Thursday March 22nd, 2007
Implantable brain chips: ethical and policy issues (Lahey Clinic Medical Ethics Journal)
The future may include the reality of science fiction's "cyborgs," persons who have developed some intimate and occasionally necessary relationship with a machine. It is likely that computer chips implanted in our brains and acting as sensors or actuators may soon not only assist the blind and those with failing memory, but even bestow fluency in a new language, enable "recognition" of previously unmet individuals and provide instantaneous access to encyclopedic databases.

Developments in nanotechnology, bioengineering, computers and neuroscience are converging to facilitate these amazing possibilities. Research on cochlear hearing and retinal vision has furthered the development of interfaces between neural tissues and microcomputers. The cochlear implant, which directly stimulates the auditory nerve, enables totally deaf people to hear sound. An artificial vision system, the "Dobelle Eye," uses a tiny television camera and ultrasonic distance sensors mounted on eyeglasses and connected to a miniature computer worn on a belt. This invention enables the blind to navigate independently, "read" letters, "watch" television, use a computer and access the Internet. 1 These "visual" activities are achieved by triggering pulses from the microcomputer to an array of platinum electrodes implanted on the surface of the brain's visual cortex. In March 1998, a "locked in" victim of a brain-stem stroke became the first recipient of a brain-to-computer interface, enabling him to communicate on a computer by thinking about moving the cursor. 2

Used for therapy such as remediating retardation, replacing lost memory faculties, or substituting for defective sensory abilities, implantable brain chips are noncontroversial and desirable interventions. The issues that arise with such therapeutic uses of implantable brain chips primarily involve questions of equity and the costs of implementing this technology.

Questions that are far more difficult are raised by the potential for enhancement. The linkage of smaller, lighter and more powerful computer systems with radio technologies that involve low frequency electromagnetic waves widely used for wireless communication, will enable future users to access information and communicate anywhere or anytime.

Through miniaturization of components, systems have already been developed that are wearable and nearly invisible, so that individuals supported by a personal information structure 3 can move about and interact freely, as well as share experiences with others through networking. 4 The wearable computer project envisions users accessing a large communally-based data source. 5 The next step in this development is use of the implantable brain chip and direct neural interfacing. 6

As intelligence or sensory "amplifiers," the implantable chips will generate at least four benefits: l) increasing the range of senses, enabling, for example, seeing infrared light, ultraviolet light and chemical spectra; 2) enhancing memory; 3) enabling "cyberthink" - invisible communication with others when making decisions; and 4) facilitating access to information where and when it is needed. These enhancements will produce major improvements in quality of life or in job performance. The first prototypes for these improvements in human functioning should be avail-able in five years, military devices within 10 years, adoption by information workers within 15 years, and general use in 20 to 30 years.

A myriad of technical, ethical and social concerns should be considered before proceeding with implantable chips. 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. The question of whether or not 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 usage. However, the issue of whether there should be a higher standard for safety when technologies are used for enhancement rather than therapy needs public debate. Because of the enormous potential for societal impact, it is debatable whether the informed con-sent of recipients should be sufficient for permitting implementation.

Consideration needs to be given to the sociological and psychological effects 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. Not only may the boundaries of the real and the virtual worlds blur, but the pressures to act as a part of the whole, as a "collective consciousness," rather than as an isolated individual would be increased. The sense of self as a unique and isolated individual might be changed. Modifying the brain and its powers could change our psychic states and our understanding of what it means to be human. The borders between me "the physical self" and me "the perceptory intellectual self" could change as the ability to perceive and interact expands. Whether this would lead to bestowing greater weight to collective responsibilities and whether this would be beneficial are unknown.

Since usage may also engender a human being with augmented sensory capacities, the implications 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 environ-mental stimuli like changes in barometric pressure. These capacities would change the "norm" for humans. As the numbers of enhanced humans increase, today's nor-mal might be seen as subnormal, leading to the medicalization of another area of life. Thus, substantial questions revolve around whether there should be limits placed upon modifications of essential aspects of the human species.

Changes in human nature would be-come more pervasive if the altered consciousness were that of children. Will parents in our intensely competitive society be able to secure implants for their children, and if so, how will that change the already unequal lottery of life? Will the inequalities produced create a demand for universal coverage of these devices in healthcare plans, further increasing costs to society? Or will implanted brain chips be available only to those who can afford a substantial investment, thus further widening the gap between the haves and the have-nots? Of major concern should be the social impact of implementing a technology that widens the divisions not only between individuals, but also between rich and poor nations.

Beyond these more imminent prospects, British scientists have concluded that in about 30 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." 7 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. Combined with cloning technologies and given the possibility of continually recording and editing our lives, novel meanings of the self would be generated.

The most frightening implication of this technology is the grave possibility that it would facilitate totalitarian control of humans. Using such technology, commercial interests or governments could control and monitor citizens. In a free society this possibility may seem remote, although it is plausible to project initial compulsory usage for children, for the military or for criminals. Policy decisions will arise about this usage, and also about mandating implants to affect specific behaviors. A paramount worry involves who will control the technology and what will be programmed; this issue overlaps the uneasiness about privacy concerns and the need for secure communication links. The prospects for sinister invasions of liberty and privacy are alarming.

In view of the potentially revolutionary implications of the implantable brain chip, should its development and implementation be prohibited or, at the very least, regulated? This is the question that open dialogue needs to address. Certainly, it appears that moving towards implantable brain chips can be a positive step in the evolution of humans. Nevertheless, the issues as described in this paper are weighty and need international consideration. Disagreement exists even between the authors of this paper: Gerald Maguire thinks there should be no limits placed on how people can choose to modify themselves; Ellen McGee thinks that, at least initially, when used for enhancement, the technology should be regulated, treated as research on human subjects, and closely monitored for its effects. Both authors are worried about uses in the military and for children or other individuals whose choices might be compelled. McGee is particularly troubled by the inequities, especially on an international level, that will arise if this technology is left to a market economy. Our discussions have convinced us that public debate and multidisciplinary evaluation from thinkers in the fields of computer science, biophysics, medicine, law, religion, philosophy, public policy and international economy are urgently needed.

Footnotes 1 Artificial vision system for the blind announced by the Dobelle Institute. Press Release. Science Daily .

2 Headlam B. The mind that moves objects. The New York Times Magazine June 11, 2000:63-4.

3 Mann S. Wearable computing: A first step toward personal imaging. Computer Vol. 30, No. 2, February 1997. .

4 Mann S. Wearable, tetherless, computer-mediated reality (with possible future applications to the disabled). .

5 Augmented Memory . June 1997.

6 Thomas P. Thought control. New Scientist March 9, 1996.

7 Dawley H. Remembrance of things past - on a chip. Business Week August 5, 1996. Acknowledgments: This essay summarizes and updates a consideration of these issues published in the Hastings Center Report Jan-Feb 1999.