3<\/a><\/sup>. \u201cTwo or three years ago,\u201d he says, \u201cwe\u2019d have said either that would never be possible, or it was at least 20 years away.\u201d<\/p>\nBut, he says, using AI tools also introduces ethical issues of which regulators have little experience. Machine-learning software learns to analyse data by generating algorithms that cannot be predicted and that are difficult, or impossible, to comprehend. This introduces an unknown and perhaps unaccountable process between a person\u2019s thoughts and the technology that is acting on their behalf.<\/p>\n
Developers are realizing that prostheses work more efficiently when certain computations are left to BCI devices, and when these devices try to predict what the user will do next. The benefits of offloading computations are obvious. Seemingly simple acts such as picking up a cup of coffee are actually highly complex: people subconsciously execute many computations. Fitting prostheses with sensors and mechanisms for autonomously generating coherent movements makes it easier for users to perform tasks. But this also means that much of what robotic limbs do is not actually directed by the user.<\/p>\n
The predictive nature of some algorithms used to help people operate prostheses leads to further concerns. Predictive text generators that are found in mobile phones highlight this issue: they can be useful, time-saving tools, but anyone who has sent an unintended message owing to an errant auto-correct or auto-fill function knows how things can go wrong.<\/p>\n
Such algorithms learn from previous data and guide users towards decisions on the basis of what they have done in the past. But if an algorithm constantly suggests a user\u2019s next word or action, and the user merely approves that option, the authorship of a message or movement will become ambiguous. \u201cAt some point,\u201d Kellmeyer says, \u201cyou have these very strange situations of shared or hybrid agency.\u201d Part of the decision comes from the user, and part comes from the algorithm of the machine. \u201cIt opens up a problem \u2014 an accountability gap.\u201d<\/p>\n
Maslen is confronting this problem as part of a collaborative project called BrainCom, funded by the European Union, that is developing speech synthesizers. Such technology has to accurately vocalize what users want to say to be useful. To guard against errors, users could be given the opportunity to approve each word for broadcast \u2014 although constantly and covertly relaying speech fragments to the user for review might make for a cumbersome system.<\/p>\n
Safeguards such as this would be especially important if devices struggled to distinguish between neural activity intended for speech and that which underlies private thought. Societal norms require that the fundamental boundary between private thought and outward behaviour be protected.<\/p>\n
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Reading, writing and responsibility<\/strong><\/p>\nBecause the symptoms of many brain diseases come and go, brain-monitoring techniques are increasingly being used to directly control DBS electrodes so that stimulation is provided only when needed.<\/p>\n
Recording electrodes \u2014 such as those that warned Patient 6 of impending seizures \u2014 track brain activity to determine when symptoms are happening or are about to occur. Rather than merely alerting the user to the need to take action, they trigger a stimulating electrode to nullify this activity. If a seizure is probable, DBS quietens the causative activity; if tremor-related activity increases, DBS suppresses the underlying cause. Such a closed-loop system was approved by the Food and Drug Administration for epilepsy in 2013, and such systems for Parkinson\u2019s disease are edging closer to the clinic.<\/p>\n
For neuroethicists, one concern is that inserting a decision-making device into someone\u2019s brain raises questions about whether that person remains self-governing, especially when these closed-loop systems increasingly use AI software that autonomously adapts its operations. In the case of a device for monitoring blood glucose that automatically controls insulin release to treat diabetes, such decision-making on behalf of a patient is uncontroversial. But well-intentioned interventions in the brain might not always be welcome. For instance, a person who uses a closed-loop system to manage a mood disorder could find themselves unable to have a negative emotional experience, even in a situation in which it would be considered normal, such as a funeral. \u201cIf you have a device that constantly steps up in your thinking or decision-making,\u201d says Gilbert, \u201cit might compromise you as an agent.\u201d<\/p>\n
The epilepsy-management device used by Patient 6 and the other recipients that Gilbert interviewed was designed to keep patients in control by sounding a warning about impending seizures, which enabled the patient to choose whether to take medication.<\/p>\n
Despite this, for five of the six recipients, the device became a major decision-maker in their lives. One of the six typically ignored the device. Patient 6 came to accept it as an integral part of their new self, whereas three recipients, without feeling that their sense of self had been fundamentally shifted, were happy to rely on the system. However, another was plunged into depression, and reported that the BCI device \u201cmade me feel I had no control\u201d.<\/p>\n
\u201cYou have the ultimate decision,\u201d Gilbert says, \u201cbut as soon as you realize the device is more effective in the specific context, you won\u2019t even listen to your own judgement. You\u2019ll rely on the device.\u201d<\/p>\n
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Beyond the clinic<\/strong><\/p>\nThe goal of neuroethicists \u2014 to maximize the benefits of emerging techniques and to minimize their harm \u2014 has long been entrenched in medical practice. The development of consumer technology, by contrast, is notoriously covert and subjected to minimal oversight.<\/p>\n
With technology companies now investigating the feasibility of mass-market BCI devices, Ienca thinks that this is an important moment. \u201cWhen a technology is in its germinal stage,\u201d he says, \u201cit\u2019s very hard to predict the outcomes of that technology. But when the tech is mature \u2014 in terms of market size or deregulation \u2014 it can be too societally entrenched to improve it.\u201d In his opinion, there is now sufficient knowledge to act in an informed manner, before neurotechnology is widely used.<\/p>\n
One issue that Ienca is addressing is privacy. \u201cBrain information is probably the most intimate and private of all information,\u201d he says. Digitally stored neural data could be stolen by hackers or used inappropriately by companies to whom users grant access. Ienca says that neuroethicists\u2019 concerns have forced developers to attend to the security of their devices, to more diligently protect consumer data, and to cease demanding access to social-media profiles and other sources of personal information as a condition of a device\u2019s use. Nevertheless, as consumer neurotechnology gains steam, ensuring that privacy standards are acceptable remains a challenge.<\/p>\n
Privacy and agency feature prominently in recommendations that are being produced by various working groups, including large-scale neuroscience projects and panels convened by independent bodies. But Kellmeyer thinks that there is still considerable work to be done. \u201cThe matrix of traditional ethics, which focuses on autonomy, justice and related concepts, will not be enough,\u201d he says. \u201cWe also need an ethics and a philosophy of human\u2013technology interactions.\u201d Many neuroethicists think that the ability to directly access the brain will make it necessary to update basic human rights.<\/p>\n
Maslen is already helping to shape BCI-device regulation. She is in discussion with the European Commission about regulations it will implement in 2020 that cover non-invasive brain-modulating devices that are sold straight to consumers. Maslen became interested in the safety of these devices, which were covered by only cursory safety regulations. Although such devices are simple, they pass electrical currents through people\u2019s scalps to modulate brain activity. Maslen found reports of them causing burns, headaches and visual disturbances. She also says clinical studies have shown that, although non-invasive electrical stimulation of the brain can enhance certain cognitive abilities, this can come at the cost of deficits in other aspects of cognition.<\/p>\n
Maslen and her colleagues wrote a policy paper targeted at European regulators who were reviewing the regulation of various quasi-medical products such as laser hair-removal devices. The regulators agreed with the paper\u2019s recommendations: that the new regulations should tighten safety standards, but also that (unlike for medical devices) consumers should remain free to decide whether the devices bring the gains that their manufacturers claim.<\/p>\n
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