Extending Our View on Using BCIs for Locked-in Syndrome

Abstract

Locked-in syndrome (LIS) is a severe neurological condition that typically leaves a patient unable to move, talk and, in many cases, initiate communication. Brain Computer Interfaces (or BCIs) promise to enable individuals with conditions like LIS to re-engage with their physical and social worlds. In this paper we will use extended mind theory to offer a way of seeing the potential of BCIs when attached to, or implanted in, individuals with LIS. In particular, we will contend that functionally integrated BCIs extend the minds of individuals with LIS beyond their bodies, allowing them greater autonomy than they can typically hope for in living with their condition. This raises important philosophical questions about the implications of BCI technology, particularly the potential to change selves, and ethical questions about whether society has a responsibility to aid these individuals in re-engaging with their physical and social worlds. It also raises some important questions about when these interventions should be offered to individuals with LIS and respecting the rights of these individuals to refuse intervention. By aiding willing individuals in re-engaging with their physical and social worlds, BCIs open up avenues of opportunity taken for granted by able individuals and introduce new ways in which these individuals can be harmed. These latter considerations serve to highlight our emergent social responsibilities to those individuals who will be suitable for, and receive, BCIs.

Brain to Computer Communication: Ethical Perspectives on Interaction Models

“…Ethical issues concerning these systems prominently include personal autonomy, responsibility, and liability issues-such as those exemplified by questions a-b above. The promotion of personal autonomy afforded by BCI systems is discussed in [11]. The focus is shifted here from the promotion to the protection of human autonomy, in the light of distinctive shared control issues arising in BCI interaction contexts.…”

“…9 For an introduction to individualistic and relational conceptions of autonomy, see [37]. The promotion of autonomy of locked-in patients afforded by BCI systems is appropriately emphasized in [11], pp. 127-129.…”

“…Finally, let us note that producers of goods can be held liable for damaging events that are difficult to predict and control, on the basis of economic considerations aptly summarized in the Latin formula ubi commoda ibi incommoda: expected producer profit provides there a basis for ascribing liability and determining compensations to consumers and society at large. 11 On the whole, these broad analogies suggest that relatively small adjustments, if any, of extant ethical and legal frameworks may be needed to cope with liability issues arising in connection with brain-actuated robots.…”

“…This issue is examined in the light of the distinction between negative and positive rights in[11]. Moreover, Fenton and Alpert discuss possible enhancement effects in LIS subjects deriving from the use of BCI systems in the light of extended mind theories in the philosophy of mind, according to which BCI-controlled peripheral devices may enable one to augment neural structures for cognitive processing[11, p. 127].…”

Locked-in Syndrome, BCI, and a Confusion about Embodied, Embedded, Extended, and Enacted Cognition

“…In a recent contribution to this journal [1] Andrew Fenton and Sheri Alpert (F&A) have argued that the so-called "extended mind hypothesis" 1 allows us to understand why Brain Computer Interfaces (BCIs) have the potential to change the self of patients suffering from Locked-in Syndrome (LIS) by extending their minds beyond their bodies. I do not quarrel with the claim "that BCI technology has the potential to change the lives of … individuals with LIS in some fundamental ways" by "aiding willing individuals in reengaging with their physical and social worlds" (p. 120) [1].…”