Brain-computer interfaces (BCIs) are no longer a thing of science fiction. The technology is already available to some patients to treat conditions like epilepsy and blindness. Soon, projects like Elon Musk’s Neuralink could make BCIs available to a broad consumer audience.
However, with the technology’s widespread adoption has come serious concerns about the safety and ethics of brain-computer interfaces.
The potential for brain injury, technological dependence and social stigma have experts of all kinds discussing the harm that BCI technology may cause.
Brain-computer interfaces – also called brain-machine interfaces – include any technology that creates a real-time and direct connection between a user’s brain and a computer. BCIs can be invasive or non-invasive.
An invasive BCI will likely require surgery to implant electrodes under the scalp, allowing the computer to communicate with the brain. Some BCIs may directly embed electrodes into the brain.
Real-world examples of BCI include certain types of bionic eyes or devices that use BCI technology to provide rudimentary vision to people with acquired blindness.
By stimulating areas of the brain responsible for vision processing, it’s possible to stream video information captured by a pair of glasses to the patient’s brain, allowing them to see patches of light and dark. These bionic eyes can’t fully restore a person’s vision, but the visibility they provide is often enough to give some additional autonomy to people with non-congenital blindness.
Other examples of BCI include implants that can predict seizures and stimulate the brain to prevent them, as well as implants that enable limited restoration of motion in people with paralysis.
Soon, BCIs that enable individuals to perform tasks with thought alone could become available to consumers. The best-known BCI project currently in the works is likely Elon Musk’s Neuralink, an implant that aims to enable users to type, use devices and control computers by thinking.
Scientists at Facebook are reportedly working on a similar project – a headset that can convert a user’s brain activity into text, allowing for hands-free typing.
The rapid adoption of data-processing technologies like artificial intelligence (AI) – already in use at 70% of companies worldwide – is helping to accelerate BCI development. By using AI to track patterns in a user’s brain signals, researchers and developers can develop more effective BCIs and expand applications of the technology.
With invasive surgery and implants always comes the risk of injury or complications like infection or glial scarring, which can inhibit the regeneration of neurons.
Animal welfare activists recently condemned Neuralink after data received by the Physicians Committee for Responsible Medicine from UC Davis suggested that several monkeys had died during Neuralink’s animal trials. Human trials are on track to begin by the end of 2022, but experts are concerned that injuries and death during animal trials could suggest the technology isn’t ready for human experimentation.
The more advanced the BCI implant, the more electrode connections to the brain it will likely have. As a result, better implants may be more complicated to install and remove surgically.
There are also concerns about the psychological impact that BCI implants may have. One recent study evaluated the use of invasive implants that provided advanced warning of seizures in six patients with epilepsy.
According to the study’s authors, some patients adapted well to the BCI, while others didn’t –with one patient experiencing “feelings of postoperative self-estrangement.” They suggest that better-preparedness protocols specific to BCI implants could prevent similar harm in the future.
The dangers of obsolete BCI implants
Users of BCIs will likely need continuous and long-term support – including repairs and upgrades – from the company that manufactured their BCI. But what happens to a BCI user if a manufacturer goes out of business?
In 2019, Second Sight began phasing out the Argus II, a retinal prosthesis providing users limited sight restoration. Within months, users learned that the company would no longer offer upgrades and repairs – if their prosthesis failed, it would fail for good.
Left in place, a non-functional prosthesis has the potential to cause severe injury and complications to its user. It may also prevent or interfere with MRIs. However, the surgery necessary to remove the device is costly and invasive, putting it out of reach of many users with the Argus II.
As BCIs become more common, adopters of the technology may have to weigh the risk that their implant will eventually become obsolete or its manufacturer will go out of business, leaving them in the lurch.
Legal frameworks and programs supporting owners of obsolete BCIs could help minimize this risk, but currently, the potential harms of obsolescence will fall almost entirely on users.
Experts are concerned the new BCI market could create the potential for surgical injuries, long-term complications and other health impacts. Obsolete BCIs could also create serious challenges for adopters without the proper support.
Brain-computer interfaces remain experimental for now, but high-profile projects from companies like Facebook and Neuralink could soon bring BCI technology to a much broader commercial audience.