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Prosthetic Ethics

Prosthetic Ethics. James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford CT James.Hughes@trincoll.edu. Committee on Ethical and Societal Issues in National Security Applications of Emerging Technologies

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Prosthetic Ethics

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  1. Prosthetic Ethics James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford CT James.Hughes@trincoll.edu Committee on Ethical and Societal Issues in National Security Applications of Emerging Technologies November 2-3, 2011 Beckman Center, National Academy of Sciences Irvine, CA http://ieet.org/archive/20111102-ProstheticEthics.ppt

  2. Non-Problems & Old Problems • Some ethical issues are false problems, at least from an Enlightenment POV • Others are old problems, like ensuring safety and access • A few are novel because of the efficacy of neuroprosthetics Institute for Ethics and Emerging Technologies 2011

  3. Non-Problems • Supersoldiers • Sports enhancement • Disappearing disabled cultures • Authenticity Institute for Ethics and Emerging Technologies 2011

  4. SuperSoldiers • Ethics of military force, or of military applications • Do prosthetics change • likelihood of exploiting soldiers as guinea pigs or in the field • ability to exercise judgment in field, reduce collateral damage (drones) • likelihood of engaging in conflicts Institute for Ethics and Emerging Technologies 2011

  5. Sports Enhancement • Oscar Pistorius • Sports is a rule-governed game • If athletes with prosthetics want to compete they can start their own leagues • Not relevant to society Institute for Ethics and Emerging Technologies 2011

  6. Disappearing Disabilities • 99% of disabled happy to give up their disabilities • Only children forced to use • Last century: dramatic decline in veteran and civilian amputees • 1000 amputees from Iraq/Afghan vets • 1000+ surgeons in Civil War, 60,000+ amputees • Changes cost-benefit analysis for social priority-setting (Loeb) • Difficulty in commercializing the direct neural control prosthethics developed by DARPA or others Institute for Ethics and Emerging Technologies 2011

  7. “Authenticity” • Not human, not me But • Body image is malleable • Prosthetics easily incorporated, even made a valued aesthetic feature Institute for Ethics and Emerging Technologies 2011

  8. Aestheticizing Prosthetics • Aimee Mullins Smartphone dock installed in prosthetic Institute for Ethics and Emerging Technologies 2011

  9. Anyway We Are All Cyborgs • Since literacy we have become dependent on brain prosthetics on paper • Shoes, clothing, tools • The idea of prosthetic enhancement is ancient: Icarus • Central to the Enlightenment project Institute for Ethics and Emerging Technologies 2011

  10. Old Problems • Safety of devices • Moving line between disability/normal/enhanced • Unequal access • Ownership & intellectual property • Privacy & cybersecurity Institute for Ethics and Emerging Technologies 2011

  11. Safety • Federal Food, Drug, and Cosmetic Act covers all implants and other devices "intended to affect the structure or any function of the body of man or other animals“ But FDA’s • 510k (similar to prior approval) loophole • Center for Devices and Radiological Health underfunded to handle scope and pace of innovation • Authority inadequate to gather clinical trial information or compel reporting of post-approval adverse events Are military IRBs’ reviews adequate to protect soldiers from experimental technologies Institute for Ethics and Emerging Technologies 2011

  12. Defining Disabled/Enhanced • When Medicare changed its definition for coverable cochlear implants from deafness to severe hearing loss it expanded coverage for millions of seniors • 25 million people in the U.S. have hearing loss • Of those, 2.4 million have severe to profound deafness • 25% of those aged 65 to 74 have hearing impairments • 40% over age 75 have hearing impairments Institute for Ethics and Emerging Technologies 2011

  13. Superhuman Abilities • Tuneable cochlear and visual nerve implants, or prosthetics with greater than human strength • Turning point: when people want to replace limb, eyes or organs with prosthetics Institute for Ethics and Emerging Technologies 2011

  14. Unequal Access • In every other industrialized country the debate is what should be in or out of the plan • Here it is up to 1500 private and 60 or so public insurance plans • Critical: Speed of innovation of cheap versions Institute for Ethics and Emerging Technologies 2011

  15. Ownership & Property • Devices given to wounded warriors that have restricted civilian uses (akin to allowing them to take home weapons) • Repossession of a device for lack of payment (RepoMen) • Restricted travel to countries that are on a proscribed export list • Violating IP by allowing someone to examine, sharing details about device Institute for Ethics and Emerging Technologies 2011

  16. Privacy and Cybersecurity National security secrecy and corporate IP inhibit open source innovation, translation to application • Already issue with mobile technology and RFID • Privacy of biometric information - controversy in 2002 over the VeriChip patient ID and tracking system • Implanted medical records, e-cash, telecom • Wireless hacking of prosthetics (Jay Radcliffe: insulin pump hacking) • Self-hacking to control drug administration • Required registration of high-power prosthetics See: 2005 EU Report “Ethical Aspects of ICT Implants in the Human Body” Institute for Ethics and Emerging Technologies 2011

  17. Newer Problems • Timing of implants and upgradeability • Brain-machine interfaces • Structural unemployment • Remote behavior control • Mood control • Blurred culpability Institute for Ethics and Emerging Technologies 2011

  18. Timing of Implants • Accelerating pace of innovation • Especially rapid advances in biocompatible materials • Cochlear implants • Critical language window • Destruction of cochlear tissue Institute for Ethics and Emerging Technologies 2011

  19. Artificial Pancreas • Diabetes growing rapidly • Realtime blood sugar monitoring • Automated release of insulin • Implanted Institute for Ethics and Emerging Technologies 2011

  20. Brain-Machine Interfaces • Prosthetic bodies & human brains (Robocop) versus robot brains in human bodies (Terminator) • All neural prosthetic research from peripheral nerves to cerebral on the Kurzweilian trajectory to nanoneural BCIs Institute for Ethics and Emerging Technologies 2011

  21. Nathan Kline and Manfred Clynes • 1960. “Cyborgs and Space,” Astronautics, Sept. • Monitoring and controlling the body/brain of the astronaut from ground control Institute for Ethics and Emerging Technologies 2011

  22. Implants for Depression & OCD • Depression • Obsessive-compulsive disorder Institute for Ethics and Emerging Technologies 2011

  23. Brain-Computer Interfaces Institute for Ethics and Emerging Technologies 2011

  24. NanoNeural Network • Self-replicating • Two-way communication with trillions of neurons • Networked inside and out • Perfect virtual reality, mind back-up, upload Institute for Ethics and Emerging Technologies 2011

  25. Structural Unemployment • Prior cases: • literate/numerate workers • smartphones • Competing not only against automation and globalization, but also against brain-machine enhanced workers (vets?) • AugCog Institute for Ethics and Emerging Technologies 2011

  26. Autonomy & Addiction • Remote behavior control of criminals, soldiers, astronauts • Wireheading: mood control • Blurred culpability: developer, software, user Institute for Ethics and Emerging Technologies 2011

  27. For more information • Institute for Ethics and Emerging Technologiesieet.org • Me:director@ieet.org • These slides: http://ieet.org/archive/20111102-ProstheticEthics.ppt Institute for Ethics and Emerging Technologies 2011

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