A case study on the subject of neuroethics and neuro-specific human rights in the context of brain-computer interface

So, the story, in a nutshell, is the following: they implanted the patient with an experimental device designed to improve the patient's life; the patient started to feel better; then the device was removed, and the patient started to feel bad - even worse than before.

Why this is probably nothing new for assistive tech and prosthetics in general, this is probably one of the first documented cases involving brain implants. Now, the details are truly concerning. The patient in question was suffering from severe epilepsy, and the implanted device has been used to predict seizures (no DBS or other stimulation occurred, despite the case report being published in the Brain Stimulation journal). This helped the patient to feel more in control, hugely improving self-reported quality of life. The patient reported feeling embodiment, empowered and even achieving symbiotic agency with the BCI. She essentially felt the technology become part of herself.

Then the company (NeuroVista) went bankrupt, and the device had to be explanted; I don't know the complete story (please, share more details if you know about this particular trial or company, that would be appreciated).?

The patient opposed it but had to go with the procedure. After explantation, she reported a feeling of profound loss. As the authors put it - "it robbed her of the new person she had become with the technology... They took away that part of me that I could rely on … that part of me is gone".?

This paper raises a lot of serious questions for the field. Once again, this probably happened during the development of other implants, but brain implants can more directly alter the neurological health, self-image, and reasoning of the patient, so the situation is arguably more intense. It's not the first time when patients are stuck with an unsupported piece of neurotech inside them - see the coverage of the case with retinal implants by BBC https://www.bbc.com/news/technology-60416058. Probably, there will be more such cases, given the explosion of the invasive BCI industry. A lot of these companies will go bankrupt because the startups always do. Of course, the industry players should be more responsible; but talking about responsibility alone wouldn't fix the problem.?

How exactly do we protect patients in such cases? Living with an unsupported brain implant from a non-existing company is probably not the best idea, even if it functions for a moment. Even if companies would be forced to allocate some insurance funds for patient care during the trials stage, this would not do much in terms of tech support.

Another thing that is not helping, is the huge difference between implanted devices. All cardio stimulators or insulin pumps are more or less comparable and can be replaced if needed. On the other hand, implantable BCI is an emerging field, so the solutions and even basic working principles for every brain implant are unique.

The authors also raise more general philosophical and legal questions regarding the symbiotic nature of the brain-machine connection. In this case, the patient clearly indicated that she feels like a new self. If the device becomes part of the patient's mental self-image, doesn't it make them a new person to some extent? If so, what are the rights (neuro-rights?) of this person? If the removal of the device effectively terminates this de novo symbiotic person, does it need the same protection as the patient?

I honestly don't know the answers to these questions, and probably no one does for now.

See the original paper: https://www.sciencedirect.com/science/article/pii/S1935861X23017606?via%3Dihub#sec5

#neuroscience?#neurotech?#braincomputerinterface?#bci?#implants