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van Velthoven EAM, van Stuijvenberg OC, Haselager DRE, Broekman M, Chen X, Roelfsema P, Bredenoord AL, Jongsma KR. Ethical implications of visual neuroprostheses-a systematic review. J Neural Eng 2022; 19. [PMID: 35475424 DOI: 10.1088/1741-2552/ac65b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/08/2022] [Indexed: 11/12/2022]
Abstract
Objective. The aim of this review was to systematically identify the ethical implications of visual neuroprostheses.Approach. A systematic search was performed in both PubMed and Embase using a search string that combined synonyms for visual neuroprostheses, brain-computer interfaces (BCIs), cochlear implants (CIs), and ethics. We chose to include literature on BCIs and CIs, because of their ethically relavant similarities and functional parallels with visual neuroprostheses.Main results. We included 84 articles in total. Six focused specifically on visual prostheses. The other articles focused more broadly on neurotechnologies, on BCIs or CIs. We identified 169 ethical implications that have been categorized under seven main themes: (a) benefits for health and well-being; (b) harm and risk; (c) autonomy; (d) societal effects; (e) clinical research; (f) regulation and governance; and (g) involvement of experts, patients and the public.Significance. The development and clinical use of visual neuroprostheses is accompanied by ethical issues that should be considered early in the technological development process. Though there is ample literature on the ethical implications of other types of neuroprostheses, such as motor neuroprostheses and CIs, there is a significant gap in the literature regarding the ethical implications of visual neuroprostheses. Our findings can serve as a starting point for further research and normative analysis.
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Affiliation(s)
- E A M van Velthoven
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands
| | - O C van Stuijvenberg
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands
| | - D R E Haselager
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands
| | - M Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands.,Department of Neurosurgery, Leiden Medical Center, Leiden, The Netherlands
| | - X Chen
- Department of Vision & Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - P Roelfsema
- Department of Vision & Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.,Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam, The Netherlands.,Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - A L Bredenoord
- Erasmus School of Philosophy, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - K R Jongsma
- Department of Medical Humanities, Julius Center, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands
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Roe AW, Chen G, Xu AG, Hu J. A roadmap to a columnar visual cortical prosthetic. CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Burwell S, Sample M, Racine E. Ethical aspects of brain computer interfaces: a scoping review. BMC Med Ethics 2017; 18:60. [PMID: 29121942 PMCID: PMC5680604 DOI: 10.1186/s12910-017-0220-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Brain-Computer Interface (BCI) is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes (e.g., gaming) as well as health-related purposes (e.g., communication). The unprecedented direct connection created by BCI between human brains and computer hardware raises various ethical, social, and legal challenges that merit further examination and discussion. METHODS To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. RESULTS Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. CONCLUSIONS We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers.
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Affiliation(s)
- Sasha Burwell
- Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada
| | - Matthew Sample
- Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada.,Departments of Neurology and Neurosurgery, Experimental Medicine and Biomedical Ethics Unit, McGill University, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada
| | - Eric Racine
- Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada. .,Department of Experimental Medicine, McGill University, Montréal, Canada. .,Department of Medicine and Department of Social and Preventative Medicine, Université de Montréal, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada. .,Departments of Neurology and Neurosurgery, Experimental Medicine and Biomedical Ethics Unit, McGill University, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada.
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Trimper JB, Wolpe PR, Rommelfanger KS. When "I" becomes "We": ethical implications of emerging brain-to-brain interfacing technologies. FRONTIERS IN NEUROENGINEERING 2014; 7:4. [PMID: 24575002 PMCID: PMC3921579 DOI: 10.3389/fneng.2014.00004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/25/2014] [Indexed: 11/30/2022]
Affiliation(s)
- John B Trimper
- Department of Psychology, Emory University Atlanta, GA, USA
| | - Paul Root Wolpe
- Neuroethics Program, Center for Ethics, Emory University Atlanta, GA, USA ; Departments of Medicine and Pediatrics, Emory University Atlanta, GA, USA
| | - Karen S Rommelfanger
- Neuroethics Program, Center for Ethics, Emory University Atlanta, GA, USA ; Department of Neurology, Emory University Atlanta, GA, USA
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Wolbring G, Diep L, Yumakulov S, Ball N, Leopatra V, Yergens D. Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain? Healthcare (Basel) 2013; 1:20-52. [PMID: 27429129 PMCID: PMC4934504 DOI: 10.3390/healthcare1010020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 06/12/2013] [Accepted: 07/08/2013] [Indexed: 11/22/2022] Open
Abstract
So far, the very meaning of health and therefore, treatment and rehabilitation is benchmarked to the normal or species-typical body. We expect certain abilities in members of a species; we expect humans to walk but not to fly, but a bird we expect to fly. However, increasingly therapeutic interventions have the potential to give recipients beyond species-typical body related abilities (therapeutic enhancements, TE). We believe that the perfect storm of TE, the shift in ability expectations toward beyond species-typical body abilities, and the increasing desire of health consumers to shape the health system will increasingly influence various aspects of health care practice, policy, and scholarship. We employed qualitative and quantitative methods to investigate among others how human enhancement, neuro/cognitive enhancement, brain machine interfaces, and social robot discourses cover (a) healthcare, healthcare policy, and healthcare ethics, (b) disability and (c) health consumers and how visible various assessment fields are within Neuro/Cogno/Human enhancement and within the BMI and social robotics discourse. We found that health care, as such, is little discussed, as are health care policy and ethics; that the term consumers (but not health consumers) is used; that technology, impact and needs assessment is absent; and that the imagery of disabled people is primarily a medical one. We submit that now, at this early stage, is the time to gain a good understanding of what drives the push for the enhancement agenda and enhancement-enabling devices, and the dynamics around acceptance and diffusion of therapeutic enhancements.
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Affiliation(s)
- Gregor Wolbring
- Department of Community Health Sciences, Specialization in Community Rehabilitation and Disability Studies, University of Calgary, Calgary, AB T2N4N1, Canada.
| | - Lucy Diep
- Department of Community Health Sciences, Specialization in Community Rehabilitation and Disability Studies, University of Calgary, Calgary, AB T2N4N1, Canada.
| | - Sophya Yumakulov
- Faculty of Medicine, University of Calgary, Calgary, AB T2N4N1, Canada.
| | - Natalie Ball
- Faculty of Medicine, University of Calgary, Calgary, AB T2N4N1, Canada.
| | - Verlyn Leopatra
- Faculty of Medicine, University of Calgary, Calgary, AB T2N4N1, Canada.
| | - Dean Yergens
- Faculty of Medicine, University of Calgary, Calgary, AB T2N4N1, Canada.
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Who Needs to Fit in? Who Gets to Stand out? Communication Technologies Including Brain-Machine Interfaces Revealed from the Perspectives of Special Education School Teachers Through an Ableism Lens. EDUCATION SCIENCES 2013. [DOI: 10.3390/educsci3010030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The Asilomar Survey: Stakeholders' Opinions on Ethical Issues Related to Brain-Computer Interfacing. NEUROETHICS-NETH 2011; 6:541-578. [PMID: 24273623 PMCID: PMC3825606 DOI: 10.1007/s12152-011-9132-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 07/28/2011] [Indexed: 10/29/2022]
Abstract
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.
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Lipsman N, Mendelsohn D, Taira T, Bernstein M. The Contemporary Practice of Psychiatric Surgery: Results from a Survey of North American Functional Neurosurgeons. Stereotact Funct Neurosurg 2011; 89:103-10. [DOI: 10.1159/000323545] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 12/13/2010] [Indexed: 11/19/2022]
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