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)

The increasing availability of brain data within and outside the biomedical field, combined with the application of artificial intelligence (AI) to brain data analysis, poses a challenge for ethics and governance. We identify distinctive ethical implications of brain data acquisition and processing, and outline a multi-level governance framework. This framework is aimed at maximizing the benefits of facilitated brain data collection and further processing for science and medicine whilst minimizing risks and preventing harmful use. The framework consists of four primary (...) areas of regulatory intervention: binding regulation, ethics and soft law, responsible innovation, and human rights. (shrink)

BackgroundThe neurotechnology behind brain-computer interfaces (BCIs) raises various ethical questions. The ethical literature has pinpointed several issues concerning safety, autonomy, responsibility and accountability, psychosocial identity, consent, privacy and data security. This study aims to assess BCI users’ experiences, self-observations and attitudes in their own right and looks for social and ethical implications.MethodsWe conducted nine semi-structured interviews with BCI users, who used the technology for medical reasons. The transcribed interviews were analyzed according to the Grounded Theory coding method.ResultsBCI users perceive themselves (...) as active operators of a technology that offers them social participation and impacts their self-definition. Each of these aspects bears its own opportunities and risks. BCIs can contribute to retaining or regaining human capabilities. At the same time, BCI use contains elements that challenge common experiences, for example when the technology is in conflict with the affective side of BCI users. The potential benefits of BCIs are regarded as outweighing the risks in that BCI use is considered to promote valuable qualities and capabilities. BCI users appreciate the opportunity to regain lost capabilities as well as to gain new ones.ConclusionsBCI users appreciate the technology for various reasons. The technology is highly appreciated in cases where it is beneficial in terms of agency, participation and self-definitions. Rather than questioning human nature, the technology can retain and restore characteristics and abilities which enrich our lives. (shrink)

There is growing interest in contact tracing apps for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. (...) We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness. (shrink)

Ethical issues concerning brain–computer interfaces have already received a considerable amount of attention. However, one particular form of BCI has not received the attention that it deserves: Affective BCIs that allow for the detection and stimulation of affective states. This paper brings the ethical issues of affective BCIs in sharper focus. The paper briefly reviews recent applications of affective BCIs and considers ethical issues that arise from these applications. Ethical issues that affective BCIs share with other neurotechnologies are presented and (...) ethical concerns that are specific to affective BCIs are identified and discussed. (shrink)

Research conducted on Brain-Computer Interfaces has grown considerably during the last decades. With the help of BCIs, users can gain a wide range of functions. Our aim in this paper is to analyze the impact of BCIs on autonomy. To this end, we introduce three abilities that most accounts of autonomy take to be essential: the ability to use information and knowledge to produce reasons; the ability to ensure that intended actions are effectively realized ; and the ability to enact (...) intentions within concrete relationships and contexts. We then consider the impact of BCI technology on each of these abilities. Although on first glance, BCIs solely enhance self-determination because they restore or improve abilities, we will show that there are other positive, but also negative impacts on user autonomy, which require further philosophical and ethical discussions. (shrink)

Recent findings suggest that medical students’ moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany. Between 2012 and 2013, medical students were tested using Lind’s Moral Competence Test prior to and after completing different ethics classes. The experimental group participated in principle-based structured case discussions and was compared with a control group with theory-based case discussions. The pre/post C-scores (...) were compared using a Wilcoxon Test, ANOVA and effect-size calculation. The C-score improved by around 3.2 C-points in the EG, and by 0.2 C-points in the CG. The mean C-score difference was not statistically significant for the EG or between the two groups. There was no statistical significance for the teachers’ influence on C-score. In both groups, students with below-average C-scores improved and students with above-average C-scores regressed. The increase of the C-Index was greater in the EG than in the CG. The absolute effect-size of the EG compared with the CG was 3.0 C-points, indicating a relevant effect. Teaching ethics with PBSCDs did not provide a statistically significant influence on students’ moral competence, compared with TBCDs. Yet, the effect size suggests that PBSCDs may improve moral competence among medical students more effectively. Further research with larger and completely randomized samples is needed to gain definite explanations for the results. (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)

:Brain–computer interfaces are driven essentially by algorithms; however, the ethical role of such algorithms has so far been neglected in the ethical assessment of BCIs. The goal of this article is therefore twofold: First, it aims to offer insights into whether the problems related to the ethics of BCIs can be better grasped with the help of already existing work on the ethics of algorithms. As a second goal, the article explores what kinds of solutions are available in that body (...) of scholarship, and how these solutions relate to some of the ethical questions around BCIs. In short, the article asks what lessons can be learned about the ethics of BCIs from looking at the ethics of algorithms. To achieve these goals, the article proceeds as follows. First, a brief introduction into the algorithmic background of BCIs is given. Second, the debate about epistemic concerns and the ethics of algorithms is sketched. Finally, this debate is transferred to the ethics of BCIs. (shrink)

Scientists, engineers, and healthcare professionals are currently developing a variety of new devices under the category of brain-computer interfaces (BCIs). Current and future applications are both medical/assistive (e.g., for communication) and non-medical (e.g., for gaming). This array of possibilities comes with ethical challenges for all stakeholders. As a result, BCIs have been an object of both hope and concern in various media. We argue that these conflicting sentiments can be productively understood in terms of personhood, specifically the impact of BCIs (...) on what it means to be a person and to be recognized as such by others. To understand the dynamics of personhood in the context of BCI use and investigate whether ethical guidance is required, a meeting entitled "BCIs and Personhood: A Deliberative Workshop" was held in May 2018. In this article, we describe how BCIs raise important questions about personhood and propose recommendations for BCI development and governance. (shrink)

Recent results from neuroimaging appear to indicate that some patients in a vegetative state have partially intact awareness. These results may demonstrate misdiagnosis and suggest the need not only for alternative forms of treatment, but also for the reconsideration of end-of-life decisions in cases of disorders of consciousness. This article addresses the second consequence. First, I will discuss which aspects of consciousness may be involved in neuroimaging findings. I will then consider various factors relevant to ethical end-of-life decision-making, and analyse (...) whether and to what extent the above consequence applies to these factors. It will be shown that knowledge of the existence of partial awareness in patients with disorders of consciousness only influences end-of-life decision-making if certain background assumptions are made. (shrink)

ZusammenfassungFünfzehn Jahre nach ihrer Entstehung ist die Neuroethik ein internationales wissenschaftliches Feld mit enormer Dynamik. Innerhalb weniger Jahre wurden eigene Kongresse, Zeitschriften, Forschungsförderprogramme, Fachgesellschaften und Institute gegründet. Gleichwohl besteht erheblicher Dissens über die Definition und den Gegenstandsbereich dieses neuen Gebiets. Wir argumentieren hier für eine differenzierte Konzeption, wonach neben der Reflexion ethischer Probleme der Neurowissenschaft und ihrer überwiegend neurotechnologischen Anwendungen auch die ethische Reflexion neurowissenschaftlicher Forschung zur Moralität zur Neuroethik gehört. Dies umfasst zwar nicht neurowissenschaftliche oder neuropsychologische Studien zur Moralität, (...) wohl aber die Reflexion der Bedeutung dieser Forschung für die Ethik und das Recht. Wir geben einen Überblick über die wichtigsten Themen der Neuroethik, woraus deutlich wird, wie sehr in verschiedenen gesellschaftlichen Bereichen, auch jenseits von Medizin und Gesundheitswesen, neuroethische Fragen relevant sind. Das Potenzial der Neuroethik als eines neuen Wissenschaftsfeldes liegt darin, durch eine Verknüpfung neurophilosophischer und medizinethischer Themen sowie eine breite interdisziplinäre Vernetzung neue Antworten auf gesellschaftlich drängende Fragen zu finden. (shrink)

Research with psychiatric patients raises frequently discussed, ethical questions, one of which is: Can psychiatric patients give consent to participation in research at all? To answer this and similar questions adequately, it is - according to our thesis - necessary to analyze first, which theoretical assumptions are made in established practice. -/- To solve the question after the possibility of consent, compatible understandings of ‘disease’, ‘illness’ and ‘autonomy’ are crucial, but there is no consensual use of these terms in philosophy. (...) Therefore we first are going to explain different concepts of ‘autonomy’ and ‘disease’. Subsequent to this we will test how the different conceptualizations of ‘autonomy’ and ‘disease’ can be related to each other and how the reasonable combinations shape possible answers to the opening question. It will become apparent that an adequate analysis of ‘autonomy’ and ‘disease’ raises ethical dilemma in psychiatry, for which we shall suggest possible solutions. (shrink)

In a recent paper, Schaefer et al. proposed to enhance autonomy via improving reasoning abilities through cognitive enhancement [1]. While initially their idea additionally seems to elegantly avoid objections against genetic enhancements based on the value of autonomy, we want to draw attention to several problems their approach poses. First, we will show that it is not at all clear that safe and meaningful methods to genetically or pharmaceutically enhance cognition will be feasible any time soon. Second, we want to (...) provide a deeper discussion of the role of cognition and reasoning abilities in philosophical concepts of autonomy, as discussed in the mentioned paper. In doing so, we wish to demonstrate that using reasoning abilities as the common denominator in different accounts of autonomy in the context of enhancement does not do justice to the highly complex interrelations between cognition, reasoning abilities and autonomy. Neither should this way of arguing be accepted as a basis to call for practical outcomes, such as funding research into e. g. genetic cognitive enhancements, if the examined concepts of autonomy are taken seriously. (shrink)

In the present article we examine the anthropological implications of “intelligent” neurotechnologies (INTs). For this purpose, we first give an introduction to current developments of INTs by specifying their central characteristics. We then present and discuss traditional anthropological concepts such as the “homo faber,” the concept of humans as “deficient beings,” and the concept of the “cyborg,” questioning their descriptive relevance regarding current neurotechnological applications. To this end, we relate these anthropological concepts to the characteristics of INTs elaborated before. As (...) we show, the explanatory validity of the anthropological concepts analyzed in this article vary significantly. While the concept of the homo faber, for instance, is not capable of adequately describing the anthropological implications of new INTs, the cyborg proves to be capable of grasping several aspects of today’s neurotechnologies. Nevertheless, alternative explanatory models are needed in order to capture the new characteristics of INTs in their full complexity. (shrink)

Social robots are designed to perform intelligent, emotional, and autonomous behavior in order to establish intimate relationships with humans, for instance, in the context of elderly care. However, the imitation of qualities usually assumed to be necessary for human reciprocal interaction may impact our understanding of social interaction. Against this background, we compare the technical operations based on which social robots imitate human-like behavior with the concepts of emotionality, intelligence, and autonomy as usually attached to humans. In doing so, we (...) aim at making a conceptual contribution to the intuition that the technical imitation of emotional, intelligent, and autonomous behavior differs qualitatively from human forms of emotionality, intelligence, and autonomy. We conclude that the increasing tendency of social robots to imitate human characteristics and the thus increased human tendency of anthropomorphizing technical systems put forth new forms of human–machine interactions (HMI) that call for a critical examination. Thus, the emerging forms of interaction may lead, for instance, to false, reinforced, and perplexing assumptions regarding reciprocity. Therefore, studies are needed that critically examine the potential consequences and psychological effects that may be associated with the use of social robots, especially with regard to vulnerable groups such as children or the elderly. (shrink)

Social robotics aims at designing robots capable of joint interaction with humans. On a conceptual level, sufficient mutual understanding is usually said to be a necessary condition for joint interaction. Against this background, the following questions remain open: in which sense is it legitimate to speak of human–robot joint interaction? What exactly does it mean to speak of humans and robots sufficiently understanding each other to account for human–robot joint interaction? Is such joint interaction effectively possible by reference, e.g., to (...) the mere ascription or simulation of understanding? To answer these questions, we first discuss technical approaches which aim at the implementation of certain aspects of human–human communication and interaction in social robots in order to make robots accessible and understandable to humans and, hence, human–robot joint interaction possible. Second, we examine the human tendency to anthropomorphize in this context, with a view to human understanding of and joint interaction with social robots. Third, we analyze the most prominent concepts of mutual understanding and their implications for human–robot joint interaction. We conclude that it is—at least for the time being—not legitimate to speak of human–robot joint interaction, which has relevant implications both morally and ethically. (shrink)

For almost two decades, the concept of epistemic injustice has been a point of reference to discuss the extent to which persons can be disadvantaged in their role as knowers and what morally relevant consequences might follow from such violations. This volume brings together contributions that have significantly shaped debates about the concept of epistemic injustice and its meaning, as well as recent contributions on its implications and possible consequences of situations of epistemic injustice. With contributions by David Coady | (...) Katharina Eisenhut | Miranda Fricker | Orsolya Friedrich | Agomoni Ganguli-Mitra | Axel Gelfert | Hilkje C. Hänel | Julia A. Harzheim | Lars Leeten | José Medina | Ruben Sakowsky | Ela Sauerborn | Sebastian Schleidgen | Katharina Trettenbach | Verina Wild | Andreas Wolkenstein. (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)

ZusammenfassungWährend die Implementierung und Nutzung von Ethikberatung in deutschen Krankenhäusern in den letzten 20 Jahren vorangeschritten ist, entstehen erst in den letzten Jahren zunehmend Ethikberatungsangebote im außerklinischen Bereich. In den Landkreisen Traunstein und Berchtesgadener Land in Südost-Bayern wurde 2012 eine außerklinische Ethikberatung etabliert. Um im Rahmen einer ersten Evaluation wissenschaftliche Erkenntnisse über den Bedarf, die Inanspruchnahme und die Zufriedenheit mit diesem Beratungsangebot zu gewinnen, wurde eine Dokumentenanalyse und eine Fragebogenerhebung unter den Hausärzten der beiden Landkreise durchgeführt. Insgesamt nahmen 58 der (...) 195 angeschriebenen Hausärzte an der Umfrage teil.Die Auswertung der Dokumentation der außerklinischen Ethikberatung zeigte, dass die meisten Anfragen von betreuenden Angehörigen und aus Pflegeheimen kamen. Den Ergebnissen der Fragebogenerhebung zufolge sahen sich die Hausärzte mit vielfältigen ethischen Fragestellungen konfrontiert. Das Angebot einer ethischen Fallbesprechung zur Lösung dieser Konflikte wurde bislang jedoch nur von 17 Hausärzten in Anspruch genommen. Als Hauptgründe für die fehlende Nutzung des Angebots wurde der mangelnde Bekanntheitsgrad, der fehlende Bedarf und der organisatorische bzw. zeitliche Aufwand angeführt. Gleichzeitig äußerten Hausärzte, die eine ethische Fallbesprechung in Anspruch genommen haben, zu einem Großteil Interesse an einer erneuten Beratung und empfanden das Ergebnis der Ethikberatung als hilfreich. Damit verdeutlichen die Ergebnisse der Studie, dass Hausärzte zwar vielfältige ethische Fragestellungen in ihrem Arbeitsalltag wahrnehmen, aber bislang nur vergleichsweise selten ein externes Beratungsangebot zur Entscheidungsunterstützung in Betracht ziehen. (shrink)