We are at the advent of powerful new brain-machine interface technologies that offer remarkable advances, but also raise ethical issues which demand attention. The brain-machine interface revolution is happening in many countries worldwide, brought about by increased computational power, microelectronics, and understanding the fundamentals of brain function.
The results have been remarkable. People who are paralyzed without the ability to speak or move can now communicate and walk, changing their world. Most of these advances have been made with invasive technology, but some have been made with multiple monitors and caps over the skull.
As remarkable as these changes are in improving health, their proliferation will be accompanied by numerous ethical considerations.
It is possible these devices may understand our innermost thoughts and even our unconscious motivations. Furthermore, this technology opens the door for the potential of mind control, changing the way we think, our values, thoughts, and perceptions. That has not yet happened, but the potential is real.
What follows is an outline of potential ethical abuses and proposals to amend privacy regulations to include our personal thoughts, creating a legal shield from these technologies. While brain-machine interfaces represent one of the next great leaps in the technological revolution, the lynchpin of their current design is often an implantable chip within or affixed to the skull, directly or wirelessly connected to a machine that collects brain data, which is stored for immediate or future interpretation.
This collection of electrical signals and brain waves is a cause for concern. What follows are several outlined issues that arise from the use and storage of our innermost thoughts.
The sensitive nature of thought
Brain-machine interfaces can record and transmit highly private information, such as an individual’s innermost thoughts, emotional states, and mental health conditions. Given the sensitive nature of this data, strict safeguards are crucial to prevent unauthorized access or misuse.
In recent years, big corporations have collected and stored personal data without obtaining explicit consent from users, raising concerns that similar breaches of trust may occur with brain-machine interfaces.
Such breaches may expose even more intimate aspects of our lives, making it imperative to ensure that adequate measures are in place to protect this data.
Discrimination and exploitation risks
Brain-machine interfaces have the potential to provide valuable insights into an individual’s truthfulness, psychological traits, and attitudes. However, this information could also be used to discriminate against people in employment or other contexts. For instance, imagine an employer conducting a “background check” using your brain-machine interface data, which would be a violation of your privacy. This profoundly personal information could be used to deny you opportunities based on factors that are beyond your control.
Hacking and external control vulnerabilities
The wireless communication features of brain-machine interfaces risk being hacked and controlled externally by malicious actors. If successful, these attacks could expose private information or manipulate the device, which may harm the user. In today’s world, where cyberattacks are on the rise, the potential outcomes of brain-machine interface hacking are especially alarming.
The need for robust legal protection
Although the Health Insurance Portability and Accountability Act (HIPAA; U.S.) and General Data Protection Regulation (GDPR; E.U.) provide some privacy protections, it is yet to be determined if they can deal with the challenges associated with the amount and sensitivity of data produced by advanced brain machine interfaces. It is essential to revise these laws to include specific safeguards for personal and workplace data breaches related to brain-machine interfaces.
Cognitive liberty and mental privacy
Brain-machine interfaces pose ethical concerns regarding the potential violation of cognitive liberty—the right for individuals to be free from unwarranted intrusion into their minds and mental processes. These interfaces can provide access to thoughts, memories, and subjective experiences, raising concerns about mental privacy and self-determination.
It is essential to ask: who has the right to access the neural data generated by brain-machine interfaces? Can this data be used for purposes beyond medical treatment without consent? How do we ensure protection against the misuse of this technology for mind control or manipulation?
As brain-machine interface technology advances, clear guidelines and regulations must be established around cognitive liberty to prevent these concerns from becoming a reality.
Informed consent and decisional capacity
Obtaining informed consent from individuals who use brain-machine interfaces, especially those with neurological conditions or disabilities, is a challenging task. There are concerns regarding the decision-making ability of individuals with impaired mental states to fully comprehend the risks and implications of allowing a device to interface with their brain.
To ensure that users of brain-machine interfaces can provide valid informed consent, rigorous protocols must be implemented to assess decisional capacity and obtain permission. Additionally, safeguards will be necessary for vulnerable populations. The consent process should involve legal guardians, medical ethics boards, and other relevant parties.
Establishing strict guidelines for assessing decisional capacity and obtaining consent is essential to uphold ethical standards.
Equity and access concerns
Brain-machine interfaces are a new technology that could revolutionize how we interact with the world. However, there is a risk that these devices will only be available to those with significant financial resources or that certain groups will be excluded from their development and testing. This could exacerbate existing disparities and further marginalize underserved communities.
To prevent this from happening, we need to ensure that brain-machine interfaces are accessible to all, regardless of socioeconomic status. We must also ensure that diverse populations are adequately represented in research and development. This will help us understand how different groups may respond to these devices and ensure they are safe and effective for everyone.
In addition, we need to take measures to prevent further marginalization of underserved communities. This could include outreach programs to educate people about the potential benefits of brain-machine interfaces and policies to ensure these devices are affordable and accessible.
By addressing these equity concerns, we can ensure everyone can benefit from this exciting new technology while avoiding unintended consequences and negative impacts on vulnerable populations.
Enhancement and human evolution
Brain-machine interfaces have the potential to do more than just provide therapy. They could also enhance human cognitive abilities and even accelerate our evolution. This raises important ethical questions about fairness, the limits of human enhancement, and the long-term effects on our species.
We need to ask ourselves if limits on the degree of cognitive enhancement are allowed. It is also essential to navigate the blurred lines between therapy and enhancement. Furthermore, we must consider the societal and evolutionary consequences of significantly augmenting human capabilities.
As brain-machine interface technology progresses, we must continue to engage in ethical deliberation involving diverse perspectives and stakeholders.
A call for ethical vigilance
As brain-machine interface technology evolves, reports suggest that some countries like China aim to embrace them with fierce national implementation. A meta-analysis of over 600 research papers published by Chinese institutions found that the country has developed perhaps the highest level of expertise in the field on the global stage. While most countries are currently focused on the use of brain-machine interfaces for use in therapeutic settings, China seems to be more engaged in applying the technology across a vast range of sectors.
By ensuring that Chinese academics and manufacturers are highly literate in the field of brain-machine interfaces, they reduce the need for foreign cooperation when researching and developing such technologies, enabling a streamlined research-to-manufacturing pipeline.
They plan to invest heavily in the industry and apply the technologies across various fields, namely “medicine, healthcare, industrial safety, education and sports, and smart life.” Chinese leaders likely believe that brain-machine interfaces are the next step in human evolution.
Beyond medical and civilian applications, we cannot discount the use of brain-machine interfaces in military settings, such as more precise weapons operations.
As such, brain-machine ethics are a global, societal issue beyond the narrow scope of medicine.
It is not farfetched to suggest that we are approaching the technological capacity to change the very thoughts we create, the first stepping stone towards tangible mind control technologies.
Here are some examples of brain-machine interfaces currently in use:
Blackrock Neurotech’s UtahArray and MoveAgain brain computer interface system: This brain-machine interface technology uses microelectrodes implanted in the brain to record neural activity. It enables paralyzed patients to control computer cursors, robotic arms, or other devices using their thoughts. In 2021, the technology received the FDA breakthrough device designation.
Synchron’s Stentrode: This device is implanted in the brain’s motor cortex via the jugular vein. It allows control of digital devices using neural signals. It has been successfully implanted in patients in the U.S. and Australia.
Neuralink: Elon Musk’s company has created a brain-machine interface device that uses electrode “threads” implanted in the brain to treat neurological conditions in humans.
Non-Invasive EEG-Based Interfaces: NextMind, Neurable, and EMOTIV offer wearable headsets that use electroencephalography to detect brain signals. These headsets allow people to control computer interfaces and augmented/virtual reality experiences without using their hands.
While these devices are still primarily experimental, they enable a wide range of regenerative and futuristic applications in the very near future. Here are some key advantages these technologies present:
Restoring communication and independence: These devices could help people who have lost the ability to move or speak, such as those with locked-in syndrome, amyotrophic lateral sclerosis, or severe spinal cord injuries, by translating neural signals into computer commands. They would allow users to control wheelchairs or robotic limbs, operate computers, and communicate through text or speech synthesis.
Enhancing mobility and motor function: Those who suffer from paralysis or mobility restrictions due to stroke or cerebral palsy will undoubtedly benefit from such technology. In bypassing traditional motor pathways, brain-machine interfaces allow control of assistive devices such as prosthetic limbs or exoskeletons through brain signals alone. This can help individuals regain lost motor functions and improve their mobility.
Facilitating neurorehabilitation: Neurorehabilitation programs could also support patients with neurological disorders or injuries in relearning motor skills or regaining cognitive functions.
Improving web and digital accessibility: Brain-machine interfaces offer an alternative method for interacting with digital interfaces. They enable individuals with severe physical disabilities to navigate the web, operate computers, and access online services without relying on traditional input methods like keyboards or mice.
Although obstacles such as guaranteeing safety, dependability, and cost-effectiveness still need to be tackled, brain-machine interfaces could vastly improve the quality of life for
many individuals.
However, if we do not tread lightly, many of the devices listed above could be prototypes for more sinister devices down the line. We must address ethical concerns in advance. Developers of brain-machine interfaces should prioritize strong security measures and privacy protections, ensuring that both invasive and non-invasive versions of these devices protect their users’ personal information and autonomy.
Additionally, those with the power to regulate these devices must ensure the reasonable limitation of these devices to protect the user’s personal thoughts, desires, and actions from abuse and even alteration.
In the long run, the success of brain-machine interfaces will depend on the public’s trust that their most intimate data will be handled ethically. By addressing these ethical dilemmas head-on and implementing strict safeguards, we can leverage the transformative potential of brain-machine interfaces while maintaining the sanctity of the human mind
William A. Haseltine, PhD, is chair and president of the think tank ACCESS Health
International, a former Harvard Medical School and School of Public Health
professor and founder of the university’s cancer and HIV/AIDS research
departments. He is also the founder of more than a dozen biotechnology
companies, including Human Genome Sciences.
