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Elon Musk’s startup, Neuralink, has been working on the plan to implant a brain chip embedded in a human skull since its founding in 2016.

After years of animal testing, Musk announced in December that the company plans to begin human trials within six months (though this isn’t the first time he’s said such trials are on the horizon).

Neuralink has spent more than half a decade figuring out how to translate brain signals into digital output – imagine being able to move a cursor, send a text message or write a word processor just by thinking.

And while the initial focus is on medical use cases, such as helping paralyzed people communicate, Musk aspires to take Neuralink chips into the mainstream — as he puts it, to put “Fitbit in your skull.”

Musk’s company isn’t the only group working on brain-computer interfaces, or systems to facilitate direct communication between human brains and external computers. Other researchers are looking at using BCIs to restore lost senses and control prosthetics, among other applications.

While still in their infancy, these technologies have been around long enough for researchers to gain a growing sense of how neural implants interact with our brains.

As Anna Wexler, assistant professor of philosophy in the Department of Medical Ethics and Health Policy at the University of Pennsylvania, puts it: “Of course it causes changes. The question is what kinds of changes does it cause, and how much impact? Changes matter?”

Interfering with the delicate processes of the human mind is hard work, and the effects are not always desired or intended. People who use BCIs can feel a deep sense of dependence on the devices, or as if their sense of themselves has changed. And before we get to the point where people are lining up to get a smartphone implanted in their brains, it’s important to grapple with its unique ethical risks.

From science fiction to a multi-billion dollar industry

In the 1974 movie The Terminal Man, a man gets a brain implant to help with his seizures. While the operation seems successful at first, things go wrong when constant exposure to the chip causes a psychotic rampage.

And while humans have yet to produce flying cars, human missions to Mars, or engineer convincing replicas, BCIs may be the most important technology for not only catching up but in some cases overtaking early science fiction depictions. More than 200,000 people around the world already use some type of BCI, most of them for medical reasons. Perhaps the most famous use case is cochlear implants, which enable the deaf to hear to some extent.

Another notable use case is seizure prevention: Existing devices can monitor brain signaling activity to predict seizures and warn a person so they can avoid certain activities or take preventive medication.

Some researchers have proposed systems that not only detect seizures but also prevent them through electrical stimulation, a mechanism roughly described in The Terminal Man. The transplants have been performed on people with Parkinson’s disease, depression, obsessive-compulsive disorder and epilepsy in human trials for years.

Recent improvements in artificial intelligence and neuroscanning materials have made devices less invasive and more scalable, which has naturally attracted a wave of private and military funding. Paradromics, Blackrock Neurotech and Synchron are just a few of the project-backed competitors working on devices for people with paralysis.

And last November, a startup, Science, unveiled a concept for a bioelectrical interface to help treat blindness. And last September, Magnus Medical received approval from the US Food and Drug Administration for a targeted brain stimulation treatment for major depressive disorder.

Meanwhile, Neuralink has faced a history of over-promising — for example, failing to meet schedules, and has reportedly launched a federal investigation into allegations of animal welfare violations. Intelligence firm Grand View Research estimated the global brain implant market at $4.9 billion in 2021, and other companies predicted that the number could double by 2030.

Currently, BCIs have been restricted to the medical field, but a wide range of non-medical uses for this technology have been proposed. Research published in 2018 described participants using BCIs to interact with several apps on an Android tablet, including typing, messaging, and searching the web just by imagining the relevant movements. More speculative applications include playing video games, manipulating virtual reality, or even receiving data inputs such as text messages or videos directly, bypassing the need for a screen.

This may sound like science fiction, but the truth is that we have reached a point where the cultural and ethical barriers to this type of technology are starting to trump the technical barriers. Despite the fictional nature of The Terminal Man, his disastrous role raises real questions about the unintended effects of BCIs.

Change of mind

There have been no confirmed cases of violent irritations caused by BCIs, but the overwhelming evidence suggests that the devices can cause cognitive changes outside of their intended applications. Some of these changes have been positive. After all, BCIs aim to change certain things about their users.

Wexler, a professor of philosophy at the University of Pennsylvania, interviewed people with Parkinson’s disease who were undergoing deep brain stimulation, a surgical treatment that involves implanting thin metal wires that send electrical impulses to the brain to help relieve motor symptoms, and found that many of them lost their symptoms. A sense of self before undergoing treatment.

Erin Klein and Sarah Goering, researchers at the University of Washington, observed positive changes in personality and self-perception among people who used BCIs.

In a 2016 paper on attitudes and ethical considerations surrounding DBS, they report that study participants often felt that therapy helped them restore an “authentic” self that had been eroded by depression or obsessive-compulsive disorder.

One patient said, “I started to wonder what I am, what depression is, and what the trigger is.” Speaking in late 2022 about similar research, neuropsychologist Cynthia Cobo described an increased sense of control and autonomy among the patients she interviewed.

But not all of the changes the researchers found are beneficial. In interviews with people who had BCIs, Frederick Gilbert, a professor of philosophy at the University of Tasmania who specializes in applied neuroethicists, noticed some strange effects.

He said: “The concepts of personality, identity, agency, authenticity, autonomy, self – these are very compact, ambiguous and opaque dimensions. No one really agrees with what you mean, but we have had cases where it’s clear that BCIs have brought about changes in personality or the expression of sexuality.”

Across several interview studies, Gilbert observed that patients reported feelings of not recognizing themselves, or what is commonly referred to as “estrangement” in the research.

“They know they are themselves, but it’s not like it was before the transplant,” he said. Some have expressed feelings of having new abilities unrelated to the implant, such as a woman in her late 50s who hurt herself while trying to lift a pool table she thought she could move on her own.

And for people who use BCIs to help with significant medical limitations, it makes sense that the treatment could have a positive psychological impact. But when it comes to considering brain chips for common use, there is a lot of concern about the downsides.

Smartphone in your mind

As technology improves, we’re getting closer to seeing a “Fitbit in your skull”. But there is reason to be careful. After all, if it was so easy to become addicted to your phone, just think of how addictive it could be if it was wired directly into your brain.

Gilbert told of a patient he interviewed who developed a kind of decision paralysis, ultimately feeling he couldn’t go out or make up his mind about what to eat without first consulting the machine that showed what was going on in his brain.

“There’s nothing wrong with having a device that complements the decision, but in the end, the device was kind of taking the place of the person in the decision, taking them out of the loop,” Gilbert said.

Sometimes, a patient can rely so much on their devices that they feel they cannot function without them. Gilbert encountered several study participants who became depressed after losing support for their devices and having them removed, often because a particular trial had ended or funding had run out.

One study participant, who was given a device to detect signs of epileptic activity, said in an interview: “You gradually grow and get used to it. It becomes me.”

This type of dependence is further complicated by the fact that BCIs are difficult to financially support and maintain, and often require brain surgery to remove and reimplant them. Because BCIs are still very much in the experimental stage, there is a lack of global standards or stable financial support, and many devices are at risk of losing funding suddenly. And early adopters can have their sense of self shaken by supply chain issues, hardware upgrades, or company bankruptcy.

There are also privacy concerns that come with computer access to your brainwaves. “If you get a device to help you move your prosthetic arm, for example, that device will pick up other sources of noise that you might not want to be outside of your brain,” Gilbert said. “There is a lot of background noise, and background noise can be decoded. That noise is necessarily transformed.” And it sits somewhere on the cloud.”

A person can learn a lot by studying your brain waves, and if a hacker gains access to your data, they can read your mind, in a sense, by looking for specific expressions of brain signaling activity.

Because BCIs are still primarily restricted to the medical field, most early adopters are happy to make these kinds of trade-offs.

“If someone has a disability that makes them unable to communicate, they will generally be happy if there is technology that allows them to do so,” Wexler said.

But, aside from the idea that non-medical BCIs likely present a host of new problems, it’s not clear the trade-offs will be worth it just to have a Fitbit in your head.

And while we’re still a long way from the cyborg future of electronically connected minds predicted by people like Elon Musk, the industry’s exponential growth is adding more urgency to ethical considerations previously restricted to science fiction. And if a brain chip can change key parts of your personality, companies shouldn’t rush to put it in people’s minds.

Source: ScienceAlert

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