Prosthetic Ethics James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford

Prosthetic Ethics

James J. Hughes Ph.D.Executive Director, Institute for Ethics and Emerging Technologies

Public Policy Studies, Trinity College, Hartford CT

[email protected]

Committee on Ethical and Societal Issues in National Security Applications of Emerging TechnologiesNovember 2-3, 2011Beckman Center, National Academy of SciencesIrvine, CA

http://ieet.org/archive/20111102-ProstheticEthics.ppt

Non-Problems & Old Problems

Some ethical issues are false problems, at least from an Enlightenment POV

Others are old problems, like ensuring safety and access

A few are novel because of the efficacy of neuroprosthetics

Institute for Ethics and Emerging Technologies 2011

Non-Problems

Supersoldiers Sports enhancement Disappearing disabled cultures Authenticity


SuperSoldiers

Ethics of military force, or of military applications

Do prosthetics change likelihood of exploiting soldiers

as guinea pigs or in the field ability to exercise judgment in

field, reduce collateral damage (drones)

likelihood of engaging in conflicts


Sports Enhancement

Oscar PistoriusSports is a rule-

governed gameIf athletes with

prosthetics want to compete they can start their own leagues

Not relevant to society


Disappearing Disabilities

99% of disabled happy to give up their disabilities

Only children forced to use Last century: dramatic decline in

veteran and civilian amputees 1000 amputees from Iraq/Afghan vets 1000+ surgeons in Civil War, 60,000+

amputees Changes cost-benefit analysis for

social priority-setting (Loeb) Difficulty in commercializing the direct

neural control prosthethics developed by DARPA or others


“Authenticity”

Not human, not me

ButBody image is

malleableProsthetics easily

incorporated, even made a valued aesthetic feature


Aestheticizing Prosthetics

Aimee Mullins


Smartphone dock installed in prosthetic

Anyway We Are All Cyborgs

Since literacy we have become dependent on brain prosthetics on paper

Shoes, clothing, tools The idea of prosthetic

enhancement is ancient: Icarus

Central to the Enlightenment project


Old Problems

Safety of devicesMoving line between

disability/normal/enhancedUnequal accessOwnership & intellectual

propertyPrivacy & cybersecurity


Safety

Federal Food, Drug, and Cosmetic Act covers all implants and other devices "intended to affect the structure or any function of the body of man or other animals“

But FDA’s 510k (similar to prior approval)

loophole Center for Devices and Radiological

Health underfunded to handle scope and pace of innovation

Authority inadequate to gather clinical trial information or compel reporting of post-approval adverse events


Are military IRBs’ reviews adequate to protect soldiers from experimental technologies

Defining Disabled/Enhanced

When Medicare changed its definition for coverable cochlear implants from deafness to severe hearing loss it expanded coverage for millions of seniors

25 million people in the U.S. have hearing loss Of those, 2.4 million have severe to profound

deafness 25% of those aged 65 to 74 have hearing impairments 40% over age 75 have hearing impairments


Superhuman Abilities

Tuneable cochlear and visual nerve implants, or prosthetics with greater than human strength

Turning point: when people want to replace limb, eyes or organs with prosthetics


Unequal Access

In every other industrialized country the debate is what should be in or out of the plan

Here it is up to 1500 private and 60 or so public insurance plans

Critical: Speed of innovation of cheap versions


Ownership & Property

Devices given to wounded warriors that have restricted civilian uses (akin to allowing them to take home weapons)

Repossession of a device for lack of payment (RepoMen)

Restricted travel to countries that are on a proscribed export list

Violating IP by allowing someone to examine, sharing details about device


Privacy and Cybersecurity

Already issue with mobile technology and RFID

Privacy of biometric information - controversy in 2002 over the VeriChip patient ID and tracking system

Implanted medical records, e-cash, telecom

Wireless hacking of prosthetics (Jay Radcliffe: insulin pump hacking)

Self-hacking to control drug administration

Required registration of high-power prosthetics


National security secrecy and corporate IP inhibit open source innovation, translation to application

See: 2005 EU Report “Ethical Aspects of ICT Implants in the Human Body”

Newer Problems

Timing of implants and upgradeability

Brain-machine interfaces Structural unemployment Remote behavior control Mood control Blurred culpability


Timing of Implants

Accelerating pace of innovationEspecially rapid

advances in biocompatible materials

Cochlear implantsCritical language windowDestruction of cochlear

tissue



Artificial Pancreas

Diabetes growing rapidly

Realtime blood sugar monitoring

Automated release of insulin

Implanted

Brain-Machine Interfaces

Prosthetic bodies & human brains (Robocop) versus robot brains in human bodies (Terminator)

All neural prosthetic research from peripheral nerves to cerebral on the Kurzweilian trajectory to nanoneural BCIs



Nathan Kline and Manfred Clynes

1960. “Cyborgs and Space,” Astronautics, Sept.

Monitoring and controlling the body/brain of the astronaut from ground control


Implants for Depression & OCD

DepressionObsessive-compulsive

disorder


Brain-Computer Interfaces


NanoNeural Network

Self-replicatingTwo-way

communication with trillions of neurons

Networked inside and out

Perfect virtual reality, mind back-up, upload

Structural Unemployment

Prior cases: literate/numerate workers smartphones

Competing not only against automation and globalization, but also against brain-machine enhanced workers (vets?)

AugCog


Autonomy & Addiction

Remote behavior control of criminals, soldiers, astronauts

Wireheading: mood control

Blurred culpability: developer, software, user



For more information

Institute for Ethics and Emerging Technologiesieet.org

Me: [email protected]

These slides:

http://ieet.org/archive/20111102-ProstheticEthics.ppt

Documents

Prosthetic Ethics James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford