Putting a computer into someone’s brain used to sound like the stuff of science fiction. Today this is a reality. Academic and commercial groups are testing “brain-computer interface” devices to enable people with disabilities to work more independently. But Elon Musk’s company Neuralink has put this technology front and center in discussions of security, ethics and neuroscience.
In January 2024, Musk announced that Neuralink placed his first chip in the brain of a human subject. The Conversation reached out to two academics at the University of Washington School of Medicine — bioethicist Nancy Jecker and neurosurgeon Andrew Ko, who implants brain chip devices — for their thoughts on the ethics of this new frontier in neuroscience.
How does a brain chip work?
Neuralink’s coin-sized device, called N1, is designed to allow patients to perform actions by simply focusing, without moving their bodies.
Subjects in the company’s PRIME study (short for Precision Robotic Implanted Brain-Computer Interface) undergo surgery to have the device implanted in a part of the brain that controls movement. The chip records and processes the brain’s electrical activity, then transfers this data to an external device such as a phone or computer.
The external device “decodes” the patient’s brain activity and learns to associate certain patterns with the patient’s goal: moving a computer cursor up the screen, for example. Over time, the software can recognize a pattern of neural firing that occurs repeatedly while the participant imagines that task, and then execute the task for the person.
Neuralink’s current trial focuses on helping people with paralyzed limbs control computers or smartphones. Brain-computer interfaces, commonly called BCIs, can also be used to control devices such as wheelchairs.
Several companies are testing BCIs. What is Neuralink different?
Noninvasive devices implanted outside a person’s head have long been used in clinical trials but have failed to gain approval from the Food and Drug Administration for commercial development.
There are other brain-computer devices, like Neuralink’s, that are completely implanted and wireless. But the N1 implant combines more technologies into a single device: It can target individual neurons, record from thousands of sites in the brain, and charge its tiny battery wirelessly. These are important advances that can produce better results.
Why does Neuralink receive criticism?
nerve connection Received FDA approval For human trials in May 2023. Musk announces the company’s first human trial on social media platform X – formerly Twitter – in January 2024.
However, apart from a brochure asking for voluntary participation in the trial, there is little information about the implant. Neuralink has not registered with ClinicalTrials.gov as is customary and required by some academic journals.
Some scientists are disturbed by this lack of transparency. Sharing information about clinical trials is important because it helps other researchers learn about areas related to their research and can improve patient care. Academic journals may also be biased toward positive results, preventing researchers from learning from failed experiments.
Members at the Hastings Center, a bioethics think tank, warned that while Musk’s brand of “science by press release” is increasingly commonplace, it is not science. They advise against relying on someone who has a large financial interest in the outcome of an investigation as the sole source of information.
When scientific research is funded by government agencies or philanthropic groups, its purpose is to promote the public good. Neuralink, on the other hand, embodies a private capital model that is becoming increasingly common in science. Firms that raise funds from private investors to support scientific breakthroughs may strive to do good, but they also seek to maximize profits, which may conflict with the interests of patients.
In 2022, the U.S. Department of Agriculture investigated animal cruelty at Neuralink after employees accused the company of rushing testing and botched procedures on test animals in the race for results, according to a Reuters report. The agency’s review found no violations, according to a letter from the USDA secretary to lawmakers reviewed by Reuters. However, the secretary noted an “adverse surgical event” in 2019 that Neuralink self-reported.
In a separate incident also reported by Reuters, the Ministry of Transport fined Neuralink for violating rules on transporting hazardous materials, including flammable liquids.
What other ethical issues does Neuralink’s case raise?
When brain-computer interfaces are used to help patients suffering from disabling conditions work more independently, for example by helping them communicate or move, this can profoundly improve their quality of life. In particular, it helps people regain their sense of authority or autonomy, which is one of the fundamental principles of medical ethics.
Medical interventions, no matter how well-intentioned, can have undesirable consequences. When it comes to BCIs, scientists and ethicists are particularly concerned about the potential for identity theft, password hacking, and blackmail. Considering how devices access users’ thoughts, there is also the possibility that their autonomy could be manipulated by third parties.
Medical ethics requires physicians to help patients by minimizing potential harm. In addition to errors and privacy risks, scientists are also concerned about the possible negative effects of a fully implanted device like Neuralink; because device components cannot be easily replaced after implantation.
When evaluating any invasive medical intervention, patients, providers, and developers seek a balance between risk and benefit. At current levels of safety and reliability, the benefit of a permanent implant must be great enough to justify the uncertain risks.
What’s next?
For now, Neuralink’s trials are focusing on paralyzed patients. Musk said his ultimate goal for BCIs is to help humanity, including healthy humans, “keep pace” with artificial intelligence.
This raises questions about justice, another fundamental principle of medical ethics. Some types of supercharged brain-computer synthesis could worsen social inequalities if only wealthy citizens had access to such hardware.
But what is more pressing is the possibility that the device may be shown to be increasingly useful for people with disabilities, but cannot be used due to loss of research funding. For patients whose access to a device depends on a research study, the prospect of losing access after the study ends can be devastating. This raises thorny questions about whether it is ethical to provide early access to breakthrough medical interventions before they receive full FDA approval.
Clear ethical and legal rules are needed to ensure that the benefits resulting from scientific innovations such as Neuralink’s brain chip are balanced with patient safety and societal benefit.
This article is republished from The Conversation, an independent, nonprofit news organization providing facts and analysis to help you understand our complex world.
Written by: Nancy S. Jecker, University of Washington and Andrew Ko, University of Washington.
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The authors do not work for, consult, own shares in, or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic duties.