Ethical implications of visual neuroprostheses—a systematic review

Abstract

Objective. The aim of this review was to systematically identify the ethical implications of visual neuroprostheses. Approach. A systematic search was performed in both PubMed and Embase using a search string that combined synonyms for visual neuroprostheses, brain–computer interfaces (BCIs), cochlear implants (CIs), and ethics. We chose to include literature on BCIs and CIs, because of their ethically relavant similarities and functional parallels with visual neuroprostheses. Main results. We included 84 articles in total. Six focused specifically on visual prostheses. The other articles focused more broadly on neurotechnologies, on BCIs or CIs. We identified 169 ethical implications that have been categorized under seven main themes: (a) benefits for health and well-being; (b) harm and risk; (c) autonomy; (d) societal effects; (e) clinical research; (f) regulation and governance; and (g) involvement of experts, patients and the public. Significance. The development and clinical use of visual neuroprostheses is accompanied by ethical issues that should be considered early in the technological development process. Though there is ample literature on the ethical implications of other types of neuroprostheses, such as motor neuroprostheses and CIs, there is a significant gap in the literature regarding the ethical implications of visual neuroprostheses. Our findings can serve as a starting point for further research and normative analysis.

Understanding the Ethical Issues of Brain-Computer Interfaces (BCIs): A Blessing or the Beginning of a Dystopian Future?

“…The conspicuous use of these devices could make the user's medical problem more apparent or even the user can be treated by society as a 'cyborg' [ 27 ]. Additionally, the use of BCIs for medical purposes and, even more so, the use of BCIs for commercial purposes can influence social norms [ 28 ] of what is considered normal.…”

The Metaverse as a Virtual Model of Platform Urbanism: Its Converging AIoT, XReality, Neurotech, and Nanobiotech and Their Applications, Challenges, and Risks

“…Kenji et al [206] present the potential risks of AI and neurotechnology, including intentional misuse, unintended side effects, and loss of control, as well as how these technologies can be managed to minimize undesirable outcomes. van Velthoven et al [33] identify 169 ethical implications, which should be considered in the early process of technological development, and categorize them into several themes, including benefits for health and well-being, harm and risk, societal effects, and regulation and governance. A major conundrum posed in this regard is to assess whether new rights must be established specifically, as well as the adequacy of the existing laws on the protection of human rights [26,32,35].…”

“…This scholarship describes them as being largely not for the collective advantage of humans apart from their sounding noble goals, focusing on the serious concerns and controversies related to their commercial and governance uses beyond the medical and health application domains. While this argument continues to be counterclaimed by the advocates of hybrid intelligence and other controversial intellectual movements, numerous studies have recently revealed a plethora of risks and negative implications of neurotechnology and nanobiotechnology in various domains, including smart cities, XR, computational intelligence, algorithmic governance, security, surveillance, biometrics, medicine, and public healthcare (e.g., [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]). Most of these application domains are associated with the Metaverse.…”

“…The former stimulates nervous system structures using neural interfaces to influence or improve neural activity, e.g., deep brain stimulation for medical treatment [131]. The latter replaces or restores sensory or cognitive functions using electrodes to interface with the nervous system [33]. Neuromodulation is defined as "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body" [29].…”

Developer perspectives on the ethics of AI-driven neural implants: a qualitative study

“…These technological advancements are paired with ethical questions. In the ethical literature, concerns about autonomy, informed consent, participant selection in clinical research, responsibility for actions, privacy and data-security, potential surgical risks and questions regarding costs and accessibility of neurotechnologies have often been described 7 , 8 . The convergence of AI with neurotechnologies expands existing and introduces new ethics concerns, including concerns regarding agency and identity, mental privacy, augmentation, accuracy, transparency and biases 3 , 9 .…”