Brain–Computer Interfaces - Index of

380 B.Z. Allison
such as privacy, liability [68], and laziness. We should consider whether and how a
changing BCI landscape will, or should, affect ethical questions.
Choosing the right BCI is a relatively minor consideration today, since it is so
hard to get any BCI in the first place. However, this is changing as BCIs become
more common and flexible. While key factors such as cost or utility will heavily
influence these decisions, the ethical concerns raised by invasive BCIs cannot be
ignored.
The decision to use an invasive BCI should stem from consideration of the costs
and risks as well as the non-invasive alternatives. Today, non-invasive BCIs can do
anything that invasive BCIs can do. Despite repeated efforts to suggest that noninvasive
approaches are inadequate for some tasks [19, 34], repeated rebuttals in the
literature [45, 85] have shown that noninvasive BCIs offer performance equal or
better than invasive BCIs.
This will probably change within ten years. Many new advances could foreshadow
invasive BCIs that offer performance that non-invasive counterparts cannot.
A recent article in Nature described an invasive system in monkeys that could detect
many details of desired movements and thereby allow up to 6.5 bits per second [67].
Taylor and Stetner (Chapter “Intracortical BCIs: A Brief History of Neural Timing”)
describe how invasive BCIs could provide even more precise information than actual
movements (see also [70]). Tasks such as controlling a BCI by imagining specific
finger movements may soon be feasible with invasive BCIs only. Invasive BCIs
might someday allow people to precisely and independently control each finger on
an artificial hand.
Thus, the ethical quandaries raised when deciding whether to recommend an
invasive BCI to a patient will, and should, change if invasive BCIs offer new options.
This may extend beyond BCIs for communication if, for example, invasive systems
turn out to be the best way to treat stroke or other disorders.
However, invasive BCIs still require surgery, frequent checkups, and uncertain
long-term damage, limiting potential users to people with a real medical need.
Dr. Wolpaw opened the 2003 Society for Neuroscience symposium with: “Your
brain or mine?” Invasive BCIs will offer better and better options to the people who
need them, and should be researched and used. But, as BCIs become more ubiquitous,
the practical problems inherent in invasive or nonportable BCIs will seriously
limit adoption among user groups without a medical need for BCIs.
Will this change? Within the BCI community, there is no serious consideration
of implanting BCIs in persons without a medical need. BCI ethics can draw on conventional
medical ethics, which typically oppose surgery (especially brain surgery)
unless there is a medical need. These ethical standards might change if there is some
dramatic advancement that obviates surgery, such as Star Trek style “hyposprays”
that can somehow inject devices without surgery. In the distant future, if invasive
BCIs have little history of medical complications and can provide substantial benefits
over other options, surgery might be considered less dramatic. People who wear
glasses often turn to eye surgery to improve their vision, even though it was considered
too risky a generation ago, and is still not medically necessary. Similarly,
people might someday consider some types of neurosurgery less dramatic – or, they