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Recommendations for Responsible Development and Application of Neurotechnologies. NEUROETHICS-NETH 2021; 14:365-386. [PMID: 33942016 PMCID: PMC8081770 DOI: 10.1007/s12152-021-09468-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 04/15/2021] [Indexed: 12/12/2022]
Abstract
Advancements in novel neurotechnologies, such as brain computer interfaces (BCI) and neuromodulatory devices such as deep brain stimulators (DBS), will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose (1) democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, (2) new measures, including “Neurorights,” for data privacy, security, and consent to empower neurotechnology users’ control over their data, (3) new methods of identifying and preventing bias, and (4) the adoption of public guidelines for safe and equitable distribution of neurotechnological devices.
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Lavazza A, Garasic M. Vampires 2.0? The ethical quandaries of young blood infusion in the quest for eternal life. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:421-432. [PMID: 32447568 DOI: 10.1007/s11019-020-09952-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Can transfusions of blood plasma slow down ageing or even rejuvenate people? Recent preclinical studies and experimental tests inspired by the technique known as parabiosis have aroused great media attention, although for now there is no clear evidence of their effectiveness. This line of research and the interest it is triggering testify to the prominent role played by the idea of combating the "natural" ageing process in the scientific and social agenda. While seeking to increase the duration of healthy living time may be considered a duty, it also raises ethical questions about how to pursue this goal. Specifically, therapies and techniques accessible only to a fraction of the population seem destined to exponentially increase social inequality and to produce undesirable consequences. In this article we address the issue precisely in the light of the prospected use of plasma for the rejuvenation of a small elite of people.
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Affiliation(s)
- Andrea Lavazza
- Centro Universitario Internazionale, via Garbasso 42, 52100, Arezzo, Italy.
| | - Mirko Garasic
- IMT School for Advanced Studies, Lucca, Italy
- Lumsa University, Rome, Italy
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Robinson JT, Pohlmeyer E, Gather MC, Kemere C, Kitching JE, Malliaras GG, Marblestone A, Shepard KL, Stieglitz T, Xie C. Developing Next-generation Brain Sensing Technologies - A Review. IEEE SENSORS JOURNAL 2019; 19:10.1109/jsen.2019.2931159. [PMID: 32116472 PMCID: PMC7047830 DOI: 10.1109/jsen.2019.2931159] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Advances in sensing technology raise the possibility of creating neural interfaces that can more effectively restore or repair neural function and reveal fundamental properties of neural information processing. To realize the potential of these bioelectronic devices, it is necessary to understand the capabilities of emerging technologies and identify the best strategies to translate these technologies into products and therapies that will improve the lives of patients with neurological and other disorders. Here we discuss emerging technologies for sensing brain activity, anticipated challenges for translation, and perspectives for how to best transition these technologies from academic research labs to useful products for neuroscience researchers and human patients.
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Affiliation(s)
- Jacob T. Robinson
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, USA
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
| | - Eric Pohlmeyer
- John Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - Malte C. Gather
- SUPA, School of Physics & Astronomy, University of St Andrews, St Andrews KY16 9SS Scotland, UK
| | - Caleb Kemere
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, USA
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - John E. Kitching
- Time and Frequency Division, NIST, 325 Broadway, Boulder, Colorado 80305, USA
| | - George G. Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge CB3 0FA, UK
| | - Adam Marblestone
- MIT Media Lab, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Kenneth L. Shepard
- Department of Electrical Engineering, Columbia University, New York, NY 10027, USA
| | - Thomas Stieglitz
- Institute of Microsystem Technology, Laboratory for Biomedical Microtechnology, D-79110 Freiburg, Germany
- Cluster of Excellence BrainLinks-BrainTools, University of Freiburg, 79110 Freiburg, Germany
- Bernstein Center Freiburg, University of Freiburg, 79104 Freiburg, Germany
| | - Chong Xie
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712, USA
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Bard I, Gaskell G, Allansdottir A, da Cunha RV, Eduard P, Hampel J, Hildt E, Hofmaier C, Kronberger N, Laursen S, Meijknecht A, Nordal S, Quintanilha A, Revuelta G, Saladié N, Sándor J, Santos JB, Seyringer S, Singh I, Somsen H, Toonders W, Torgersen H, Torre V, Varju M, Zwart H. Bottom Up Ethics - Neuroenhancement in Education and Employment. NEUROETHICS-NETH 2018; 11:309-322. [PMID: 30220937 PMCID: PMC6132847 DOI: 10.1007/s12152-018-9366-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/18/2018] [Indexed: 10/28/2022]
Abstract
Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/Protective highlights counter normative consequences and opposes the use enhancers. The Individual/Proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern.
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Affiliation(s)
- Imre Bard
- Department of Methodology, London School of Economics, London, UK
| | - George Gaskell
- Department of Methodology, London School of Economics, London, UK
| | | | | | - Peter Eduard
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Juergen Hampel
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, IL USA
| | - Christian Hofmaier
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Nicole Kronberger
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Sheena Laursen
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Anna Meijknecht
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Salvör Nordal
- Centre for Ethics University of Iceland, Reykjavik, Iceland
| | | | - Gema Revuelta
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Saladié
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Judit Sándor
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | | | - Simone Seyringer
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre University of Oxford, Oxford, UK
| | - Han Somsen
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Winnie Toonders
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Helge Torgersen
- Institute of Technology Assessment Austrian Academy of Sciences, Vienna, Austria
| | - Vincent Torre
- Centre for Neurobiology, International School for Advanced Studies, Trieste, Italy
| | - Márton Varju
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | - Hub Zwart
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
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Santarnecchi E, Pascual-Leone A. The Illusion of the Perfect Brain Enhancer. CEREBRUM : THE DANA FORUM ON BRAIN SCIENCE 2017; 2017:cer-11-17. [PMID: 30210662 PMCID: PMC6132045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many questions loom over transcranial direct current stimulation (tDCS), a non-invasive form of neurostimulation in which constant, low current is delivered directly to areas of the brain using small electrodes. It was first established in neuroscience research in the 1950s and 60s, but has seen rapid growth, particularly in the last five years. Originally developed to help patients with brain injuries such as strokes, tDCS is now also used to enhance language and mathematical ability, attention span, problem solving, memory, coordination, and even gaming skills. The authors examine its potential and pitfalls.
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Wexler A. The Social Context of "Do-It-Yourself" Brain Stimulation: Neurohackers, Biohackers, and Lifehackers. Front Hum Neurosci 2017; 11:224. [PMID: 28539877 PMCID: PMC5423946 DOI: 10.3389/fnhum.2017.00224] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/18/2017] [Indexed: 11/13/2022] Open
Abstract
The "do-it-yourself" (DIY) brain stimulation movement began in earnest in late 2011, when lay individuals began building stimulation devices and applying low levels of electricity to their heads for self-improvement purposes. To date, scholarship on the home use of brain stimulation has focused on characterizing the practices of users via quantitative and qualitative studies, and on analyzing related ethical and regulatory issues. In this perspective piece, however, I take the opposite approach: rather than viewing the home use of brain stimulation on its own, I argue that it must be understood within the context of other DIY and citizen science movements. Seen in this light, the home use of brain stimulation is only a small part of the "neurohacking" movement, which is comprised of individuals attempting to optimize their brains to achieve enhanced performance. Neurohacking itself is an offshoot of the "life hacking" (or "quantified self") movement, in which individuals self-track minute aspects of their daily lives in order to enhance productivity or performance. Additionally, the home or DIY use of brain stimulation is in many ways parallel to the DIY Biology (or "biohacking") movement, which seeks to democratize tools of scientific experimentation. Here, I describe the place of the home use of brain stimulation with regard to neurohackers, lifehackers, and biohackers, and suggest that a policy approach for the home use of brain stimulation should have an appreciation both of individual motivations as well as the broader social context of the movement itself.
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Affiliation(s)
- Anna Wexler
- Department of Science, Technology and Society, Massachusetts Institute of TechnologyCambridge, MA, USA
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Lavazza A. Can Neuromodulation also Enhance Social Inequality? Some Possible Indirect Interventions of the State. Front Hum Neurosci 2017; 11:113. [PMID: 28326031 PMCID: PMC5339233 DOI: 10.3389/fnhum.2017.00113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/22/2017] [Indexed: 12/21/2022] Open
Abstract
There is evidence that noninvasive brain stimulation (NIBS), and especially transcranial direct current stimulation (tDCS), can improve some cognitive functions, at least temporarily. However, as the improvement only applies to some “lucky” people, it may raise ethical, social and legal issues related to fairness in selective contexts (exams, competitions, job interviews). In this regard, an important element tends to be overlooked: the variability in individual response to tDCS in particular. If intensive study or practice and massive doses of chemical enhancers can have slightly different effects over different people, tDCS can sometimes be completely ineffective. The variability in individual response, if tDCS were widely used, could add to the already present natural inequalities between people, or even create new ones, leaving some in a disadvantaged condition. The discussion of the various ethical, social and legal consequences of different individual responses to tDCS might also address a potential indirect intervention by the State. In fact, if NIBS were to be widespread in competitive contexts, those who do not benefit from tDCS would be disadvantaged compared to those able to enhance their skills thanks to neuromodulation technologies. The most disadvantaged people for their lower response to tDCS could then acquire the right to receive and use free and safe cognitive enhancing drugs or other forms of bettering cognitive skills and functions, so as to reduce the gap between them and those who respond well to tDCS, in the light of the principle of equal opportunity.
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Affiliation(s)
- Andrea Lavazza
- Department of Neuroethics, Centro Universitario Internazionale Arezzo, Italy
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Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol 2016; 128:56-92. [PMID: 27866120 DOI: 10.1016/j.clinph.2016.10.087] [Citation(s) in RCA: 1034] [Impact Index Per Article: 129.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 12/19/2022]
Abstract
A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform tDCS in a therapeutic setting. In addition, the easy management and low cost of tDCS devices allow at home use by the patient, but this might raise ethical and legal concerns with regard to potential misuse or overuse. We must be careful to avoid inappropriate applications of this technique by ensuring rigorous training of the professionals and education of the patients.
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Wexler A. The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals. JOURNAL OF MEDICAL ETHICS 2016; 42:211-5. [PMID: 26324456 DOI: 10.1136/medethics-2015-102704] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 08/11/2015] [Indexed: 05/07/2023]
Abstract
Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications.
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Armon E, Kohls NB, Giordano J. On the viability of neurotechnology and mind–body methods in pediatric mental health: Perspectives on integrating new tools to complement old techniques. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Santarnecchi E, Feurra M, Barneschi F, Acampa M, Bianco G, Cioncoloni D, Rossi A, Rossi S. Time Course of Corticospinal Excitability and Autonomic Function Interplay during and Following Monopolar tDCS. Front Psychiatry 2014; 5:86. [PMID: 25101009 PMCID: PMC4104833 DOI: 10.3389/fpsyt.2014.00086] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 07/07/2014] [Indexed: 12/21/2022] Open
Abstract
While polarity-specific after-effects of monopolar transcranial direct current stimulation (tDCS) on corticospinal excitability are well-documented, modulation of vital parameters due to current spread through the brainstem is still a matter of debate, raising potential concerns about its use through the general public, as well as for neurorehabilitation purposes. We monitored online and after-effects of monopolar tDCS (primary motor cortex) in 10 healthy subjects by adopting a neuronavigated transcranial magnetic stimulation (TMS)/tDCS combined protocol. Motor evoked potentials (MEPs) together with vital parameters [e.g., blood pressure, heart-rate variability (HRV), and sympathovagal balance] were recorded and monitored before, during, and after anodal, cathodal, or sham tDCS. Ten MEPs, every 2.5-min time windows, were recorded from the right first dorsal interosseous (FDI), while 5-min epochs were used to record vital parameters. The protocol included 15 min of pre-tDCS and of online tDCS (anodal, cathodal, or sham). After-effects were recorded for 30 min. We showed a polarity-independent stabilization of cortical excitability level, a polarity-specific after-effect for cathodal and anodal stimulation, and an absence of persistent excitability changes during online stimulation. No significant effects on vital parameters emerged both during and after tDCS, while a linear increase in systolic/diastolic blood pressure and HRV was observed during each tDCS condition, as a possible unspecific response to experimental demands. Taken together, current findings provide new insights on the safety of monopolar tDCS, promoting its application both in research and clinical settings.
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Affiliation(s)
- Emiliano Santarnecchi
- Unit of Neurology and Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy ; Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
| | - Matteo Feurra
- Unit of Neurology and Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy ; Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
| | - Federico Barneschi
- Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
| | - Maurizio Acampa
- U.O.C. Stroke Unit, Department of Medicine, Surgery and Neuroscience, Le Scotte Policlinic , Siena , Italy
| | - Giovanni Bianco
- Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
| | - David Cioncoloni
- Unit of Neurology and Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy ; Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
| | - Alessandro Rossi
- Unit of Neurology and Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy
| | - Simone Rossi
- Unit of Neurology and Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy ; Brain Investigation and Neuromodulation Lab, University of Siena , Siena , Italy
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