Ethical Assessment of Implantable Brain Chips
Ellen M. McGee and G. Q. Maguire, Jr.
The future may well involve the reality of science fiction's cyborg, persons who have developed some intimate and occasionally necessary relationship with a machine. It is likely that implantable computer chips acting as sensors, or actuators, may soon assist not only failing memory, but even bestow fluency in a new language, or enable "recognition" of previously unmet individuals. The progress already made in therapeutic devices, in prosthetics and in computer science indicate that it may well be feasible to develop direct interfaces between the brain and computers.
Worldwide there are at least three million people living with artificial implants. In particular, research on the cochlear implant and retinal vision have furthered the development of interfaces between neural tissues and silicon substrate micro probes. The cochlear implant, which directly stimulates the auditory nerve, enables over 10,000 totally deaf people to hear sound; the retinal implantable chip for prosthetic vision may restore vision to the blind. Research on prosthetic vision has proceeded along two paths: 1) retinal implants, which avoid brain surgery and link a camera in eyeglass frames via laser diodes to a healthy optic nerve and nerves to the retina, and 2) cortical implants, which require brain surgery and the pneumatic insertion of electrodesinto the brain to penetrate the visual cortex and produce highly localized stimulation.
The latest stage in the evolution towards the implantable brain chip involves combining these advances in prostheses technology with developments in computer science. The linkage of smaller, lighter, and more powerful computer systems with radio technologies will enable users to access information and communicate anywhere or anytime. Through miniaturization of components, systems have been generated that are wearable and nearly invisible, so that individuals, supported by a personal information structure, can move about and interact freely, as well as, through networking, share experiences with others. The wearable computer project envisions users accessing the Remembrance Agent of a large communally based data source.
Wearables and body-nets are intermediate technologies; the logical next step in this development is the implantable brain chip, direct neural interfacing. As early as 1968, Nicholas Negroponte, presently director of MIT's Media Lab, first prophesied this symbiosis between mankind and machine. His colleague, Professor Gershenfeld, asserts that "in 10 years, computers will be everywhere; in 20 years, embedded by bioengineers in our bodies..." Neither visionary professes any qualms about this project, which they expect to alter human nature itself. "Suddenly technology has given us powers with which we can manipulate not only external reality the physical world but also, and much more portentously, ourselves." Once networked the result will be a "collective consciousness", "the hive mind." "The hive mind...is about taking all these trillions of cells in our skulls that make individual consciousness and putting them together and arriving at a new kind of consciousness that transcends all the individuals."
The technology for implantable devices is becoming available, and at prices that make such systems very cost effective. Three stages of introduction of such devices can be delineated. The earliest adopters will be those with a disability, who will use this as a more powerful prosthetic device. The next stage, represents the movement from therapy to enhancement, and it is at this point that ethical evaluation becomes imperative. One of the first groups of non-disabled "volunteers" will probably be the professional military, where the use of an implanted computing and communication device with new interfaces to weapons, information, and communications could be lifesaving. The third group of users will probably be those involved in very information intensive businesses, who will use these devices to develop an expanded information transfer capability.
As intelligence or sensory "amplifiers", the implantable chip will generate at least four benefits: 1) it will increase the dynamic range of senses, enabling, for example, seeing IR, UV, and chemical spectra; 2) it will enhance memory; 3) it will enable "cyberthink" invisible communication with others when making decisions, and 4) it will enable consistent and constant access to information where and when it is needed. For many these enhancements will produce major improvements in the quality of life, or their survivability, or their performance in a job. The first prototype devices for these improvements in human functioning should be available in five years, with the military prototypes starting within ten years, and information workers using prototypes within fifteen years; general adoption will take roughly twenty to thirty years. The brain chip will probably function as a prosthetic cortical implant. The user's visual cortex will receive stimulation from a computer based either on what a camera sees or based on an artificial "window" interface.
Not every computer scientist views such prospects with equanimity. Michael Dertouzos writes, "even if it would someday be possible to convey such higher-level information to the brain and that is a huge technical "If" we should not do it. Bringing light impulses to the visual cortex of a blind person would justify such an intrusion, but unnecessarily tapping into the brain is a violation of our bodies, of nature, and for many, of God's design."
This succinctly formulates the essentialist and creationist argument against the implantable chip. Fears of tampering with human nature are widespread; the theme that nature is good and technology evil, that the power to recreate oneself is overreaching hubris, and that reengineering humanity can only result in disaster, is a familiar response to each new control that man exercises. The mystique of the natural is fueled by the romantic world view of a benign period when humans lived in harmony with nature. However attractive, it is probable that this vision is faulty inasmuch as man has always used technology to survive, and to enhance life; the use of technology is natural to man. Thus this negative response to the prospect of implantable chips is certainly inadequate, although it points to a need to evaluate the technology in terms of the good or evil possibilities for its use by men, or governments.
The call not to "play God" is also familiar, and suffers from the same difficulties articulated by David Hume. This critique relies on a religious sense that improving on the design of creation insults the Creator. In particular, it proposes that attempts to alter the functioning of the brain for purposes of creating a superior human being can be decried as usurping God's power. To be persuasive this argument must depend on a restrictive, even for religionists, view of creation, one that sees no role for human creativity.
Rejection of wiring brains directly to a computer also stems from a desire for bodily integrity, and intuitions about the sanctity of the body. Thus, many accept the invasion of the organic by the mechanical for curative purposes, but feel that such uses for enhancement are wrong. This conviction, that respect for humans requires the physical integrity of the body is a version of "the inviolability-of persons view", a deontological position. Using this standard, a distinction is drawn between therapeutic and enhancement procedures; "An intervention that is life-saving, rehabilitative, or otherwise therapeutic can be consistent with the principle that the physical integrity of the body should be preserved even if it involves a bodily 'mutilation' or intrusion, provided that it promotes the integrity of the whole." Implantable chips that amplify the senses, or enhance memory or networking capacities would, thus, be suspect. For others, however, there is no bright line between therapy and enhancement how deficient does my memory have to be before it would be ethical to wire my brain to a computer? and the argument is too weak to preclude the use of this technology, anymore than it is possible to proscribe cosmetic surgery, or the use of mood-improving drugs if the benefits seems to outweigh the medical risks. However, even if we discount the force of these three arguments, there are a myriad of other technical, ethical and social concerns to consider before proceeding with implantable chips. The areas of concern for technology assessment are extensive, including risks, appropriateness, societal impact, costs and equity issues and need evaluation by a multi disciplinary team. Study of this device would seem to need participants from at least the fields of computer science, biophysics, medicine, law, philosophy, public policy and international economy. Unlike the scientific community at the advent of genetic technologies, the computer industry has not, as yet, engaged in a public dialogue of these promising, but risky technologies. This avoidance of discussion, and simple reliance upon principles of free scientific inquiry and the market economy is itself a moral stance requiring justification.
Ethical appraisal of implantable computer chips should assess at least the following areas of concern: issues of safety and informed consent, issues of manufacturing and scientific responsibility, anxieties about the psychological impacts of enhancing human nature, worries about possible usage in children, and most troublesome, issues of privacy and autonomy. As is the case in evaluation of any future technology, it is unlikely that we can reliably predict all effects. Nevertheless, the potential for harm must be considered.
The most obvious and basic problems involve safety. Evaluation of the costs and benefits of these implants requires a consideration of the surgical and long term risks. One question, whether the difficulties with development of non-toxic materials will allow long term usage? should be answered in studies on therapeutic options and thus, not be a concern for enhancement usages. However, it is conceivable that there should be a higher standard for safety when technologies are used for enhancement rather than therapy, and this issue needs public debate. Whether the informed consent of recipients should be sufficient reason for permitting implementation is questionable in view of the potential societal impact. Other issues such as the kinds of warranties users should receive, and the liability responsibilities if quality control of hard/soft/firmware is not up to standard, could be addressed by manufacturing regulation. Provisions should be made to facilitate upgrades since users presumably would not want multiple operations, or to be possessors of obsolete systems. Manufacturers must understand and devise programs for teaching users how to implement the new systems. There will be a need to generate data on individual implant recipient usefulness, and whether all users benefit equally. Additional practical problems with ethical ramifications include whether there will be a competitive market in such systems and if there will be any industry-wide standards for design of the technology.
One of the least controversial uses of this enhancement technology will be its implementation as therapy. It is possible that the technology could be used to enable those who are naturally less cognitively endowed to achieve on a more equitable basis. Certainly, uses of the technology to remediate retardation or to replace lost memory faculties in cases of progressive neurological disease, could become a covered item in health care plans. Enabling humans to maintain species typical functioning would probably be viewed as a desirable, even required, intervention, although this may become a constantly changing standard. The costs of implementing this technology needs to be weighed against the costs of impairment, although it may be that decisions should be made on the basis of rights rather than usefulness.
Consideration also needs to be given to the psychological impact of enhancing human nature. Will the use of computer-brain interfaces change our conception of man and our sense of identity? If people are actually connected via their brains the boundaries between self and community will be considerably diminished. The pressures to act as a part of the whole rather than as a single isolated individual would be increased; the amount and diversity of information might overwhelm, and the sense of self as a unique and isolated individual would be changed.
Since usage may also engender a human being with augmented sensory capacities, the implications, even if positive, need consideration. Supersensory sight will see radar, infrared and ultraviolet images, augmented hearing will detect softer and higher and lower pitched sounds, enhanced smell will intensify our ability to discern scents, and an amplified sense of touch will enable discernment of environmental stimuli like changes in barometric pressure. These capacities would change the "normal" for humans, and would be of exceptional application in situations of danger, especially in battle. As the numbers of enhanced humans increase, today's normal range might be seen as subnormal, leading to the medicalization of another area of life. Thus, substantial questions revolve around whether there should be any limits placed upon modifications of essential aspects of the human species. Although defining human nature is notoriously difficult, man's rational powers have traditionally been viewed as his claim to superiority and the center of personal identity. Changing human thoughts and feeling might render the continued existence of the person problematical. If one accepts, as most cognitive scientists do, "the materialist assertion that mind is an emergent phenomenon from complex matter, ... cybernetics may one day provide the same requisite level of complexity as a brain." On the other hand, not all philosophers espouse the materialist contention and use of these technologies certainly will impact discussions about the nature of personal identity, and the traditional mind-body problem. Modifying the brain and its powers could change our psychic states, altering both the self-concept of the user, and our understanding of what it means to be human. The boundary between me "the physical self" and me "the perceptory/intellectual self" could change as the ability to perceive and interact expands far beyond what can be done with video conferencing. The boundaries of the real and virtual worlds may blur, and a consciousness wired to the collective and to the accumulated knowledge of mankind would surely impact the individual's sense of self. Whether this would lead to bestowing greater weight to collective responsibilities and whether this would be beneficial are unknown.
Changes in human nature would become more pervasive if the altered consciousness were that of children. In an intensely competitive society, knowledge is often power. Parents are driven to provide the very best for their children. Will they be able to secure implants for their children, and if so, how will that change the already unequal lottery of life? Standards for entrance into schools, gifted programs and spelling bees all would be affected. The inequalities produced might create a demand for universal coverage of these devices in health care plans, further increasing costs to society. However, in a culture such as ours, with different levels of care available on the basis of ability to pay, it is plausible to suppose that implanted brain chips will be available only to those who can afford a substantial investment, and that this will further widen the gap between the haves and the have-not. A major anxiety should be the social impact of implementing a technology that widens the divisions not only between individuals, and genders, but also, between rich and poor nations. As enhancements become more widespread, enhancement becomes the norm, and there is increasing social pressure to avail oneself of the "benefit."Thus, even those who initially shrink from the surgery may find it becomes a necessity, and the consent part of "informed consent"would become subject to manipulation.
Beyond these more imminent prospects is the possibility that in thirty years, "it will be possible to capture data presenting all of a human being's sensory experiences on a single tiny chip implanted in the brain." This data would be collected by biological probes receiving electrical impulses, and would enable a user to recreate experiences, or even to transplant memory chips from one brain to another. In this eventuality, psychological continuity of personal identity would be disrupted with indisputable ramifications . Would the resulting person have the identities of other persons?
The most frightening implication of this technology is the grave possibility that it would facilitate totalitarian control of humans. In a prescient projection of experimental protocols, George Annas writes of the "project to implant removable monitoring devices at the base of the brain of neonates in three major teaching hospitals....The devices would not only permit us to locate all the implantees at any time, but could be programmed in the future to monitor the sound around them and to play subliminal messages directly to their brains." Using such technology governments could control and monitor citizens. In a free society this possibility may seem remote, although it is not implausible to project usage for children as an early step. Moreover, in the military environment the advantages of augmenting capacities to create soldiers with faster reflexes, or greater accuracy, would exert strong pressures for requiring enhancement. When implanted computing and communication devices with interfaces to weapons, information, and communication systems become possible, the military of the democratic societies might require usage to maintain a competitive advantage. Mandated implants for criminals are a foreseeable possibility even in democratic societies. Policy decisions will arise about this usage, and also about permitting usage, if and when it becomes possible, to affect specific behaviors. A paramount worry involves who will control the technology and what will be programmed; this issue overlaps with uneasiness about privacy issues, and the need for control and security of communication links. Not all the countries of the world prioritize autonomy, and the potential for sinister invasions of liberty and privacy are alarming.
In view of the potentially devastating implications of the implantable brain chip should its development and implementation be prohibited? This is, of course, the question that open dialogue needs to address, and it raises the disputed topic of whether technological development can be resisted, or whether the empirical slippery slope will necessarily result in usage, in which case regulation might still be feasible. Issues raised by the prospect of implantable brain chips are hard ones, because the possibilities for both good and evil are so great. The issues are too significant to leave to happenstance, computer scientists, or the commercial market. It is vital that world societies assess this technology and reach some conclusions about what course they wish to take.