The effects of closed-loop brain implants on autonomy and deliberation: what are the risks of being kept in the loop?
Gilbert, F and O'Brien, T and Cook, M, The effects of closed-loop brain implants on autonomy and deliberation: what are the risks of being kept in the loop?, Cambridge Quarterly of Healthcare Ethics, 27, (2) pp. 316-325. ISSN 0963-1801 (2018) [Refereed Article]
A new generation of implantable Brain Computer Interfaces (BCI) devices have been tested
for the first time in a human clinical trial with significant success. These intelligent implants
detect specific neuronal activity patterns, like an epileptic seizure, then provide information
to help patients to respond to the upcoming neuronal events. By forecasting a seizure, the
technology keeps patients in the decisional loop; the device gives control to patients on how
to respond and decide on a therapeutic course ahead time. Being kept in the decisional loop
can positively increase patients quality of life; however, doing so does not come free of
ethical concerns. There is currently a lack of evidence concerning the various impacts of
closed‐loop system BCIs on patients' decision‐making processes, especially how being in the
decisional loop impacts patients' sense of autonomy. This article addresses these gaps by
providing data we obtained from a first‐in‐human clinical trial involving patients implanted
with advisory brain devices. This manuscript explores ethical issues related to the risks
involved with being kept in the decisional loop.