In this paper, I examine the ethics of e - trust and e - trustworthiness in the context of health care, looking at direct computer-patient interfaces (DCPIs), information systems that provide medical information, diagnosis, advice, consenting and/or treatment directly to patients without clinicians as intermediaries. Designers, manufacturers and deployers of such systems have an ethical obligation to provide evidence of their trustworthiness to users. My argument for this claim is based on evidentialism about trust and trustworthiness: (...) the idea that trust should be based on sound evidence of trustworthiness. Evidence of trustworthiness is a broader notion than one might suppose, including not just information about the risks and performance of the system, but also interactional and context-based information. I suggest some sources of evidence in this broader sense that make it plausible that designers, manufacturers and deployers of DCPIs can provide evidence to users that is cognitively simple, easy to communicate, yet rationally connected with actual trustworthiness. (shrink)

Neural engineers and clinicians are starting to translate advances in electrodes, neural computation, and signal processing into clinically useful devices to allow control of wheelchairs, spellers, prostheses, and other devices. In the process, large amounts of brain data are being generated from participants, including intracortical, subdural and extracranial sources. Brain data is a vital resource for BCI research but there are concerns about whether the collection and use of this data generates risk to privacy. Further, the nature of BCI research (...) involves understanding and making inferences about device users’ mental states, thoughts, and intentions. This, too, raises privacy concerns by providing otherwise unavailable direct or privileged access to individuals mental lives. And BCI-controlled prostheses may change the way clinical care is provided and the type of physical access caregivers have to patients. This, too, has important privacy implications. I In this chapter we examine several of these privacy concerns in light of prominent views of the nature and value of privacy. We argue that increased scrutiny needs to be paid to privacy concerns arising from Big Data and decoding of mental states, but that BCI research may also provide opportunity for individuals to enhance their privacy. (shrink)

__Neurotechnology and Direct Brain Communication__ focuses on recent neuroscientific investigations of infant brains and of patients with disorders of consciousness, both of which are at the forefront of contemporary neuroscience. The prospective use of neurotechnology to access mental states in these subjects, including neuroimaging, brain simulation and brain computer interfaces, offers new opportunities for clinicians and researchers, but has also received specific attention from philosophical, scientific, ethical and legal points of view. This book offers the first systematic (...) assessment of these issues, investigating the tools neurotechnology offers to care for verbally non-communicative subjects and suggesting a multidisciplinary approach to the ethical and legal implications of ordinary and experimental practices. The book is divided into three parts: the first and second focus on the scientific and clinical implications of neurological tools for DOC patient and infant care. With reference to these developments, the third and final part presents the case for re-evaluating classical ethical and legal concepts, such as authority, informed consent and privacy. Neurotechnology and Direct Brain Communication will appeal to researchers and postgraduate students in the fields of cognitive science, medical ethics, medical technology, and the philosophy of the mind. With implications for patient care, it will also be a useful resource for clinicians, medical centres and health practitioners. (shrink)

This paper argues that one problem that besets black-box AI is that it lacks algorithmic justifiability. We argue that the norm of shared decision making in medical care presupposes that treatment decisions ought to be justifiable to the patient. Medical decisions are justifiable to the patient only if they are compatible with the patient’s values and preferences and the patient is able to see that this is so. Patient-directed justifiability is threatened by black-box AIs because (...) the lack of rationale provided for the decision makes it difficult for patients to ascertain whether there is adequate fit between the decision and the patient’s values. This paper argues that achieving algorithmic transparency does not help patients bridge the gap between their medical decisions and values. We introduce a hypothetical model we call Justifiable AI to illustrate this argument. Justifiable AI aims at modelling normative and evaluative considerations in an explicit way so as to provide a stepping stone for patient and physician to jointly decide on a course of treatment. If our argument succeeds, we should prefer these justifiable models over alternatives if the former are available and aim to develop said models if not. (shrink)

Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain–computer interface combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI–FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation rehabilitation training (...) and the other group received BCI combined with FES training. We constructed functional networks in both groups of patients based on direct directed transfer function and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: after rehabilitation training, the Fugl–Meyer assessment scale score was significantly improved in the BCI–FES group, and there was no significant difference in the FES group. Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI–FES group were improved after rehabilitation training. The node strength in the contralesional hemisphere and central region of patients in the BCI–FES group was significantly higher than that in the FES group after the intervention, and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI–FES group. These results suggest that BCI–FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI–FES rehabilitation training. (shrink)

This volume summarizes the ethical, social and cultural contexts of interfacing brains and computers. It is intended for the interdisciplinary community of BCI stakeholders. Insofar, engineers, neuroscientists, psychologists, physicians, care-givers and also users and their relatives are concerned. For about the last twenty years brain-computer-interfaces (BCIs) have been investigated with increasing intensity and have in principle shown their potential to be useful tools in diagnostics, rehabilitation and assistive technology. The central promise of BCI technology is enabling severely impaired (...) people in mobility, grasping, communication, and entertainment. Successful applications are for instance communication devices enabling locked-in patients in staying in contact with their environment, or prostheses enabling paralysed people in reaching and grasping. In addition to this, it serves as an introduction to the whole field of BCI for any interested reader. (shrink)

This article describes research to build an embodied conversational agent as an interface to a question-and-answer system about a National Science Foundation program. We call this ECA the LifeLike Avatar, and it can interact with its users in spoken natural language to answer general as well as specific questions about specific topics. In an idealized case, the LifeLike Avatar could conceivably provide a user with a level of interaction such that he or she would not be certain as to whether (...) he or she is talking to the actual person via video teleconference. This could be considered a extended version of the seminal Turing test. Although passing such a test is still far off, our work moves the science in that direction. The Uncanny Valley notwithstanding, applications of such lifelike interfaces could include those where specific instructors/caregivers could be represented as stand-ins for the actual person in situations where personal representation is important. Possible areas that come to mind that might benefit from these lifelike ECAs include health-care support for elderly/disabled patients in extended home care, education/training, and knowledge preservation. Another more personal application would be to posthumously preserve elements of the persona of a loved one by family members. We apply this approach to a Q/a system for knowledge preservation and dissemination, where the specific individual who had this knowledge was to retire from the US National Science Foundation. The system is described in detail, and evaluations were performed to determine how well the system was perceived by users. (shrink)

New brain-computer interface and neuroimaging techniques are making differentiation less ambiguous and more accurate between unresponsive wakefulness syndrome patients and patients with higher cognitive function and awareness. As research into these areas continues to progress, new ethical issues will face physicians of patients suffering from total locked-in syndrome, characterized by complete loss of voluntary muscle control, with retention of cognitive function and awareness detectable only with neuroimaging and brain-computer interfaces. Physicians, researchers, ethicists and hospital ethics committees should (...) be aware of and prepared to handle ethical issues unique to these totally locked-in patients. Several thought experiments are discussed, to highlight potential ethical dilemmas surrounding surrogate decision-making, autonomy, end-of-life care, and pediatric care, which will be unique to total LIS patients. These, along with other ethical problems especially relevant to total LIS patients, merit further discussion among physicians, researchers, ethicists and hospital ethics committees, to facilitate consensus regarding these issues, and improve patient care. (shrink)

Brain–computer interfacing technologies are used as assistive technologies for patients as well as healthy subjects to control devices solely by brain activity. Yet the risks associated with the misuse of these technologies remain largely unexplored. Recent findings have shown that BCIs are potentially vulnerable to cybercriminality. This opens the prospect of “neurocrime”: extending the range of computer-crime to neural devices. This paper explores a type of neurocrime that we call brain-hacking as it aims at the illicit access to (...) and manipulation of neural information and computation. As neural computation underlies cognition, behavior and our self-determination as persons, a careful analysis of the emerging risks of malicious brain-hacking is paramount, and ethical safeguards against these risks should be considered early in design and regulation. This contribution is aimed at raising awareness of the emerging risk of malicious brain-hacking and takes a first step in developing an ethical and legal reflection on those risks. (shrink)

Multi-modal integration, which combines multiple neurophysiological signals, is gaining more attention for its potential to supplement single modality’s drawbacks and yield reliable results by extracting complementary features. In particular, integration of electroencephalography and functional near-infrared spectroscopy is cost-effective and portable, and therefore is a fascinating approach to brain-computer interface. However, outcomes from the integration of these two modalities have yielded only modest improvement in BCI performance because of the lack of approaches to integrate the two different features. In addition, (...) mismatch of recording locations may hinder further improvement. In this literature review, we surveyed studies of the integration of EEG/fNIRS in BCI thoroughly and discussed its current limitations. We also suggested future directions for efficient and successful multi-modal integration of EEG/fNIRS in BCI systems. (shrink)

In the future, policies surrounding end-of-life decisions will be faced with the question of whether competent people in a completely locked-in state should be enabled to make end-of-life decisions via brain-computer interfaces (BCI). This article raises ethical issues with acting through BCIs in the context of these decisions, specifically self-administration requirements within assisted suicide policies. We argue that enabling patients to end their life even once they have entered completely locked-in state might, paradoxically, prolong and uphold their quality (...) of life. (shrink)

Brain-Computer Interface is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes as well as health-related purposes. The unprecedented direct connection created by BCI between human brains and computer (...) hardware raises various ethical, social, and legal challenges that merit further examination and discussion. To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers. (shrink)

Entropy-based algorithms have been suggested as robust estimators of electroencephalography (EEG) predictability or regularity. This study aimed to examine possible disturbances in EEG complexity as a means to elucidate the pathophysiological mechanisms in chronic stroke, before and after a brain computer interface (BCI)-motor observation intervention. Eleven chronic stroke subjects and nine unimpaired subjects were recruited to examine the differences in their EEG complexity. The BCI-motor observation intervention was designed to promote functional recovery of the hand in stroke subjects. Fuzzy (...) approximate entropy (fApEn), a novel entropy-based algorithm designed to evaluate complexity in physiological systems, was applied to assess the EEG signals acquired from unimpaired subjects and stroke subjects, both before and after training. The results showed that stroke subjects had significantly lower EEG fApEn than unimpaired subjects (p < 0.05) in the motor cortex area of the brain (C3, C4, FC3, FC4, CP3, CP4) in both hemispheres before training. After training, motor function of the paretic upper limb, assessed by the Fugl-Meyer Assessment-Upper Limb (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) improved significantly (p < 0.05). Furthermore, the EEG fApEn in stroke subjects increased considerably in the central area of the contralesional hemisphere after training (p < 0.05). A significant correlation was noted between clinical scales (FMA-UL, ARAT, and WMFT) and EEG fApEn in C3/C4 in the contralesional hemisphere (p < 0.05). This finding suggests that the increase in EEG fApEn could be an estimator of the variance in upper limb motor function improvement. In summary, fApEn can be used to identify abnormal EEG complexity in chronic stroke, when used with BCI-motor observation training. Moreover, these findings based on the fApEn of EEG signals also expand the existing interpretation of training-induced functional improvement in stroke subjects. Entropy-based analysis might serve as a novel approach to understanding the abnormal cortical dynamics of stroke and the neurological changes induced by rehabilitation training. (shrink)

Brain–computer interfacing (BCI) aims at directly capturing brain activity in order to enable a user to drive an application such as a wheelchair without using peripheral neural or motor systems. Low signal to noise ratio’s, low processing speed, and huge intra- and inter-subject variability currently call for the addition of intelligence to the applications, in order to compensate for errors in the production and/or the decoding of brain signals. However, the combination of minds and machines through BCI’s and intelligent (...) devices (IDs) can affect a user’s sense of agency. Particularly confusing cases can arise when the behavioral control switches implicitly from user to ID. I will suggest that in such situations users may be insecure about the extent to which the resulting behavior, whether successful or unsuccessful, is genuinely their own. Hence, while performing an action, a user of a BCI–ID may be uncertain about being the agent of the act. Several cases will be examined and some implications for (legal) responsibility (e.g. establishing the presence of a ‘guilty mind’) are discussed. (shrink)

The fundamental ideas concerning computation and recursion naturally find their place at the interface between logic and theoretical computer science. The contributions in this book, by leaders in the field, provide a picture of current ideas and methods in the ongoing investigations into the pure mathematical foundations of computability theory. The topics range over computable functions, enumerable sets, degree structures, complexity, subrecursiveness, domains and inductive inference. A number of the articles contain introductory and background material which it is hoped (...) will make this volume an invaluable resource for specialists and non-specialists alike. (shrink)

ObjectiveThis study aimed to examine the effectiveness and safety of the Brain-computer interface in treatment of upper limb dysfunction after stroke.MethodsEnglish and Chinese electronic databases were searched up to July 2021. Randomized controlled trials were eligible. The methodological quality was assessed using Cochrane’s risk-of-bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 488 patients from 16 RCTs were included. The results showed that the meta-analysis of BCI-combined treatment on the improvement of the upper limb function showed statistical significance (...) [standardized mean difference : 0.53, 95% CI: 0.26–0.80, P < 0.05]; BCI treatment can improve the abilities of daily living of patients after stroke, and the analysis results are statistically significant ; and the BCI-combined therapy was not statistically significant for the analysis of the Modified Ashworth Scale.ConclusionThe meta-analysis indicates that the BCI therapy or BCI combined with other therapies such as conventional rehabilitation training and motor imagery training can improve upper limb dysfunction after stroke and enhance the quality of daily life. (shrink)

The European Summer School in Logic, Language and Information is organized every year by the Association for Logic, Language and Information in different sites around Europe. The main focus of ESSLLI is on the interface between linguistics, logic and computation. ESSLLI offers foundational, introductory and advanced courses, as well as workshops, covering a wide variety of topics within the three areas of interest: Language and Computation, Language and Logic, and Logic and Computation. During two weeks, around 50 courses and 10 (...) workshops are offered to the attendants, each of 1.5 hours per day during a five days week, with up to seven parallel sessions. ESSLLI also includes a student session and four evening lectures by senior scientists in the covered areas. The 15 revised full papers presented were carefully reviewed and selected. The papers are organized in topical sections on The papers are organized in topical sections on language and computation; logic and computation; and logic and language. (shrink)

Thousands of youth suffering from acquired brain injury or other early-life neurological disease live, mature, and learn with only limited communication and interaction with their world. Such cognitively capable children are ideal candidates for brain-computer interfaces. While BCI systems are rapidly evolving, a fundamental gap exists between technological innovators and the patients and families who stand to benefit. Forays into translating BCI systems to children in recent years have revealed that kids can learn to operate simple BCI with (...) proficiency akin to adults. BCI could bring significant boons to the lives of many children with severe physical impairment, supporting their complex physical and social needs. However, children have been neglected in BCI research and a collaborative BCI research community is required to unite and push pediatric BCI development forward. To this end, the pediatric BCI Canada collaborative network was formed, under a unified goal to cooperatively drive forward pediatric BCI innovation and impact. This article reflects on the topics and discussions raised in the foundational BCI-CAN meeting held in Toronto, ON, Canada in November 2019 and suggests the next steps required to see BCI impact the lives of children with severe neurological disease and their families. (shrink)

Connecting human minds to various technological devices and applications through brain-computer interfaces (BCIs) affords intriguingly novel ways for humans to engage and interact with the world. Not only do BCIs play an important role in restorative medicine, they are also increasingly used outside of medical or therapeutic contexts (e.g., gaming or mental state monitoring). A striking peculiarity of BCI technology is that the kind of actions it enables seems to differ from paradigmatic human actions, because, effects in the (...) world are brought about by devices such as robotic arms, prosthesis, or other machines, and their execution runs through a computer directed by brain signals. In contrast to usual forms of action, the sequence does not need to involve bodily or muscle movements at all. A motionless body, the epitome of inaction, might be acting. How do theories of action relate to such BCI-mediated forms of changing the world? We wish to explore this question through the lenses of three perspectives on agency: subjective experience of agency, philosophical action theory, and legal concepts of action. Our analysis pursues three aims: First, we shall discuss whether and which BCI-mediated events qualify as actions, according to the main concepts of action in philosophy and law. Secondly, en passant, we wish to highlight the ten most interesting novelties or peculiarities of BCI-mediated movements. Thirdly, we seek to explore whether these novel forms of movement may have consequences for concepts of agency. More concretely, we think that convincing assessments of BCI-movements require more fine-grained accounts of agency and a distinction between various forms of control during movements. In addition, we show that the disembodied nature of BCI-mediated events causes troubles for the standard legal account of actions as bodily movements. In an exchange with views from philosophy, we wish to propose that the law ought to reform its concept of action to include some, but not all, BCI-mediated events and sketch some of the wider implications this may have, especially for the venerable legal idea of the right to freedom of thought. In this regard, BCIs are an example of the way in which technological access to yet largely sealed-off domains of the person may necessitate adjusting normative boundaries between the personal and the social sphere. (shrink)

Brain-Computer Interface (BCI) research and (future) applications raise important ethical issues that need to be addressed to promote societal acceptance and adequate policies. Here we report on a survey we conducted among 145 BCI researchers at the 4th International BCI conference, which took place in May–June 2010 in Asilomar, California. We assessed respondents’ opinions about a number of topics. First, we investigated preferences for terminology and definitions relating to BCIs. Second, we assessed respondents’ expectations on the marketability of different (...) BCI applications (BCIs for healthy people, BCIs for assistive technology, BCIs-controlled neuroprostheses and BCIs as therapy tools). Third, we investigated opinions about ethical issues related to BCI research for the development of assistive technology: informed consent process with locked-in patients, risk-benefit analyses, team responsibility, consequences of BCI on patients’ and families’ lives, liability and personal identity and interaction with the media. Finally, we asked respondents which issues are urgent in BCI research. (shrink)

Changes in information technologylead to new topics and new emphases in computerethics. The present article examines a varietyof such issues, and argues that computer ethicsmust become more rigorous and develop astronger theoretical base. The articleconcludes with a discussion of ways to makecomputer ethics more effective in bringinghelpful changes to the world.

This paper presents a gamified motor imagery brain-computer interface (MI-BCI) training in immersive virtual reality. Aim of the proposed training method is to increase engagement, attention, and motivation in co-adaptive event-driven MI-BCI training. This was achieved using gamification, progressive increase of the training pace, and virtual reality design reinforcing the body ownership transfer (embodiment) into the avatar. From the 20 healthy participants performing 6 runs of 2-class MI-BCI training (left/right hand), 19 were trained for a basic level of MI-BCI (...) operation, with average peak accuracy in the session equal to 75.84\%. This confirms the proposed training method succeeded in improvement of the MI-BCI skills; moreover, participants were leaving the session in high positive affect. Although the performance was not directly correlated to the degree of embodiment, subjective magnitude of the body ownership transfer illusion correlated with the abilities to modulate the sensorimotor rhythm. (shrink)

Brain–computer interfaces (BCIs) utilizing machine learning techniques are an emerging technology that enables a communication pathway between a user and an external system, such as a computer. Owing to its practicality, electroencephalography (EEG) is one of the most widely used measurements for BCI. However, EEG has complex patterns and EEG-based BCIs mostly involve a cost/time-consuming calibration phase; thus, acquiring sufficient EEG data is rarely possible. Recently, deep learning (DL) has had a theoretical/practical impact on BCI research because (...) of its use in learning representations of complex patterns inherent in EEG. Moreover, algorithmic advances in DL facilitate short/zero-calibration in BCI, thereby suppressing the data acquisition phase. Those advancements include data augmentation (DA), increasing the number of training samples without acquiring additional data, and transfer learning (TL), taking advantage of representative knowledge obtained from one dataset to address the so-called data insufficiency problem in other datasets. In this study, we review DL-based short/zero-calibration methods for BCI. Further, we elaborate methodological/algorithmic trends, highlight intriguing approaches in the literature, and discuss directions for further research. In particular, we search forgenerative model-based andgeometric manipulation-based DA methods. Additionally, we categorize TL techniques in DL-based BCIs intoexplicitandimplicitmethods. Our systematization reveals advances in the DA and TL methods. Among the studies reviewed herein, ~45% of DA studies used generative model-based techniques, whereas ~45% of TL studies used explicit knowledge transferring strategy. Moreover, based on our literature review, we recommend an appropriate DA strategy for DL-based BCIs and discuss trends of TLs used in DL-based BCIs. (shrink)

Intelligent neurotechnology is an emerging field that combines neurotechnologies like brain-computer interface (BCI) with artificial intelligence. This paper introduces a capability framework to assess the responsible use of intelligent BCI systems and provide practical ethical guidance. It proposes two tests, the threshold and flourishing tests, that BCI applications must meet, and illustrates them in a series of cases. After a brief introduction (Section 1), Section 2 sets forth the capability view and the two tests. It illustrates the threshold test (...) using examples from clinical medicine of BCI applications that enable patients with profound disabilities to function at a threshold level through computer mediation. Section 3 illustrates the flourishing test by exploring possible future applications of BCI involving neuroenhancements for healthy people, using examples adapted from research currently underway in the US military. Section 3 applies a capability lens to a complex case involving dual effects, both therapeutic and non-therapeutic, showing how the threshold and flourishing tests resolve the case. Section 4 replies to three objections: neurorights are the best tool for assessing BCI; the two tests are moving targets; and the analysis utilizes a capability view to do work it is not designed for. The paper concludes that a capability view offers unique advantages and gives practical guidance for evaluating the responsible use of present and future BCI applications. Extrapolating from our analysis may help guide other emerging technologies, such as germline gene editing, expected to impact central human capabilities. (shrink)

Electroencephalogram based Brain–Computer Interfaces enable stroke and motor neuron disease patients to communicate and control devices. Mindfulness meditation has been claimed to enhance metacognitive regulation. The current study explores whether mindfulness meditation training can thus improve the performance of BCI users. To eliminate the possibility of expectation of improvement influencing the results, we introduced a music training condition. A norming study found that both meditation and music interventions elicited clear expectations for improvement on the BCI task, with the (...) strength of expectation being closely matched. In the main 12 week intervention study, seventy-six healthy volunteers were randomly assigned to three groups: a meditation training group; a music training group; and a no treatment control group. The mindfulness meditation training group obtained a significantly higher BCI accuracy compared to both the music training and no-treatment control groups after the intervention, indicating effects of meditation above and beyond expectancy effects. (shrink)

LANGUAGE NOTE | Document text in English; abstract also in Chinese. 腦機介面 (BCIs) 是大腦和電腦無需人工交互即可直接交流的一系列技術。隨著人工智能 (AI) 時代的到來，我們需要更多地關注腦機介面和人工智能的融合所帶來的倫理問題。那麼，與機器一起思考會帶來什麼樣的倫理問題？在本文中，圍繞這一主題，我們將重點關注以下問題：自主性、完整性、身分認同、隱私，以及 作為一種增強的方式，該技術在兒科領域的應用會帶來怎樣的風險和潛在收益。我們的結論是，雖然該技術存在多種令人擔憂的問題，同時也有可能帶來好處，但仍存在很大的不確定性。如果生命倫理學家想在這一領域有所建樹 ，他們就應該做好準備來迎接我們對醫學和醫療保健領域中一些我們視為核心價值的理解的重大轉變。 Brain-Computer Interfaces – BCIs – are a set of technologies with which brains and computers can communicate directly, without the need for manual interaction. As we are witnessing the dawn of an era in which Artificial Intelligence (AI) quite possibly will come to dominate the technological innovation landscape, we are compelled to ask questions about the ethical issues which the convergence of BCIs (...) and AI is poised to bring about. What are the ethics of thinking with machines? In this paper, we explore this question, focusing on some of the main arenas of ethical debate and contention, ranging from autonomy and integrity to identity and privacy, and discuss the risks and potential benefits of the technology in the domains of paediatric populations, and as a means of human enhancement. We conclude that, while there are multiple concerns as well as possibilities for the technology to do good, there are great uncertainties at play. If bioethicists want to stay relevant in this field, they ought to prepare themselves for seismic shift in how we conceptualise much of what we take to be core values in medicine and healthcare. (shrink)

IntroductionChildren with severe physical disabilities are denied their fundamental right to move, restricting their development, independence, and participation in life. Brain-computer interfaces (BCIs) could enable children with complex physical needs to access power mobility (PM) devices, which could help them move safely and independently. BCIs have been studied for PM control for adults but remain unexamined in children. In this study, we explored the feasibility of BCI-enabled PM control for children with severe physical disabilities, assessing BCI performance, standard (...) PM skills and tolerability of BCI.Materials and methodsPatient-oriented pilot trial. Eight children with quadriplegic cerebral palsy attended two sessions where they used a simple, commercial-grade BCI system to activate a PM trainer device. Performance was assessed through controlled activation trials (holding the PM device still or activating it upon verbal and visual cueing), and basic PM skills (driving time, number of activations, stopping) were assessed through distance trials. Setup and calibration times, headset tolerability, workload, and patient/caregiver experience were also evaluated.ResultsAll participants completed the study with favorable tolerability and no serious adverse events or technological challenges. Average control accuracy was 78.3 ± 12.1%, participants were more reliably able to activate (95.7 ± 11.3%) the device than hold still (62.1 ± 23.7%). Positive trends were observed between performance and prior BCI experience and age. Participants were able to drive the PM device continuously an average of 1.5 meters for 3.0 s. They were able to stop at a target 53.1 ± 23.3% of the time, with significant variability. Participants tolerated the headset well, experienced mild-to-moderate workload and setup/calibration times were found to be practical. Participants were proud of their performance and both participants and families were eager to participate in future power mobility sessions.DiscussionBCI-enabled PM access appears feasible in disabled children based on evaluations of performance, tolerability, workload, and setup/calibration. Performance was comparable to existing pediatric BCI literature and surpasses established cut-off thresholds (70%) of “effective” BCI use. Participants exhibited PM skills that would categorize them as “emerging operational learners.” Continued exploration of BCI-enabled PM for children with severe physical disabilities is justified. (shrink)

Brain machine interface (BMI) technology makes direct communication between the brain and a machine possible by means of electrodes. This paper reviews the existing and emerging technologies in this field and offers a systematic inquiry into the relevant ethical problems that are likely to emerge in the following decades.

'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface (BCI) has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators (IPGs) that play a central role in Deep Brain Stimulation (DBS) systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, we (...) claim that the possibility of brainjacking DBS raises particularly profound concerns about individual autonomy, since the possibility of hacking such devices raises the prospect of third parties exerting influence over the neural circuits underpinning the subject’s cognitive, emotional and motivational states. However, although it seems natural to assume that brainjacking represents a profound threat to individual autonomy, we suggest that the implications of brainjacking for individual autonomy are complicated by the fact that technologies targeted by brainjacking often serve to enhance certain aspects of the user’s autonomy. The difficulty of ascertaining the implications of brainjacking DBS for individual autonomy is exacerbated by the varied understandings of autonomy in the neuroethical and philosophical literature. In this paper, we seek to bring some conceptual clarity to this area by mapping out some of the prominent views concerning the different dimension of autonomous agency, and the implications of brainjacking DBS for each dimension. Drawing on three hypothetical case studies, we show that there could plausibly be some circumstances in which brainjacking could potentially be carried out in ways that could serve to enhance certain dimensions of the target’s autonomy. Our analysis raises further questions about the power, scope, and necessity of obtaining prior consent in seeking to protect patient autonomy when directly interfering with their neural states, in particular in the context of self-regulating closed-loop stimulation devices. (shrink)

Cognitive control has long been one of the most active areas of computational modeling work in cognitive science. The focus on computational models as a medium for specifying and developing theory predates the PDP books, and cognitive control was not one of the areas on which they focused. However, the framework they provided has injected work on cognitive control with new energy and new ideas. On the occasion of the books' anniversary, we review computational modeling in the study of cognitive (...) control, with a focus on the influence that the PDP approach has brought to bear in this area. Rather than providing a comprehensive review, we offer a framework for thinking about past and future modeling efforts in this domain. We define control in terms of the optimal parameterization of task processing. From this vantage point, the development of control systems in the brain can be seen as responding to the structure of naturalistic tasks, through the filter of the brain systems with which control directly interfaces. This perspective lays open a set of fascinating but difficult research questions, which together define an important frontier for future computational research. (shrink)

Interactive computer systems can support their users in problem solving, both in Performing their work tasks and in using the systems themselves. Not only is direct support for heuristics beneficial, but to do so modifies the form of computer support provided. This Paper defines and explores the use of problem solving heuristics in user interface design.

Novel neurotechnologies like deep brain stimulation and brain-computer interfaces promise clinical benefits for severely suffering patients. Nevertheless, such electroceuticals raise several ethical issues on different levels: while on the level of clinical neuroethics issues with direct relevance for diagnosis and treatment have to be discussed, on the level of research neuroethics questions regarding research and development of these technological devices like investigating new targets and different diseases as well as thorough inclusion criteria are dealt with. On the (...) level of theoretical neuroethics more general questions are examined including anthropological considerations on “normal” human functioning as well as implications on personality, personal identity and authenticity. This paper presents a brief review on ethical issues of deep brain stimulation and brain computer interfacing and simultaneously introduces to this themed issue with thirteen contributions dealing from different perspectives with ethical implications of electroceuticals for the human brain. (shrink)

To maximize brain plasticity after stroke, several rehabilitation strategies have been explored, including the use of intensive motor training, motor imagery, and action observation. Growing evidence of the positive impact of virtual reality (VR) techniques on recovery following stroke has been shown. However, most VR tools are designed to exploit active movement, and hence patients with low level of motor control cannot fully benefit from them. Consequently, the idea of directly training the central nervous system has been promoted by utilizing (...) motor-imagery (MI) based brain-computer interfaces (BCIs). To date, detailed information on which VR strategies lead to successful functional recovery is still largely missing, and very little is known about how to optimally integrate BCI and VR paradigms for stroke rehabilitation. The purpose of this study was to examine the efficacy of a BCI-VR system using a MI paradigm for post-stroke upper limb rehabilitation on functional assessments, and related changes in MI ability and brain imaging. To achieve this, a 60 years old male chronic stroke patient was recruited. The patient underwent a 3-week intervention in a clinical environment, resulting in 10 BCI-VR training sessions. The patient was assessed before and after intervention, as well as on a one-month follow-up, in terms of clinical scales and brain imaging using functional MRI (fMRI). Consistent with prior research, we found important improvements in upper extremity scores (Fugl-Meyer) and identified increases in brain activation measured by fMRI that suggest neuroplastic changes in brain motor networks. This study expands on the current body of evidence as more data are needed on the effect of this type of interventions not only on functional improvement but also through brain imaging to study the effect of the intervention on plasticity. (shrink)

Artificial agents (AAs), particularly but not only those in Cyberspace, extend the class of entities that can be involved in moral situations. For they can be conceived of as moral patients (as entities that can be acted upon for good or evil) and also as moral agents (as entities that can perform actions, again for good or evil). In this paper, we clarify the concept of agent and go on to separate the concerns of morality and responsibility of agents (most (...) interestingly for us, of AAs). We conclude that there is substantial and important scope, particularly in Computer Ethics, for the concept of moral agent not necessarily exhibiting free will, mental states or responsibility. This complements the more traditional approach, common at least since Montaigne and Descartes, which considers whether or not (artificial) agents have mental states, feelings, emotions and so on. By focussing directly on mind-less morality we are able to avoid that question and also many of the concerns of Artificial Intelligence. A vital component in our approach is the Method of Abstraction for analysing the level of abstraction (LoA) at which an agent is considered to act. The LoA is determined by the way in which one chooses to describe, analyse and discuss a system and its context. The Method of Abstraction is explained in terms of an interface or set of features or observables at a given LoA. Agenthood, and in particular moral agenthood, depends on a LoA. Our guidelines for agenthood are: interactivity (response to stimulus by change of state), autonomy (ability to change state without stimulus) and adaptability (ability to change the transition rules by which state is changed) at a given LoA. Morality may be thought of as a threshold defined on the observables in the interface determining the LoA under consideration. An agent is morally good if its actions all respect that threshold; and it is morally evil if some action violates it. That view is particularly informative when the agent constitutes a software or digital system, and the observables are numerical. Finally we review the consequences for Computer Ethics of our approach. In conclusion, this approach facilitates the discussion of the morality of agents not only in Cyberspace but also in the biosphere, where animals can be considered moral agents without their having to display free will, emotions or mental states, and in social contexts, where systems like organizations can play the role of moral agents. The primary cost of this facility is the extension of the class of agents and moral agents to embrace AAs. (shrink)

Physically enhancing brain–machine interfaces communicate elec­tronically with the patient’s mind in both directions. They present significant opportunities to improve a patient’s health and to restore his or her physical function, but they also present problems for the patient’s sense of agency and self. This is exacerbated by notions of extension and enhancement that are not grounded in an authentic human anthropology that describes the inherently dignified person as an integral union of body and soul.

Developments in neurotechnology took a leap forward with the demonstration of the first Brain to Brain Interface (BBI). BBIs enable direct communication between two brains via a Brain Computer Interface (BCI) and bypasses the peripheral nervous system. This discovery promises new possibilities for future battlefield technology. As battlefield technology evolves, it is more likely to place greater demands on future soldiers. Future soldiers are more likely to process large amounts of data derived from an extensive networks of humans (...) and machines. This raises several ethical and philosophical concerns. This paper will look at BBI technology in current stages of research, future BBI applications in the military and how the potential use of BBIs in military operations challenges the way we understand the concept of responsibility. In this paper, I propose that an individual connected to a BBI ought not to be held fully responsible for her actions. The justification for this proposition is based on three key points such as an individual connected to a BBI does not have the ability to act freely, has a diminished sense of self-agency and may not be able to demonstrate authenticity of the thoughts and memories generated when connected to the interface. (shrink)

Brain Computer Interfaces (BCIs) enable one to control peripheral ICT and robotic devices by processing brain activity on-line. The potential usefulness of BCI systems, initially demonstrated in rehabilitation medicine, is now being explored in education, entertainment, intensive workflow monitoring, security, and training. Ethical issues arising in connection with these investigations are triaged taking into account technological imminence and pervasiveness of BCI technologies. By focussing on imminent technological developments, ethical reflection is informatively grounded into realistic protocols of brain-to-computer (...) communication. In particular, it is argued that human-machine adaptation and shared control distinctively shape autonomy and responsibility issues in current BCI interaction environments. Novel personhood issues are identified and analyzed too. These notably concern (i) the “sub-personal” use of human beings in BCI-enabled cooperative problem solving, and (ii) the pro-active protection of personal identity which BCI rehabilitation therapies may afford, in the light of so-called motor theories of thinking, for the benefit of patients affected by severe motor disabilities. (shrink)

To what extent should humans transfer, or abdicate, responsibility to computers? In this paper, I distinguish six different senses of responsible and then consider in which of these senses computers can, and in which they cannot, be said to be responsible for deciding various outcomes. I sort out and explore two different kinds of complaint against putting computers in greater control of our lives: (i) as finite and fallible human beings, there is a limit to how far we can acheive (...) increased reliability through complex devices of our own design; (ii) even when computers are more reliable than humans, certain tasks (e.g., selecting an appropriate gift for a friend, solving the daily crossword puzzle) are inappropriately performed by anyone (or anything) other than oneself. In critically evaluating these claims, I arrive at three main conclusions: (1) While we ought to correct for many of our shortcomings by availing ourselves of the computer''s larger memory, faster processing speed and greater stamina, we are limited by our own finiteness and fallibility (rather than by whatever limitations may be inherent in silicon and metal) in the ability to transcend our own unreliability. Moreover, if we rely on programmed computers to such an extent that we lose touch with the human experience and insight that formed the basis for their programming design, our fallibility is magnified rather than mitigated. (2) Autonomous moral agents can reasonably defer to greater expertise, whether human or cybernetic. But they cannot reasonably relinquish background-oversight responsibility. They must be prepared, at least periodically, to review whether the expertise to which they defer is indeed functioning as he/she/it was authorized to do, and to take steps to revoke that authority, if necessary. (3) Though outcomes matter, it can also matter how they are brought about, and by whom. Thus, reflecting on how much of our lives should be directed and implemented by computer may be another way of testing any thoroughly end-state or consequentialist conception of the good and decent life. To live with meaning and purpose, we need to actively engage our own faculties and empathetically connect up with, and resonate to, others. Thus there is some limit to how much of life can be appropriately lived by anyone (or anything) other than ourselves. (shrink)

This paper discusses current clinical applications and possible future uses of brain-computer interfaces as a means for communication, motor control and entertainment. After giving a brief account of the various approaches to direct brain-computer interaction, the paper will address individual, social and ethical implications of BCI technology to extract signals from the brain. These include reflections on medical and psychosocial benefits and risks, user control, informed consent, autonomy and privacy as well as ethical and social issues (...) implicated in putative future developments with focus on human self-understanding and the idea of man. BCI use which involves direct interrelation and mutual interdependence between human brains and technical devices raises anthropological questions concerning self-perception and the technicalization of the human body. (shrink)

The rapid advancement of artificial intelligence systems has generated a means whereby assistive bionic prosthetics can become both more effective and practical for the patients who rely upon the use of such machines in their daily lives. However, de lege lata remains relatively unspoken as to the legal status of patients whose devices contain self-learning CIS that can interface directly with the peripheral nervous system. As a means to reconcile for this lack of legal foresight, this article approaches the topic (...) of CIS-nervous system interaction and the impacts it may have on the legal definition of “persons” under the law. While other literature of this nature centres upon notions of transhumanism or self-enhancement, the approach herein approached is designed to focus solely upon the legal nature of independent CIS actions when operating alongside human subjects. To this end, it is hoped that further discussion on the topic can be garnered outside of transhumanist discourse to expedite legal consideration for how these emerging relationships ought to be received by law-generating bodies internationally. (shrink)

Healthcare professionals decide wisely about personalized medicine, treatment plans, and resource allocation by utilizing big data analytics and machine learning. To guarantee that algorithmic recommendations are impartial and fair, however, ethical issues relating to prejudice and data privacy must be taken into account. Big data analytics and machine learning have a great potential to disrupt healthcare, and as these technologies continue to evolve, new opportunities to reform healthcare and enhance patient outcomes may arise. In order to investigate the (...) class='Hi'>patient’s outcomes with empirical evidence, this research was conducted using an online survey to incorporate healthcare professionals, patient’s reviews, and clinical staff. The data were analyzed using SmartPLS 4.0 to predict the structural model. The findings revealed a direct impact as positive influence of using machine learning on healthcare performance and patient outcomes through big data analytics. Moreover, it is evident that this can lead to personalized treatment plans, early interventions, and improved patient outcomes. Additionally, big data analytics can help healthcare providers optimize resource allocation, improve operational efficiency, and reduce costs. The impact of big data analytics on patient outcome and healthcare performance is expected to continue to grow, making it an important area for investment and research. (shrink)

The history of brain-computer interfaces developed from a mere idea in the days of early digital technology to today’s highly sophisticated approaches for signal detection, recording, and analysis. In the 1960s, electroencephalography was tied to the laboratory due to equipment and recording requirements. Today, amplifiers exist that are built in the electrode cap and are so resistant to movement artefacts that data collection in the field is no longer a critical issue. Within 60 years, the field has moved (...) from simple and artefact-sensitive EEG recording to making real the vision of brain-computer communication. In the last 40 years, direct brain-computer interaction went from simple communication programs to sophisticated BCI-controlled applications. In the past two decades, much research was conducted with locked-in individuals, and since the 2010s, independent home use by exemplary patients has been demonstrated. In these patients with locked-in syndrome, BCI were installed at their home and long-term usage was established, resulting in increased quality of life. Maintaining communication in disorders leading to LIS contributes significantly to the patients’ sense of being full persons. BCI as an assistive technology will likely be perceived as integral part of the self: insofar as it can prevent total loss of communication and the ensuing social isolation, it enables essential conditions for the subjective and intersubjective experience of personhood. (shrink)

The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple (...) medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)

An important challenge in bilingualism research is to understand the mechanisms underlying sentence processing in a second language and whether they are comparable to those underlying native processing. Here, we focus on verb-particle constructions (VPCs) that are among the most difficult elements to acquire in L2 English. The verb and the particle form a unit, which often has a non-compositional meaning (e.g., look up or chew out), making the combined structure semantically opaque. However, bilinguals with higher levels of English proficiency (...) can develop a good knowledge of the semantic properties of verb-particle constructions (Blais and Gonnerman, 2013). A second difficulty is that in a sentence context, the particle can be shifted after the direct object of the verb, (e.g., The professor looked it up). The processing is more challenging when the object is long (e.g. The professor looked the student’s last name up.). This shifted structure favors syntactic processing at the expense of VPC semantic processing. We sought to determine whether or not bilinguals’ reading time (RT) patterns would be similar to those observed for native monolinguals (Gonnerman and Hayes, 2005) when reading VPCs in sentential contexts. French-English bilinguals were tested for English language proficiency, working memory and explicit VPC semantic knowledge. During a self-paced reading task, participants read 78 sentences with verb-particle constructions that varied according to parameters that influence native speakers’ reading dynamics: verb-particle transparency, particle adjacency and length of the object noun phrase (NP; 2, 3, or 5 words). RTs in a critical region that included verbs, NPs and particles were measured. Results revealed that RTs were modulated by participants’ English proficiency, with higher proficiency associated with shorter RTs. Examining participants’ explicit semantic knowledge of VPCs and working memory, only readers with more native-like knowledge of VPCs and a high working memory presented RT patterns that were similar to those of monolinguals. Therefore, given the necessary lexical and computational resources, bilingual processing of novel structures at the syntax-semantics interface follows the principles influencing native processing. The findings are in keeping with theories that postulate similar representations and processing in L1 and L2 modulated by processing difficulty. (shrink)