Abstract:Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition (...) to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. (shrink)

Purpose – The purpose of this study is to think ahead into the year 2035 and reflect on the ethical implications of brain-to-brain linking. Design/methodology/approach – Philosophical argument. Findings – It is quite likely that the direction of technological research today is heading toward a closer integration of mind and machine in 2035. What is interesting is that the integration also makes mind-mind or brain-brain integration possible too. There is nothing in principle that would prevent hooking up more than one (...) brain to a machine, or connecting two or more brains together to harness their processing power to tackle a very complicated task. If that happens, the whole notion of what it is to be an individual and a self will have to be rethought. I have offered a way in which that can be done: Instead of viewing the self as being contained in a closed space traditionally defined by the skin, the self can expand outside of the skin and merge temporarily with other selves too. This also has profound implications on the notion of privacy, especially on how it is conceptualized and justified. Research limitations/implications – This research is limited to theoretical argumentation only. It relies on the current empirical and scientific investigations that are going on at the moment and provide ethical reflections on them. Practical implications – We need to anticipate technological innovations to be more proactive in deliberating and formulating policy and ethical guidelines; otherwise, ethicists will just muse after the fact, implying that there is nothing further to be done. Social implications – Brain-to-brain linking has tremendous social implications, so is the ethical reflection on the issue. Originality/value – Argument purporting to show the specific content in ethical guidelines on brain-to-brain interlinking based on the metaphysics of the self that is directly implicated by the technology has not been done before, according to the author’s best knowledge. (shrink)

While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...) show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent—predictive and advisory—BCI technologies essential to prevent potential iatrogenic harms. (shrink)