Prosthetic Ethics

1
Prosthetic Ethics

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

Committee on Ethical and Societal Issues in
National Security Applications of Emerging
Technologies November 2-3, 2011 Beckman Center,
National Academy of Sciences Irvine, CA
http//ieet.org/archive/20111102-ProstheticEthics.
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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

3
Non-Problems

• Supersoldiers
• Sports enhancement
• Disappearing disabled cultures
• Authenticity

4
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

5
Sports Enhancement

• Oscar Pistorius
• Sports is a rule-governed game
• If athletes with prosthetics want to compete they
  can start their own leagues
• Not relevant to society

6
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

7
Authenticity

• Not human, not me
• But
• Body image is malleable
• Prosthetics easily incorporated, even made a
  valued aesthetic feature

8
Aestheticizing Prosthetics

• Aimee Mullins

Smartphone dock installed in prosthetic
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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

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Old Problems

• Safety of devices
• Moving line between disability/normal/enhanced
• Unequal access
• Ownership intellectual property
• Privacy cybersecurity

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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 FDAs
• 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
12
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

13
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

14
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

15
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

16
Privacy and Cybersecurity
National security secrecy and corporate IP
inhibit open source innovation, translation to
application

• 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

See 2005 EU Report Ethical Aspects of ICT
Implants in the Human Body
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Newer Problems

• Timing of implants and upgradeability
• Brain-machine interfaces
• Structural unemployment
• Remote behavior control
• Mood control
• Blurred culpability

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Timing of Implants

• Accelerating pace of innovation
• Especially rapid advances in biocompatible
  materials
• Cochlear implants
• Critical language window
• Destruction of cochlear tissue

19
Artificial Pancreas

• Diabetes growing rapidly
• Realtime blood sugar monitoring
• Automated release of insulin
• Implanted

20
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

21
Nathan Kline and Manfred Clynes

• 1960. Cyborgs and Space, Astronautics, Sept.
• Monitoring and controlling the body/brain of the
  astronaut from ground control

22
Implants for Depression OCD

• Depression
• Obsessive-compulsive disorder

23
Brain-Computer Interfaces
24
NanoNeural Network

• Self-replicating
• Two-way communication with trillions of
  neurons
• Networked inside and out
• Perfect virtual reality, mind back-up, upload

25
Structural Unemployment

• Prior cases
• literate/numerate workers
• smartphones
• Competing not only against automation and
  globalization, but also against brain-machine
  enhanced workers (vets?)
• AugCog

26
Autonomy Addiction

• Remote behavior control of criminals, soldiers,
  astronauts
• Wireheading mood control
• Blurred culpability developer, software, user

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For more information

• Institute for Ethics and Emerging
  Technologiesieet.org
• Me director_at_ieet.org
• These slides

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