In recent years, significant advancements in neurotechnology promise to profoundly impact healthcare and human capabilities. As technologies such as Brain-Computer Interfaces (BCIs), Transcranial Direct-Current Stimulation (tDCS), and Deep Brain Stimulation (DBS) evolve, they can potentially blur the boundary between a person’s consciousness and external technological influences.
Examples of Neurotechnologies
Conditions such as Parkinson’s, Alzheimer’s, and epilepsy are caused by disruptions in brain function due to inactive neurons. Neurotechnology offers a potential solution by monitoring brain activity and selectively stimulating these faulty brain regions. This technology can help restore lost functions by activating the disrupted neurons, improving the quality of life for patients. Non-invasive methods use external devices for stimulation, whereas invasive methods involve surgically implanted electrodes.
BCIs are devices that enable control of computers through thought. In January 2024, Neuralink, founded by Elon Musk, implanted an invasive BCI into Noland Arbaugh, a quadriplegic participant in the PRIME study. The procedure aimed to restore his autonomy after a spinal cord injury. After surgery, he was able to control his laptop cursor for the first time since his injury, allowing him to reconnect with friends and family and regain independence. Neuralink aims to implant chips in 10 individuals by the end of 2024, pending FDA approval.
DBS involves implanting a small device under the skin near the collarbone, with wires reaching the brain to deliver mild electrical currents. This technology treats medical conditions like Parkinson’s disease and epilepsy. According to the Cleveland Clinic, as of 2019, experts estimated that about 160,000 people have had a DBS procedure since the 1980s and that 12,000 procedures happen each year.
tDCS, a non-invasive technique, applies low electric currents to the scalp. tDCS devices are being explored to treat depression, schizophrenia, aphasia, chronic pain, and other medical conditions. tDCS is used for non-medical applications as well including accelerated learning, focus, relaxation, and meditation. tDCS devices are currently available online ranging in cost from about $40-$500.
It is difficult to find a number that encompasses how many people use neuromodulation devices, however, the potential treatment population is vast including the millions affected by epilepsy, migraine, Parkinson’s disease, urinary incontinence, and other medical conditions. The global neurotech market grows at a compound annual rate of 12% and is expected to reach $21 billion by 2026.
Neurotechnology Regulation
The FDA regulates the implementation of neurological devices, classifying them by their degree of risk and forming the pathways necessary to bring the device to the market. In general, for high-risk devices, companies will get an Investigational Device Exemption to clinically test their devices by proving that the benefits justify the risks. The gathering of clinical data is a key step in supporting pre-market approval. BCIs are still in the clinical trial period of gaining FDA approval. DBS technologies have been gaining FDA approval to treat different medical conditions since 1997. tDCS is FDA-cleared, which is a lower standard to be met than FDA approval due to lower risk compared to other neurostimulation methods.
Neuroright to Personal Identity
Neurotechnologies have the potential to alter perception, behavior, emotion, cognition, and memory, reshaping identity and notions of “humanness”. Technologies like BCIs, tDCS, and DBS use electrical impulses to influence brain activity. This can lead to changes in emotional and behavioral responses. For instance, a study on DBS found that stimulating the subthalamic nucleus, a brain area involved in cognitive and motivational functions, led to increased positive mood and reduced anxiety in participants. Depending on how invasive the devices are and the part of the brain they target, effects on mental processes vary. While neurotechnology holds the potential for positive therapeutic benefits, the possibility of changes to human behavior has raised concerns.
At Columbia University, academic leaders united to discuss the ethical concerns of neurotechnology. This discussion led to a new human rights framework called “Neurorights”, reflecting the consensus that advances in neurotechnology outpace global, national, and corporate governance. The 5 Neurorights proposed by the Neurorights Foundation include the right to Personal Identity. The foundation writes, “Boundaries must be developed to prohibit technology from disrupting the sense of self. When neurotechnology connects individuals with digital networks, it could blur the line between a person’s consciousness and external technological inputs.”
The Neurorights Foundation, founded by Dr. Rafael Yuste, worked with the Senate of the Republic of Chile in 2021 to pass a Neurorights law and plans for a constitutional amendment. This development made Chile the world’s first country to have legislation protecting personal identity, free will, and mental privacy in reference to emergent neurotechnology.
The Main Debates
Proponents of Neurorights argue that Neurotechnology infringes on personal identity by causing unexpected changes to personality, identity, and decision-making, with evidence shown in research. In a 2016 study, a man using a brain stimulator to treat his depression for 7 years began to wonder whether the way he interacted with others was due to the device, stating “It blurs to the point where I’m not sure… frankly, who I am.” In another study, Dr. Yuste realized that by controlling specific brain circuits scientists could manipulate a mouse’s experience including its behaviors, emotions, awareness, perception, and memories. Yuste stated, “The brain works the same in the mouse and the human, and whatever we can do to the mouse today, we can do to the human tomorrow.”
Opponents of Neurorights question the sophistication of neurotechnology and its ability to cause widespread human rights concerns, seeing altering personal identity as something far in the future. Additionally, opponents draw attention to the concern that depending on the definition of identity, the Neuroright to Personal Identity may imply prohibiting neurotechnologies in general. This would significantly slow down important scientific progress in the field of neurotechnology.
Opponents of Neurorights also argue that considering existing legislation, Neurorights are unnecessary, and that passing additional human rights could be harmful. Human rights are powerful tools transforming the lives of billions of people. One central worry in the debate is that the inflation of rights may result in their devaluation. Human rights could lose their distinction, significance, and effectiveness if the passing of legislation is not considered cautiously. Proponents of Neurorights take a reformist position arguing that Neurorights must go beyond current fundamental human rights to effectively protect the right to personal identity, seeing this as a new and unique issue requiring additional legislation.
Conflicting ideas of “personal identity” add more complexity to the argument. Some view the right to use neurotechnology as an expression of personal identity, while others see preventing brain manipulation as a way to preserve and promote the freedom of the human mind.
Conclusion
In summary, the rapid advancement of neurotechnology, including BCIs, tDCS, and DBS, presents ethical dilemmas regarding personal identity. As research progresses and investments increase, these technologies could impact various aspects of human life from medical treatments to personal enhancement. The Neurorights Foundation actively works to incorporate Neurorights into international human rights law, national legal and regulatory frameworks, and ethical guidelines. The foundation has made developments in Chile, Brazil, Mexico, the United Nations, and Spain, and strives to incorporate Neurorights in the United States. As of now, at least two US states are considering legislation to protect private thoughts, reflecting a growing awareness of this issue.
