:Neuroprosthetic speech devices are an emerging technology that can offer the possibility of communication to those who are unable to speak. Patients with ‘locked in syndrome,’ aphasia, or other such pathologies can use covert speech—vividly imagining saying something without actual vocalization—to trigger neural controlled systems capable of synthesizing the speech they would have spoken, but for their impairment.We provide an analysis of the mechanisms and outputs involved in speech mediated by neuroprosthetic devices. This analysis provides a framework for accounting for (...) the ethical significance of accuracy, control, and pragmatic dimensions of prosthesis-mediated speech. We first examine what it means for the output of the device to be accurate, drawing a distinction between technical accuracy on the one hand and semantic accuracy on the other. These are conceptual notions of accuracy.Both technical and semantic accuracy of the device will be necessary for the user to have sufficient control over the device. Sufficient control is an ethical consideration: we place high value on being able to express ourselves when we want and how we want. Sufficient control of a neural speech prosthesis requires that a speaker can reliably use their speech apparatus as they want to, and can expect their speech to authentically represent them. We draw a distinction between two relevant features which bear on the question of whether the user has sufficient control: voluntariness of the speech and the authenticity of the speech. These can come apart: the user might involuntarily produce an authentic output or might voluntarily produce an inauthentic output. Finally, we consider the role of the interlocutor in interpreting the content and purpose of the communication.These three ethical dimensions raise philosophical questions about the nature of speech, the level of control required for communicative accuracy, and the nature of ‘accuracy’ with respect to both natural and prosthesis-mediated speech. (shrink)

Neurotechnologies are rapidly advancing in the past few years, such that neural prostheses and brain-computer interfaces are no longer things that only appear in science fiction movies. As interactions with neurotechnologies deepen, users have reported feeling that these tools are becoming part of their own selves and minds. The hypothesis of extended cognition can accommodate this intuition, as it maintains that artifacts can become a part of their users’ minds. However, there have also been some stark examples where users have (...) abruptly lost access to their sophisticated tools, demonstrating the sometimes vulnerable and precarious nature of certain advanced technologies. These features seem to challenge the idea that users can stand in the right relation to their tools to meet the criteria of parity that support the extended cognition theorists’ arguments. Notably, these technologies seem to violate a condition of ownership that has been appealed to on various occasions over the past two decades of literature on extended cognition. In addition to arguing that neuroprosthetics can be a part of one’s extended cognitive system, despites apparent challenges to an ownership condition, we will also review the disparate history and evaluate the current status of the ownership criterion in the literature on extended cognition. To proceed, we first review the reasons for the origin of the proposed “ownership” criterion and, second, introduce new challenges arising from emerging technologies such as neuroprosthetics. We argue that the ownership condition has at least three shortcomings: (i) ambiguity of meaning, (ii) ethical pitfalls, and (iii) it fails to capture people’s intuitions about the cognitive status of emerging neurotechnologies. Ultimately, we argue that introducing the concept of co-ownership is a necessary distinction and is better suited to explain how advanced cognitive technologies function. (shrink)

This paper explores the impact that developments in the field of neuroprosthetics will have on the ethical viability of healthy limb amputation, specifically in cases of Body Integrity Identity Dis...

Some recent arguments defending the genuine causal efficacy of the mental have been relying on empirical research on neuroprosthetics. This essay presents a critical analysis of these arguments. The problem of mental causation, and the basic idea and results of neuroprosthetics are reviewed. It is shown how appealing to the research on neuroprosthetics can be interpreted to give support to the idea of mental causation. However, it does so only in a rather deflationary sense: by holding the (...) mental identical with the neural. So contrary to what the arguments have been assuming, neuroprosthetics cannot be used to argue for nonreductive physicalism. It can rather be taken to illustrate just the opposite: how the mental and the physical are identical. (shrink)

Implantable brain-computer interfaces are being developed to restore speech capacity for those who are unable to speak. Patients with locked-in syndrome or amyotrophic lateral sclerosis could be able to use covert speech – vividly imagining saying something without actual vocalisation – to trigger neural controlled systems capable of synthesising speech. User control has been identified as particularly pressing for this type of BCI. The incorporation of machine learning and statistical language models into the decoding process introduces a contribution to the (...) output that is beyond the user’s control. Whilst this type of ‘shared control’ of BCI action is not unique to speech BCIs, the automated shaping of what a user ‘says’ has a particularly acute ethical dimension, which may differ from parallel concerns surrounding automation in movement BCIs. This paper provides an analysis of the control afforded to the user of a speech BCI of the sort under development, as well as the relationships between accuracy, control, and the user’s ownership of the speech produced. Through comparing speech BCIs with BCIs for movement, we argue that, whilst goal selection is the more significant locus of control for the user of a movement BCI, control over process will be more significant for the user of the speech BCI. The design of the speech BCI may therefore have to trade off some possible efficiency gains afforded by automation in order to preserve sufficient guidance control necessary for users to express themselves in ways they prefer. We consider the implications for the speech BCI user’s responsibility for produced outputs and their ownership of token outputs. We argue that these are distinct assessments. Ownership of synthetic speech concerns whether the content of the output sufficiently represents the user, rather than their morally relevant, causal role in producing that output. (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)

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 primary goal of this essay is to provide a comprehensive overview and analysis of the various relations between material artifacts and the embodied mind. A secondary goal of this essay is to identify some of the trends in the design and use of artifacts. First, based on their functional properties, I identify four categories of artifacts co-opted by the embodied mind, namely (1) embodied artifacts, (2) perceptual artifacts, (3) cognitive artifacts, and (4) affective artifacts. These categories can overlap and (...) so some artifacts are members of more than one category. I also identify some of the techniques (or skills) we use when interacting with artifacts. Identifying these categories of artifacts and techniques allows us to map the landscape of relations between embodied minds and the artifactual world. Second, having identified categories of artifacts and techniques, this essay then outlines some of the trends in the design and use of artifacts, focussing on neuroprosthetics, brain-computer interfaces, and personalisation algorithms nudging their users towards particular epistemic paths of information consumption. (shrink)

According to a standard view, the physical boundary of the person—the skin-and-skull boundary—matters morally because this boundary delineates between where the person begins and the world ends. On the basis of this view we make a distinction between invasive interventions that penetrate this boundary and non-invasive interventions that do not. The development of neuroprosthetics, however, raises questions about the significance of this boundary and the relationship between person and body. In particular it has been argued by appeal to the (...) Extended Mind thesis that mind and person can extend beyond the body, and hence the skin-and-skull boundary is of questionable significance. In this paper I argue that the Extended Mind thesis is consistent with the ethical relevance of the skin-and-skull barrier. Although it can be argued that cognitive processes and aspect of mind can extend beyond the skin-and-skull boundary as EM claims, it does not follow that the person is also extended beyond this boundary. The moral sense of person is closely related to the notion of person as a subject of experiences and this, in turn, is related to the sensory and somatosensory aspects of the body. The development of neuroprosthetics provides us with reason to see that persons can be variously embodied, but this is consistent with the functional and ethical significance of the skin-and-skull boundary. (shrink)

Biomedical engineering technologies such as brain–machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be (...) asked: will everyone be enhanced? Will we be “human” if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism’s reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation’s unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation—and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis. (shrink)

The paper focuses on processes of normalization through which dis/ability is simultaneously produced in specific collectives, networks, and socio-technological systems that enable the construction of such demarcations. Our point of departure is the cochlear implant, a neuroprosthetic device intended to replace and/or augment the function of the damaged inner ear. Unlike hearing aids, which amplify sounds, the CI does the work of damaged hair cells in the inner ear by providing sound signals to the brain. We examine the processes of (...) the CI’s genesis as well as its specific uses by and interrelations to the different and divergent actors that the CI assembles. We argue that the technological device and the implicated normalization process mobilize complex effects in varying socio-technical arrangements. The CI is conceived as a “boundary object” [89] or a “quasi-object” [49, 83], i.e., a metastabilized medium of translation that coordinates social, cultural, and technological action. Although intended to transform non-hearing or hard of hearing people into competent and “normal” hearing subjects, the CI system reproduces the asymmetrical structures of the disability discourse [14] through its function of “developing and maintaining coherence between intersecting social worlds” [89, 393]. Additionally, it initiates controversial discourses that have resulted in new forms of biosocial collectivities ranging from cochlear implantees with normal human hearing to human configurations who have passed through human enhancement. Our approach is thus situated at the intersection of disability and media studies and tackles the particular conditions technological media configurations impose upon the production of dis/ability. (shrink)

“With great power comes great responsibility.” In today’s world, with our growing technological power and the knowledge about its impact, we are considered to be responsible for many instances that not long ago would have been deemed a matter of fate. At the same time, the looming options of, e.g., genome editing or neuroprosthetics, threaten traditional notions of responsibility if no longer the person but the technology involved is deemed to be responsible for a specific behaviour. The growing ethical (...) debate on the expansion of human responsibility, e.g. when it comes to human-machine-interaction, ambient intelligence, or reproductive technologies, thus intertwines with the challenge to formulate an appropriate understanding of the concept of personal responsibility and our respective anthropological self-understanding in today’s technological world. The volume brings together both perspectives and aims at illuminating crucial dimensions of responsibility in light of technological innovation and our self-understanding as responsible beings. (shrink)

Ethical questions with regard to modern neurosciences have significant relevance because the human brain provides the organic basis for central aspects of our self-concept. Neuroethics identifies and reflects the ethical questions raised by modern neurosciences. Here we deal with ethical questions in the contexts of brain imaging techniques and several interventions into the human brain. Besides the central question how to preserve personal identity and higher cognitive functions we address specific ethical aspects of neurotechnology and neuroprosthetics as well as (...) the questions relevant in the context of neuroenhancement. (shrink)

As we become more and more enhanced with cyborg technology, significant issues of law and policy are raised. For example, as cyborg devices implanted within the body create a class of people with enhanced motor and computational abilities, how should the law and policy respond when the abilities of such people surpass those of the general population? And what basic human and legal rights should be afforded to people equipped with cyborg technology as they become more machine and less biology? (...) As other issues of importance, if a neuroprosthetic device is accessed by a third party and done to edit one’s memory or to plant a new memory in one’s mind, or even to place an ad for a commercial product in one’s consciousness, should there be a law of cognitive liberty or of “neuro-advertising” that applies? This paper discusses laws and statutes enacted across several jurisdictions which apply to cyborg technologies with a particular emphasis on legal doctrine which relates to neuroprosthetic devices. (shrink)

Background The rise of a new generation of intelligent neuroprostheses, brain-computer interfaces (BCI) and adaptive closed-loop brain stimulation devices hastens the clinical deployment of neurotechnologies to treat neurological and neuropsychiatric disorders. However, it remains unclear how these nascent technologies may impact the subjective experience of their users. To inform this debate, it is crucial to have a solid understanding how more established current technologies already affect their users. In recent years, researchers have used qualitative research methods to explore the subjective (...) experience of individuals who become users of clinical neurotechnology. Yet, a synthesis of these more recent findings focusing on qualitative methods is still lacking. Methods To address this gap in the literature, we systematically searched five databases for original research articles that investigated subjective experiences of persons using or receiving neuroprosthetics, BCIs or neuromodulation with qualitative interviews and raised normative questions. Results 36 research articles were included and analysed using qualitative content analysis. Our findings synthesise the current scientific literature and reveal a pronounced focus on usability and other technical aspects of user experience. In parallel, they highlight a relative neglect of considerations regarding agency, self-perception, personal identity and subjective experience. Conclusions Our synthesis of the existing qualitative literature on clinical neurotechnology highlights the need to expand the current methodological focus as to investigate also non-technical aspects of user experience. Given the critical role considerations of agency, self-perception and personal identity play in assessing the ethical and legal significance of these technologies, our findings reveal a critical gap in the existing literature. This review provides a comprehensive synthesis of the current qualitative research landscape on neurotechnology and the limitations thereof. These findings can inform researchers on how to study the subjective experience of neurotechnology users more holistically and build patient-centred neurotechnology. (shrink)

This article provides analysis of the mechanisms and outputs involved in language-use mediated by a neuroprosthetic device. It is motivated by the thought that users of speech neuroprostheses require sufficient control over what their devices externalize as synthetic speech if they are to be thought of as responsible for it, but that the nature of this control, and so the status of their responsibility, is not clear.

From mobile health and wearables to implantable medical devices and neuroprosthetics, the integration of machines into human biology and cognition is expanding. This paper explores the technological advancements that are pushing the human–machine boundaries further, raising profound questions about identity and existence in digital realms. The development of robots, androids, and AI–human hybrids promises to augment human capabilities beyond current limits. However, alongside these advancements, significant limitations arise: biological, technical, ethical, and legal. This paper further discusses the existential implications (...) of these technological strides. It addresses the philosophical dimensions of mortality, forgiveness, and the significance of death in a world where technological immortality may be within reach. By addressing these questions, the paper seeks to provide a comprehensive analysis of the potential for these advancements to reshape our understanding of existence and the quest for immortality. (shrink)