attempts have been undertaken to develop devices aiming at substituting for a missing visual capacity. In this review, we present two concepts that have been prevalent over the last (...) two decades. The first concept is sensory substitution, which refers to the use of another sensory modality to perform a task that is normally primarily sub-served by the lost sense. The second concept is cross-modal plasticity, which occurs when loss of input in one sensory modality leads to reorganization in brain representation of other sensory modalities. Both phenomena are training-dependent. We also briefly describe the history of blindness from ancient times to modernity, and then proceed to address themeansthat have been used to help blind individuals, with an emphasis on modern technologies, invasive (various type of surgical implants) and non-invasive devices. With the advent of brain imaging, it has become possible to peer into the neural substrates of sensory substitution and highlight the magnitude of the plastic processes that lead to a rewired brain. Finally, we will address the important question of the value and practicality of the available technologies and future directions. (shrink)

We present a novel procedure to engage the public in ethical deliberations on the potential impacts of brain machine interface technology. We call this procedure a convergence seminar, a form of scenario-based group discussion that is founded on the idea of hypothetical retrospection. The theoretical background of this procedure and the results of five seminars are presented.

While robot-assisted arm and hand training after stroke allows for intensive task-oriented practice, it has provided only limited additional benefit over dose-matched physiotherapy up to now. These rehabilitation devices are possibly too supportive during the exercises. Neurophysiological signals might be one way of avoiding slacking and providing robotic support only when the brain is particularly responsive to peripheral input. We tested the feasibility of three-dimensional robotic assistance for reach-to-grasp movements with a multi-joint exoskeleton during motor imagery-related desynchronization of sensorimotor oscillations (...) in the β-band only. We also registered task-related network changes of cortical functional connectivity by electroencephalography via the imaginary part of the coherence function. Healthy subjects and stroke survivors showed similar patterns – but different aptitudes – of controlling the robotic movement. All participants in this pilot study with nine healthy subjects and two stroke patients achieved their maximum performance during the early stages of the task. Robotic control was significantly higher and less variable when proprioceptive feedback was provided in addition to visual feedback, i.e. when the orthosis was actually attached to the subject’s arm during the task. A distributed cortical network of task-related coherent activity in the θ-band showed significant differences between healthy subjects and stroke patients as well as between early and late periods of the task. Brain-robot interfaces may successfully link three-dimensional robotic training to the participants’ efforts and allow for task-oriented practice of activities of daily living with a physiologically controlled multi-joint exoskeleton. Changes of cortical physiology during the task might also help to make subject-specific adjustments of task difficulty and guide adjunct interventions to facilitate motor learning for functional restoration. (shrink)

LANGUAGE NOTE | Document text in English; abstract also in Chinese. 腦機介面 (BCIs) 是大腦和電腦無需人工交互即可直接交流的一系列技術。隨著人工智能 (AI) 時代的到來，我們需要更多地關注腦機介面和人工智能的融合所帶來的倫理問題。那麼，與機器一起思考會帶來什麼樣的倫理問題？在本文中，圍繞這一主題，我們將重點關注以下問題：自主性、完整性、身分認同、隱私，以及 作為一種增強的方式，該技術在兒科領域的應用會帶來怎樣的風險和潛在收益。我們的結論是，雖然該技術存在多種令人擔憂的問題，同時也有可能帶來好處，但仍存在很大的不確定性。如果生命倫理學家想在這一領域有所建樹 ，他們就應該做好準備來迎接我們對醫學和醫療保健領域中一些我們視為核心價值的理解的重大轉變。 Brain-Computer Interfaces – BCIs – are a set of technologies with which brains and computers can communicate directly, without the need for manual interaction. As we are witnessing the dawn of an era in which Artificial Intelligence (AI) quite possibly will come to dominate the technological innovation landscape, we are compelled to ask questions about the ethical issues which the convergence of BCIs and (...) AI is poised to bring about. What are the ethics of thinking with machines? In this paper, we explore this question, focusing on some of the main arenas of ethical debate and contention, ranging from autonomy and integrity to identity and privacy, and discuss the risks and potential benefits of the technology in the domains of paediatric populations, and as a means of human enhancement. We conclude that, while there are multiple concerns as well as possibilities for the technology to do good, there are great uncertainties at play. If bioethicists want to stay relevant in this field, they ought to prepare themselves for seismic shift in how we conceptualise much of what we take to be core values in medicine and healthcare. (shrink)

Brain-machine interfaces are a growing field of research and application. The increasing possibilities to connect the human brain to electronic devices and computer software can be put to use in medicine, the military, and entertainment. Concrete technologies include cochlear implants, Deep Brain Stimulation, neurofeedback and neuroprosthesis. The expectations for the near and further future are high, though it is difficult to separate hope from hype. The focus in this paper is on the effects that these new technologies may have (...) on our ‘symbolic order’—on the ways in which popular categories and concepts may change or be reinterpreted. First, the blurring distinction between man and machine and the idea of the cyborg are discussed. It is argued that the morally relevant difference is that between persons and non-persons, which does not necessarily coincide with the distinction between man and machine. The concept of the person remains useful. It may, however, become more difficult to assess the limits of the human body. Next, the distinction between body and mind is discussed. The mind is increasingly seen as a function of the brain, and thus understood in bodily and mechanical terms. This raises questions concerning concepts of free will and moral responsibility that may have far reaching consequences in the field of law, where some have argued for a revision of our criminal justice system, from retributivist to consequentialist. Even without such a (unlikely and unwarranted) revision occurring, brain-machine interactions raise many interesting questions regarding distribution and attribution of responsibility. (shrink)

Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram signals to improve the control of active prostheses with brain-computer interfaces. Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of (...) this study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups. (shrink)

This Master’s thesis explores the relationship between Brain-Computer Interfaces (BCIs) and their human users from a functional, epistemological and phenomenological perspective. The analysis has four steps. I start out with a technical description of BCI systems in which I conceptually analyze different types of BCI applications. This results in the development of a taxonomy of applications which is the point of departure for further philosophical analysis. Thereafter, I explore the functional relationship between BCI applications and their users. That is (...) to say, I analyze functions of BCI applications, relate them to abilities of their users and explore how they extend these abilities. After that, the epistemological relation between BCI systems and their users is conceptualized by analyzing how they contribute to cognitive processes of their users, which is done by using the distributed cognition framework. And lastly, a postphenomenological framework is adapted to investigate how BCIs mediate the experiences of their users. This thesis ends with a reflection in which (1) possible developments in BCI research are placed in a broader historical-anthropological perspective, and (2) a moral consideration is given on the desirability of BCIs. (shrink)

The brain–computer interface (BCI) has made remarkable progress in the bridging the divide between the brain and the external environment to assist persons with severe disabilities caused by brain impairments. There is also continuing philosophical interest in BCIs which emerges from thoughtful reflection on computers, machines, and artificial intelligence. This article seeks to apply BCI perspectives to examine, challenge, and work towards a possible resolution to a persistent problem in the mind–body relationship, namely dualism. The original humanitarian goals of BCIs (...) and the technological inventiveness result in BCIs being surprisingly useful. We begin from the neurologically impaired person, the problems encountered, and some pioneering responses from computers and machines. Secondly, the interface of mind and brain is explored via two points of clarification: direct and indirect BCIs, and the nature of thoughts. Thirdly, dualism is beset by mind–body interaction difficulties and is further questioned by the phenomena of intentions, interactions, and technology. Fourthly, animal minds and robots are explored in BCI settings again with relevance for dualism. After a brief look at other BCIs, we conclude by outlining a future BCI philosophy of brain and mind, which might appear ominous and could be possible. (shrink)

Brain–computer interfacing (BCI) aims at directly capturing brain activity in order to enable a user to drive an application such as a wheelchair without using peripheral neural or motor systems. Low signal to noise ratio’s, low processing speed, and huge intra- and inter-subject variability currently call for the addition of intelligence to the applications, in order to compensate for errors in the production and/or the decoding of brain signals. However, the combination of minds and machines through BCI’s and intelligent devices (...) (IDs) can affect a user’s sense of agency. Particularly confusing cases can arise when the behavioral control switches implicitly from user to ID. I will suggest that in such situations users may be insecure about the extent to which the resulting behavior, whether successful or unsuccessful, is genuinely their own. Hence, while performing an action, a user of a BCI–ID may be uncertain about being the agent of the act. Several cases will be examined and some implications for (legal) responsibility (e.g. establishing the presence of a ‘guilty mind’) are discussed. (shrink)

Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram signals to improve the control of active prostheses with brain-computer interfaces. Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of (...) this study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups. (shrink)

The problem of deviant causal chains is a classic challenge in the philosophy of action. According to the causal theory of action (CTA), an event qualifies as an action if it is caused by the agent’s intention. In cases of deviant causal chains, this condition is met, but the agent loses control of the situation. To address this, theorists suggest that the intention must cause the action “in the right way”. However, defining what constitutes the “right way” is difficult, as (...) the distinction between having and not having control can be subtle. In this paper, I demonstrate that brain-computer interfaces (BCIs) provide important insights into basic causal deviance. I examine how existing strategies might account for deviant causation in BCI use and highlight their challenges. I advocate for reliability strategies—approaches that focus on identifying which causal pathways reliably connect an agent’s intentions to their outcomes. Additionally, I compare two BCIs that differ in their sources of occasional malfunction. I argue that the presence of causal deviance in a given case depends on the boundaries of the system that enables action. Such boundary analysis is unnecessary for bodily movements; however, for basic actions performed through a machine, it becomes essential. (shrink)

Recent developments in the domain of communication Brain-Computer Interface (BCI) technology have raised questions about the ability for communication BCIs to read minds. How those questions are answered depends on how we theorize the mind and mindreading in the first place. Thus, in this paper, I ask (1) what does it mean to read minds? (2) can a communication BCI do this? (3) what does this mean for potential users of this technology? and (4) what is at stake morally in (...) light of this? I show that current answers to these questions are conceptually unclear and committed to a Cartesian picture of the mind and its relation to the brain, questionably informing how debates about BCIs as mindreading devices are framed. I offer an alternative perspective on these questions by turning to an enactive perspective on mindedness. I argue that this perspective can offer conceptual as well as ethical clarification about what is at stake in the domain of communication BCIs. From this perspective, the concerns raised about BCIs as mindreading machines are demystified. Instead, concerns are raised about BCIs as enabling users to flourish as authentic communicators. (shrink)

The rapid expansion of research on Brain-Computer Interfaces is not only due to the promising solutions offered for persons with physical impairments. There is also a heightened need for understanding BCIs due to the challenges regarding ethics presented by new technology, especially in its impact on the relationship between man and machine. Here we endeavor to present a scoping review of current studies in the field to gain insight into the complexity of BCI use. By examining studies related to (...) BCIs that employ social research methods, we seek to demonstrate the multitude of approaches and concerns from various angles in considering the social and human impact of BCI technology. For this scoping review of research on BCIs’ social and ethical implications, we systematically analyzed six databases, encompassing the fields of medicine, psychology, and the social sciences, in order to identify empirical studies on BCIs. The search yielded 73 publications that employ quantitative, qualitative, or mixed methods. Of the 73 publications, 71 studies address the user perspective. Some studies extend to consideration of other BCI stakeholders such as medical technology experts, caregivers, or health care professionals. The majority of the studies employ quantitative methods. Recurring themes across the studies examined were general user opinion towards BCI, central technical or social issues reported, requests/demands made by users of the technology, the potential/future of BCIs, and ethical aspects of BCIs. Our findings indicate that while technical aspects of BCIs such as usability or feasibility are being studied extensively, comparatively little in-depth research has been done on the self-image and self-experience of the BCI user. In general there is also a lack of focus or examination of the caregiver’s perspective. (shrink)

Bionic systems, connecting biological tissues with computer or robotic devices through brain–machine interfaces, can be used in various ways to discover biological mechanisms. In this article I outline and discuss a “stimulation-connection” bionics-supported methodology for the study of the brain, and compare it with other epistemic uses of bionic systems described in the literature. This methododology differs from the “synthetic”, simulative method often followed in theoretically driven Artificial Intelligence and cognitive science, even though it involves machine models of (...) biological systems. I also bring the previous analysis to bear on some claims on the epistemic value of bionic technologies made in the recent philosophical literature. I believe that the methodological reflections proposed here may contribute to the piecewise understanding of the many ways bionic technologies can be deployed not only to restore lost sensory-motor functions, but also to discover brain mechanisms. (shrink)

Brain-Computer Interface (BCI) research and (future) applications raise important ethical issues that need to be addressed to promote societal acceptance and adequate policies. Here we report on a survey we conducted among 145 BCI researchers at the 4th International BCI conference, which took place in May–June 2010 in Asilomar, California. We assessed respondents’ opinions about a number of topics. First, we investigated preferences for terminology and definitions relating to BCIs. Second, we assessed respondents’ expectations on the marketability of different BCI (...) applications (BCIs for healthy people, BCIs for assistive technology, BCIs-controlled neuroprostheses and BCIs as therapy tools). Third, we investigated opinions about ethical issues related to BCI research for the development of assistive technology: informed consent process with locked-in patients, risk-benefit analyses, team responsibility, consequences of BCI on patients’ and families’ lives, liability and personal identity and interaction with the media. Finally, we asked respondents which issues are urgent in BCI research. (shrink)

Brain–computer interfaces (BCIs) utilizing machine learning techniques are an emerging technology that enables a communication pathway between a user and an external system, such as a computer. Owing to its practicality, electroencephalography (EEG) is one of the most widely used measurements for BCI. However, EEG has complex patterns and EEG-based BCIs mostly involve a cost/time-consuming calibration phase; thus, acquiring sufficient EEG data is rarely possible. Recently, deep learning (DL) has had a theoretical/practical impact on BCI research because of its (...) use in learning representations of complex patterns inherent in EEG. Moreover, algorithmic advances in DL facilitate short/zero-calibration in BCI, thereby suppressing the data acquisition phase. Those advancements include data augmentation (DA), increasing the number of training samples without acquiring additional data, and transfer learning (TL), taking advantage of representative knowledge obtained from one dataset to address the so-called data insufficiency problem in other datasets. In this study, we review DL-based short/zero-calibration methods for BCI. Further, we elaborate methodological/algorithmic trends, highlight intriguing approaches in the literature, and discuss directions for further research. In particular, we search forgenerative model-based andgeometric manipulation-based DA methods. Additionally, we categorize TL techniques in DL-based BCIs intoexplicitandimplicitmethods. Our systematization reveals advances in the DA and TL methods. Among the studies reviewed herein, ~45% of DA studies used generative model-based techniques, whereas ~45% of TL studies used explicit knowledge transferring strategy. Moreover, based on our literature review, we recommend an appropriate DA strategy for DL-based BCIs and discuss trends of TLs used in DL-based BCIs. (shrink)

Connecting human minds to various technological devices and applications through brain-computer interfaces (BCIs) affords intriguingly novel ways for humans to engage and interact with the world. Not only do BCIs play an important role in restorative medicine, they are also increasingly used outside of medical or therapeutic contexts (e.g., gaming or mental state monitoring). A striking peculiarity of BCI technology is that the kind of actions it enables seems to differ from paradigmatic human actions, because, effects in the world (...) are brought about by devices such as robotic arms, prosthesis, or other machines, and their execution runs through a computer directed by brain signals. In contrast to usual forms of action, the sequence does not need to involve bodily or muscle movements at all. A motionless body, the epitome of inaction, might be acting. How do theories of action relate to such BCI-mediated forms of changing the world? We wish to explore this question through the lenses of three perspectives on agency: subjective experience of agency, philosophical action theory, and legal concepts of action. Our analysis pursues three aims: First, we shall discuss whether and which BCI-mediated events qualify as actions, according to the main concepts of action in philosophy and law. Secondly, en passant, we wish to highlight the ten most interesting novelties or peculiarities of BCI-mediated movements. Thirdly, we seek to explore whether these novel forms of movement may have consequences for concepts of agency. More concretely, we think that convincing assessments of BCI-movements require more fine-grained accounts of agency and a distinction between various forms of control during movements. In addition, we show that the disembodied nature of BCI-mediated events causes troubles for the standard legal account of actions as bodily movements. In an exchange with views from philosophy, we wish to propose that the law ought to reform its concept of action to include some, but not all, BCI-mediated events and sketch some of the wider implications this may have, especially for the venerable legal idea of the right to freedom of thought. In this regard, BCIs are an example of the way in which technological access to yet largely sealed-off domains of the person may necessitate adjusting normative boundaries between the personal and the social sphere. (shrink)

This study evaluated the feasibility of using occipitoparietal alpha activity to drive target/non-target classification in a brain-computer interface for communication. EEG data were collected from 12 participants who completed BCI Rapid Serial Visual Presentation calibrations at two different presentation rates: 1 and 4 Hz. Attention-related changes in posterior alpha activity were compared to two event-related potentials : N200 and P300. Machine learning approaches evaluated target/non-target classification accuracy using alpha activity. Results indicated significant alpha attenuation following target letters at both 1 (...) and 4 Hz presentation rates, though this effect was significantly reduced in the 4 Hz condition. Target-related alpha attenuation was not correlated with coincident N200 or P300 target effects. Classification using posterior alpha activity was above chance and benefitted from individualized tuning procedures. These findings suggest that target-related posterior alpha attenuation is detectable in a BCI RSVP calibration and that this signal could be leveraged in machine learning algorithms used for RSVP or comparable attention-based BCI paradigms. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number (...) of subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

A brain-computer interface is a rapidly evolving neurotechnology connecting the human brain with a computer. In its classic form, brain activity is recorded and used to control external devices like protheses or wheelchairs. Thus, BCI users act with the power of their thoughts. While the initial development has focused on medical uses of BCIs, non-medical applications have recently been gaining more attention, for example in automobiles, airplanes, and the entertainment context. However, the attitudes of the general public towards BCIs have (...) hardly been explored. Among the general population in Germany aged 18–65 years, a representative online survey with 20 items was conducted in summer 2018 and analysed by descriptive statistics. The survey assessed: affinity for technology; previous knowledge and experience concerning BCIs; the attitude towards ethical, social and legal implications of BCI use and demographic information. Our results indicate that BCIs are a unique and puzzling way of human–machine interaction. The findings reveal a positive view and high level of trust in BCIs on the one hand but on the other hand a wide range of ethical and anthropological concerns. Agency and responsibility were clearly attributed to the BCI user. The participants’ opinions were divided regarding the impact BCIs have on humankind. In summary, a high level of ambivalence regarding BCIs was found. We suggest better information of the public and the promotion of public deliberation about BCIs in order to ensure responsible development and application of this potentially disruptive technology. (shrink)

Technologies like passive brain-computer interfaces can enhance human-machine interaction. Anyhow, there are still shortcomings in terms of easiness of use, reliability, and generalizability that prevent passive-BCI from entering real-life situations. The current work aimed to technologically and methodologically design a new gel-free passive-BCI system for out-of-the-lab employment. The choice of the water-based electrodes and the design of a new lightweight headset met the need for easy-to-wear, comfortable, and highly acceptable technology. The proposed system showed high reliability in both laboratory (...) and realistic settings, performing not significantly different from the gold standard based on gel electrodes. In both cases, the proposed system allowed effective discrimination between low and high levels of workload, vigilance, and stress even for high temporal resolution. Finally, the generalizability of the proposed system has been tested through a cross-task calibration. The system calibrated with the data recorded during the laboratory tasks was able to discriminate the targeted human factors during the realistic task reaching AUC values higher than 0.8 at 40 s of temporal resolution in case of vigilance and workload, and 20 s of temporal resolution for the stress monitoring. These results pave the way for ecologic use of the system, where calibration data of the realistic task are difficult to obtain. (shrink)

A passive brain–computer interface based upon functional near-infrared spectroscopy brain signals is used for earlier detection of human drowsiness during driving tasks. This BCI modality acquired hemodynamic signals of 13 healthy subjects from the right dorsolateral prefrontal cortex of the brain. Drowsiness activity is recorded using a continuous-wave fNIRS system and eight channels over the right DPFC. During the experiment, sleep-deprived subjects drove a vehicle in a driving simulator while their cerebral oxygen regulation state was continuously measured. Vector phase analysis (...) was used as a classifier to detect drowsiness state along with sleep stage-based threshold criteria. Extensive training and testing with various feature sets and classifiers are done to justify the adaptation of threshold criteria for any subject without requiring recalibration. Three statistical features along with six VPA features were used. The average accuracies for the five classifiers are 90.9% for discriminant analysis, 92.5% for support vector machines, 92.3% for nearest neighbors, 92.4% for both decision trees, and ensembles over all subjects’ data. Trajectory slopes of CORE vector magnitude and angle: m and m are the best-performing features, along with ensemble classifier with the highest accuracy of 95.3% and minimum computation time of 40 ms. The statistical significance of the results is validated with a p-value of less than 0.05. The proposed passive BCI scheme demonstrates a promising technique for online drowsiness detection using VPA along with sleep stage classification. (shrink)

Electroencephalography and functional near-infrared spectroscopy have potentially complementary characteristics that reflect the electrical and hemodynamic characteristics of neural responses, so EEG-fNIRS-based hybrid brain-computer interface is the research hotspots in recent years. However, current studies lack a comprehensive systematic approach to properly fuse EEG and fNIRS data and exploit their complementary potential, which is critical for improving BCI performance. To address this issue, this study proposes a novel multimodal fusion framework based on multi-level progressive learning with multi-domain features. The framework consists (...) of a multi-domain feature extraction process for EEG and fNIRS, a feature selection process based on atomic search optimization, and a multi-domain feature fusion process based on multi-level progressive machine learning. The proposed method was validated on EEG-fNIRS-based motor imagery and mental arithmetic tasks involving 29 subjects, and the experimental results show that multi-domain features provide better classification performance than single-domain features, and multi-modality provides better classification performance than single-modality. Furthermore, the experimental results and comparison with other methods demonstrated the effectiveness and superiority of the proposed method in EEG and fNIRS information fusion, it can achieve an average classification accuracy of 96.74% in the MI task and 98.42% in the MA task. Our proposed method may provide a general framework for future fusion processing of multimodal brain signals based on EEG-fNIRS. (shrink)

Common spatial pattern is an effective algorithm for extracting electroencephalogram features of motor imagery ; however, CSP mainly aims at multichannel EEG signals, and its effect in extracting EEG features with fewer channels is poor—even worse than before using CSP. To solve the above problem, a new combined feature extraction method has been proposed in this study. For EEG signals from fewer channels, wavelet packet transform, fast ensemble empirical mode decomposition, and local mean decomposition were used to decompose the band-pass (...) filtered EEG into multiple time–frequency components, and the corresponding components were selected according to the frequency characteristics of MI or the correlation coefficient between its time–frequency components and the original EEG signal. Furthermore, phase space reconstruction was performed on the selected components after the three time-frequency decompositions, the maximum Lyapunov index was calculated, and the features were reconstructed; then, CSP projection mapping was used for the reconstructed features. The support vector machine probability output model was trained by the obtained three mappings. Probability outputs by three different support vector machines were then obtained. Finally, the classification of test samples was determined by the fusion of the Dempster–Shafer evidence theory at the decision level. The results showed that the accuracy of the proposed method was 95.71% on data set III of BCI competition II, which was 2.88% higher than the existing methods. On data set IIb of BCI competition IV, the average accuracy was 86.60%, which was 2.3% higher than the existing methods. This study verified the effectiveness of the proposed method and provided an approach for the research and development of the MI-BCI system based on fewer channels. (shrink)

I use a hypothetical case study of a woman who replaces here biological arms with prostheses controlled through a brain–computer interface the explore how a BCI might interpret and misinterpret intentions. I define pre-veto intentions and post-veto intentions and argue that a failure of a BCI to differentiate between the two could lead to some troubling legal and ethical problems.

Developments in neurotechnology took a leap forward with the demonstration of the first Brain to Brain Interface (BBI). BBIs enable direct communication between two brains via a Brain Computer Interface (BCI) and bypasses the peripheral nervous system. This discovery promises new possibilities for future battlefield technology. As battlefield technology evolves, it is more likely to place greater demands on future soldiers. Future soldiers are more likely to process large amounts of data derived from an extensive networks of humans and machines. (...) This raises several ethical and philosophical concerns. This paper will look at BBI technology in current stages of research, future BBI applications in the military and how the potential use of BBIs in military operations challenges the way we understand the concept of responsibility. In this paper, I propose that an individual connected to a BBI ought not to be held fully responsible for her actions. The justification for this proposition is based on three key points such as an individual connected to a BBI does not have the ability to act freely, has a diminished sense of self-agency and may not be able to demonstrate authenticity of the thoughts and memories generated when connected to the interface. (shrink)

The first implantation of a brain chip into a human paralysis patient by Neuralink demonstrated much potential for treating debilitating neurological diseases and injuries. Nevertheless, brain chips can also be implanted in healthy people to provide an interface between the human brain with computers, robotic machines, and novel artificial intelligence platforms, which generates new ethical issues. The focus here is on the development of brain chip implants that can significantly improve memory, intelligence, and cognition, thereby boosting performance in national examinations (...) for university admissions and securing civil service jobs, thus providing a “game-changer” and “shortcut” for many students and parents. Given that Islam is a major world religion, constituting a significant portion of the global population, it is crucial for the biomedical industry to comprehend Islamic perspectives on emerging medical technologies, which will enable it to more effectively cater to a substantial and growing demographic. We thus critically examine whether the application of brain chip technology to enhance academic performance in highly competitive examinations is consistent with Islamic principles. Based on the Islamic jurisprudential framework, such an application for intellectual enhancement of normal and healthy people without any mental impairment may conflict with the injunction to preserve intellect (Hifz al-Aql) and “consideration of consequences” (murāʿāt al-ma'ālāt) in Islam. It may also be viewed as tampering with Allah’s creation (Taghyir Khalq Allah). Gaining such unfair advantages in competitive examinations will likely be viewed as unethical, by transgressing the core Islamic precepts of Amanah (trustworthiness), Al-‘Adl (justice), Ikhlas (sincerity), and Mujahadah (striving). (shrink)

Novel neurotechnologies like deep brain stimulation and brain-computer interfaces promise clinical benefits for severely suffering patients. Nevertheless, such electroceuticals raise several ethical issues on different levels: while on the level of clinical neuroethics issues with direct relevance for diagnosis and treatment have to be discussed, on the level of research neuroethics questions regarding research and development of these technological devices like investigating new targets and different diseases as well as thorough inclusion criteria are dealt with. On the level of (...) theoretical neuroethics more general questions are examined including anthropological considerations on “normal” human functioning as well as implications on personality, personal identity and authenticity. This paper presents a brief review on ethical issues of deep brain stimulation and brain computer interfacing and simultaneously introduces to this themed issue with thirteen contributions dealing from different perspectives with ethical implications of electroceuticals for the human brain. (shrink)

Brain Computer Interfaces (BCIs) enable one to control peripheral ICT and robotic devices by processing brain activity on-line. The potential usefulness of BCI systems, initially demonstrated in rehabilitation medicine, is now being explored in education, entertainment, intensive workflow monitoring, security, and training. Ethical issues arising in connection with these investigations are triaged taking into account technological imminence and pervasiveness of BCI technologies. By focussing on imminent technological developments, ethical reflection is informatively grounded into realistic protocols of brain-to-computer communication. In (...) particular, it is argued that human-machine adaptation and shared control distinctively shape autonomy and responsibility issues in current BCI interaction environments. Novel personhood issues are identified and analyzed too. These notably concern (i) the “sub-personal” use of human beings in BCI-enabled cooperative problem solving, and (ii) the pro-active protection of personal identity which BCI rehabilitation therapies may afford, in the light of so-called motor theories of thinking, for the benefit of patients affected by severe motor disabilities. (shrink)

Brain–Computer Interface (BCI) technology is a promising research area in many domains. Brain activity can be interpreted through both invasive and non-invasive monitoring devices, allowing for novel, therapeutic solutions for individuals with disabilities and for other non-medical applications. However, a number of ethical issues have been identified from the use of BCI technology. In this paper, we review the academic discussion of the ethical implications of BCI technology in the last five years. We conclude that some emerging applications of BCI (...) technology—including commercial ventures that seek to meld human intelligence with AI—present new and unique ethical concerns. Further, we seek to understand how academic literature on the topic of BCIs addresses these novel concerns. Similar to prior work, we use a limited sample to identify trends and areas of concern or debate among researchers and ethicists. From our analysis, we identify two key areas of BCI ethics that warrant further research: the physical and psychological effects of BCI technology. Additionally, questions of BCI policy have not yet become a frequent point of discussion in the relevant literature on BCI ethics, and we argue this should be addressed in future work. We provide guiding questions that will help ethicists and policy makers grapple with the most important issues associated with BCI technology. (shrink)

Brain–machine interfaces combining visual, auditory, and tactile feedback have been previously used to generate embodiment experiences during spinal cord injury rehabilitation. It is not known if adding temperature to these modalities can result in discomfort with embodiment experiences. Here, comfort levels with the embodiment experiences were investigated in an intervention that required a chronic pain SCI patient to generate lower limb motor imagery commands in an immersive environment combining visual, auditory, tactile, and thermal feedback. Assessments were made pre-/ (...) post-, throughout the intervention, and at 7 weeks follow up. Overall, high levels of embodiment in the adapted three-domain scale of embodiment were found throughout the sessions. No significant adverse effects of VR were reported. Although sessions induced only a modest reduction in pain levels, an overall reduction occurred in all pain scales at follow up. A high degree of comfort in the comfort scale for the thermal-tactile sleeve, in both the thermal and tactile feedback components of the sleeve was reported. This study supports the feasibility of combining multimodal stimulation involving visual, auditory, tactile, and thermal feedback to generate embodiment experiences in neurorehabilitation programs. (shrink)

The aim here is to implement intelligence in an engineered processing substrate – a machine mind, as it were. This solution is clearly related to work in artificial intelligence (AI) and shares many of its analytical requirements and synthesis goals, but the objective is unambiguously to make individual human minds independent of a single substrate. Brain–machine interfaces require adaptations for communication to be possible, emphasizing either the machine or the brain. Brain emulation on general‐purpose computers is convenient, because (...) model functions can be modified easily. Ultimately, a mature emulation demands a suitable computing substrate. Theoretical debates occasionally focus on the question of determinism and computation in the Von Neumann sense. ARPANET (the Advanced Research Projects Agency Network) useful for university projects and for the military, but it was not immediately obvious what sort of civilian applications would thrive on such a computer network. (shrink)

From brain machine interfaces to neural implants, present and future technological developments are not merely tools, but will change human beings themselves. Of particular interest is human integration with AI. In this paper, we focus on enhancements that enable us to outsource epistemic work to AI. How does outsourcing epistemic work to enhancements affect the authorship of and responsibility for the final product of that work? We argue that in the context of performing and reporting research, outsourcing does not (...) diminish one’s responsibility for mistakes in the final product. Moreover, we suggest that the responsibility may sometimes be shared between oneself and the group that designed, marketed, and sold the enhancement. This argument is in contrast to Coeckelbergh and Gunkel’s recent position that the concerns about authorship obscure the ethical and social issues surrounding AI outputs. (shrink)

The paper develops two related thought experiments exploring variations on an ‘animat’ theme. Animats are hybrid devices with both artificial and biological components. Traditionally, ‘components’ have been construed in concrete terms, as physical parts or constituent material structures. Many fascinating issues arise within this context of hybrid physical organization. However, within the context of functional/computational theories of mentality, demarcations based purely on material structure are unduly narrow. It is abstract functional structure which does the key work in characterizing the respective (...) ‘components’ of thinking systems, while the ‘stuff’ of material implementation is of secondary importance. Thus the paper extends the received animat paradigm, and investigates some intriguing consequences of expanding the conception of bio-machine hybrids to include abstract functional and semantic structure. In particular, the thought experiments consider cases of mind-machine merger where there is no physical Brain-Machine Interface: indeed, the material human body and brain have been removed from the picture altogether. The first experiment illustrates some intrinsic theoretical difficulties in attempting to replicate the human mind in an alternative material medium, while the second reveals some deep conceptual problems in attempting to create a form of truly Artificial General Intelligence. (shrink)