0011 Schaub 4:00
R07
Discrimination, Distribution, and Other Ethical Considerations of the Visual
Prosthetic
Jonathan Scott (jas492@pitt.edu)
Introduction
I am a biomedical engineer working at Oculus Industries.
Oculus Industries is a health-care company that focuses on
helping people with do not have perfect eyesight, whether
they be blind or have less than perfect visual acuity. I am in
charge of a project to design a type of brain-computer
interface, called a visual prosthetic, to treat people suffering
from retinitis pigmentosa, a degenerative retinal disease. The
prosthetic is referred to as Eagle Eye. The CEO has told me
that the Internet-related services and products company
MegaCorp is very interested in buying the design for the
visual prosthetic. They are offering me $300,000 to allow
them access to Eagle Eye. MegaCorp has told me that they
want to create a computer-like device in which the display is
on the eye itself and the machine is controlled by the brain.
However, the Eagle Eye prosthetic is still in trial. Although it
has had several successful tests it is not ready to be out into
the market. Also, the device is for health-care and enhancing
normal human beings like that is not a primary concern.
Background on the Eagle Eye
The Eagle Eye prosthetic has three major
components, as shown in Figure 1. The first component is a
spectacle-mounted miniature camera to take in light. The
second component transforms the light into electrical
stimulation. The third component is an array that stimulates
the living cells in the inner retina. The array is positioned to
the side of the fovea and fixed in place with a single springtensioned retinal tack that was inserted through the electrode
array [2]. It is powered by an external battery pack. The Eagle
Eye essentially works to replace the retina’s job in converting
light into electrical impulses that are sent to the brain [2].
Although retinitis pigmentosa “leads to photoreceptor
degeneration…the inner retinal cells (e.g. bipolar, horizontal,
amacrine and ganglion cells) and nerve fiber layout remains
largely preserved” [3]. The preservation of the inner retinal
cells is the reason the Eagle Eye is able work; the Eagle Eye
will not function for people who do not have the inner retinal
cells intact because there would be no way to send
information to the optic nerve, and therefore, the brain.
Furthermore, a fully developed optic nerve is required for the
prosthetic to work. An underdeveloped optic nerve would not
be able to send electrical impulses to the brain [4].
Purpose and Basic Functions
The Eagle Eye prosthetic is designed to cure patients
who are suffering from retinitis pigmentosa. Retinal
pigmentosa (RP) is the most common inherited retinal
disease. RP has a prevalence of approximately one in four
thousand [1]. The disease “results in in a progressive
degeneration of the photoreceptive layer of the retina that can
lead to a complete loss of vision” [1]. Although the
photoreceptive layer is destroyed, autopsies showed that the
nuclear layer is moderately preserved. And, more
importantly, the ganglion cells are largely spared. Studies on
patients suffering from RP have shown that electrical
stimulation on retinal areas causes visual percepts
(phosphenes) in nearby areas [1]. These findings led people
such as my team and me to begin research in ways to restore
vision through the stimulation of the ganglion cells.
University of Pittsburgh, Swanson School of Engineering
2014-10-28
Figure 1 [2]. The Eagle Eye visual prosthetic: (a)
the array implanted in the eye; (b) the visual processing unit;
(c) the spectacle mounted camera
Central to the Eagle Eye are the artificial visual
percepts. The idea of these percepts is that passing a current
through small single contact electrodes can generate the small
point-like phosphenes. The Eagle Eye transforms light into
electrical stimulation, and therefore modifies the patterns of
the phosphenes to generate rudimentary images [5].
Collections of the electrodes are what is used to manipulate
the phosphenes. The previous version of the Eagle Eye was
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five hundred micrometers and had eighteen platinum
electrodes. The current Eagle Eye is the same size but
contains sixty electrodes, providing still rudimentary, but
higher quality images [2]. The blocky image produced by the
Eagle Eye would be difficult for normal-sighted people to
interpret, but tests have shown that with the Eagle Eye
patients are “able to contrast light from dark and move more
independently, with the ability to distinguish large objects and
to avoid walking into them. They will be able to see outlines
such as buildings, cars and park benches” [4].
different between two different tests [6]. The nonlinearity and
the nonstationarity of the EEG signals have to be better
accounted for before the Eagle Eye can be a viable option.
The people at MegaCorp are likely not specialists in visual
prosthesis, or even biomedical engineers, and would not be
able to fix these problems. According to the Biomedical
Engineering Society’s (BMES) code of ethics, a biomedical
engineer must “[u]se their knowledge, skills, and abilities to
enhance the safety, health, and welfare of the public” [7]. To
sell the Eagle Eye to people who do not know how to fix its
problems, but would still sell it to the public, would enhance
the public’s safety, heath, or welfare. But a case study I have
reviewed deals with a product that is not ready to be released
[8]. The Eagle Eye is not ready to be used outside of
controlled trials and MegaCorp may preemptively release the
device. The product they create may be ready and MegaCorp
might be able to compensate for the EEG’s nonlinearity and
nonstationarity, but I would have no way of knowing.
Trial Success of the Eagle Eye
In our current trial, the system has been implanted in
thirty people at eleven centers all over the world. The subjects
have demonstrated improved motion detection, mobility and
were also able to distinguish common household objects [2].
In orientation and motion tasks, subjects successfully
navigated to a door fifty-eight percent of the time with the
system on compared with the thirty-two percent with the
system off. In twenty-two subjects, using the system enabled
them to correctly identify letters in a closed set test seventythree percent of the time as compared with the seventeen
percent when the system was off. Subjects also demonstrated
improved spatial-motor tasks including improvements seen in
square localization tasks [2]. It should be noted, however, that
these tests were performed under extremely controlled
circumstances. For example, the letter reading test was done
on a display screen in a darkened room and white letters were
displayed on a black background [2].
Eagle Eye with MegaCorp
MegaCorp’s Desire for the Eagle Eye
MegaCorp wants the Eagle Eye prosthetic because it
can bring about a wealth of new products through neural
augmentation by creating bionic eyes for fully functional
humans. They want the commercial potential that the Eagle
Eye has. It is theoretically possible to make the Eagle Eye
better than a normal human eye. At that point, the prosthetic
could also have access to infrared, X-ray, or night vision.
Soldiers in the military would be able to see enemies at night.
They could see if their target is hiding within a building
without having to set foot in it. Orders would transmitted
directly to the eye in an augmented reality, instead of having
to relay orders [4]. Doctors and surgeons would not need any
X-ray machines. They could just look through a person and
see the problem. They would also be able to have binocular
vision, being able to magnify images of their operation [4].
Everyday people could also have eyes that can run algorithms
to adjust for the intensity of sunlight. Or they could watch a
video in one eye and use the other to walk around [4]. Virtual
reality and movies become much more immersive when they
are played out directly into a person’s mind. MegaCorp wants
the Eagle Eye because a commercial bionic eye would be a
successful product in many professional and entertainment
fields.
Unsolved Complications of the Eagle Eye
Although the Eagle Eye prosthetic had several
successful tests, it is not ready to be a viable option when
dealing with blindness. The imaging technique that we used
to
create
our
Eagle
Eye
prosthetic
was
electroencephalography (EEG). One of the problems is that
the brain is a nonlinear system and the EEG signals can be
better characterized through nonlinear methods. Some of
these nonlinear properties could “degrade the task-related
EEG signals and thereby deteriorate the [Eagle Eye’s]
performance” [6]. For example, there is a limit on how fast
the brain can process stimuli. When two stimuli have to be
processed within a short timeframe, the response to the
second stimulus is significantly slowed [6]. This will shew the
EEG data and since the Eagle Eye is based off that data, it
may not always give accurate results, such as missing objects
when presented with a lot of stimuli. The nonstationarity of
the brain is also detrimental to the Eagle Eye’s performance.
The nonstationarity can lead to changes of electrode contact
and electrode position. The EEG classifications can be
There are also case studies about organizations
getting rights over technologies and projects because of
connections. [9]. MegaCorp has connections to almost every
field and they could influence people who could tell me what
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Jonathan Scott
to do (such as the CEO). I have also been working on the
Eagle Eye for a long time and I am not sure whether I want to
give it away or not. The case is about a firm that has been
unable to work on a project because another firm has
connections. Another case study I have reviewed is about
using the public to influence research. A society was unable
to stop research on genes so they built up support with the
public to halt the research [10]. The case brings up the issue
of whether it is ethical to use the support of the public to
influence the continuation of a research project because of
potential social outcomes. MegaCorp is a highly influential
and wealthy company and they may attempt to use the public
if I decide not to give them the Eagle Eye.
wealth people. Some jobs may grow to require a prosthetic,
such as surgeons have X-ray or binocular vision. The people
who do not have enough money to afford a visual prosthetic
would be excluded from having certain jobs that would
become reserved for the wealthy [11]. The normal now would
become the disabled. This would not benefit the welfare of
the public and it would also be detrimental to the “safety [and]
health…of the public” [12]. According to BMES, a
biomedical engineer must “[c]onsider the larger
consequences of [his] work” [7]. From this view, selling
MegaCorp the Eagle Eye would be damaging to society. This
is against both codes of ethics so I should not sell the Eagle
Eye.
Consequences of MegaCorp’s Eagle Eye
Further Considerations
The neural augmentation that MegaCorp envisions
could have many benefits to society. It can increase the
availability of education. If the brain is augmented with a
bionic eye, the educational benefit would be profound [11].
People would be able to access information by viewing it
directly on their “eye.” There is “[a] corollary to a more
educated society is a more creative society” [11]. As people
have access to more and more information, then they will be
able to draw connections between seemingly unrelated fields
and create new works of art, research, and solutions to social
issues. This is evident through the internet, where a relatively
small group of people can upload movies, music, and websites
to billions with the click of a mouse. According to the
National Society of Professional Engineers (NSPE),
engineers must “[h]old paramount the…welfare of the public”
and “strive to serve the public interest” [12]. The BMES also
stipulates that I must enhance the welfare of the public [7].
The Eagle Eye could benefit the lives of everyday people. If
selling the Eagle Eye to MegaCorp would enhance the public
welfare, then according to both my professional codes of
ethics I am obligated to do so.
Other Sources
I also have several other sources I can turn to help
me decide on whether to sell the Eagle Eye or not. One of
them is the woods. I find it hard to make difficult decisions
when surrounded by people or distractions. I find the woods
a calm place where I can think clearly without distractions.
Another source I could use is the movie Gattaca. In the
movie, humanity has mastered genetic manipulation and
discriminates based on the genes people have. The main
character even says “I belonged to a new underclass, no
longer determined by social status or the color of your skin.
No, we now have discrimination down to a science” [14].
Although bionic eyes are not the same as genes, it is the same
effect. Human augmentation could allow people to
discriminate based on how augmented they are.
Conclusion
I have been offered $300,000 to sell the Eagle Eye
visual prosthetic to the company MegaCorp. The Eagle Eye
is designed to help people suffering from the degenerative
retinal disease retinitis pigmentosa. The Eagle Eye works by
combining a spectacle-mounted camera, a light-to-electric
transformer, and a stimulator in the eye. Although it has
passed several trials, its roots in EEG images cause several
problems. MegaCorp wants to use it to create a bionic eye that
could improve society, harm society, or both. I would not give
MegaCorp the Eagle Eye. The prosthetic is not ready to be
introduced to people who need it to see, let alone for
entertainment or convenience. The technology will eventually
make it out to the general public; but I want to make it so that
it is more developed than it is now. If any engineer is faced
with the same or a similar dilemma as I am, I recommend they
think long and hard about their decision. They should
The neural augmentation that MegaCorp envisions
could also has many impediments to society. One of these
impediments is responsibility. Is a person morally responsible
for an action if their eyes have been programed a certain way?
For example, a soldier has a bionic eye and it is programed so
that he sees everyone as enemy soldiers pointing a gun at him
[13]. Is the soldier responsible for the deaths that would
inevitably be caused? Also, the bionic eye gives the people
who can afford a bionic eye an advantage over the people who
cannot, just as wealthy people can afford to send their children
to better schools [11]. This would create an even greater class
division than what already exists. The wealthy could enhance
themselves with eyes that would be superior to normal eyes
because the bionic eyes may be too expensive for the less
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Jonathan Scott
consider what they believe is important to society and which
side contains more persuasive arguments.
Institute for Ethics and Emerging Technologies. (online
article). http://ieet.org/index.php/IEET/print/7580
[12] “NSPE Code of Ethics for Engineers.” National
Society for Professional Engineers. (online article).
http://www.nspe.org/resources/ethics/code-ethics
[13] P. Brey (2009). “Biomedical Engineering Ethics.”
(online article).
http://www.utwente.nl/gw/wijsb/organization/brey/Publicati
es_Brey/Brey_2009_Biomed_Engineering.pdf
[14] Hawke, Ethan, perf. Gattaca. Dir. Andrew Niccol.
Columbia Pictures, 1997. Film.
Resources
[1] L. da Cruz, A. Kotecha, D. Stewart, J Zhong (2014).
“The Argus II prosthesis facilitates reaching and grasping
tasks: a case series.” BMC Ophthalmology. (online article).
http://www.biomedcentral.com/1471-2415/14/71
[2] L. da Cruz, J.M. Ong (2012). “The bionic eye: a review.”
Clinical & Experimental Ophthalmology. (online article).
http://onlinelibrary.wiley.com/doi/10.1111/j.14429071.2011.02590.x/full
[3] L. Allegrini, F. Barca, E. di Bartolo, C. Belting, L.
Cinelli, F. Genovesi-Ebert, S. Rizzo (2014). “The Argus II
Retinal Prosthesis: 12-Month Outcomes from a Single-Study
Center.” ScienceDirect. (online article)
http://www.sciencedirect.com/science/article/pii/S00029394
14001032
[4] M.U. Chittal (2011). “BIONIC EYE: A REVIEW.”
Global Research Online. (online article).
http://globalresearchonline.net/journalcontents/volume8issue
1/Article-027.pdf
[5] B. Bourkiza, A Jeffries, J.S. Pezaris, M. Vurro (2013).
“Visual Acuity of Simulated Thalamic Visual Prostheses in
Normally Sighted Humans.” PLOSONE. (online article).
http://www.plosone.org/article/info%3Adoi%2F10.1371%2
Fjournal.pone.0073592
[6] S. Gao, X. Gao, B. Hong, Y. Wang (2014). “Visual and
Auditory Brain-Computer Interface.” IEEExplore. (online
article).
http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=6
712069&tag=1
[7] “Biomedical Engineering Society Code of Ethics.”
Biomedical Engineering Society. (online article).
http://bmes.org/files/2004%20Approved%20%20Code%20o
f%20Ethics(2).pdf
[8] “To Release, or Not to Release: An Engineer’s
Perspective.” Stanford Biodesign. (online article).
http://biodesign.stanford.edu/bdn/ethicscases/21releasequesti
on.jsp
[9] “Case 1016 – Now You Have It, Now You Don’t.”
Texas Tech University. (online article).
http://www.depts.ttu.edu/murdoughcenter/products/cases.ph
p
[10] “Case Study 5: The XYZ Controversy.” Online Ethics
Center for Engineering and Science. (online article).
http://www.onlineethics.org/Education/precollege/sciencecla
ss/sectone/chapt4/cs5.aspx
[11] J. Niman (2013). “Prosthetic Technology and Human
Enhancement: Benefits, Concerns and Regulatory Schemes.”
Additional Resource
S. Rosahl (2007). “Neuroprosthetics and Neuroenhancement:
Can We Draw a Line?” Virtual Mentor. (online source).
http://virtualmentor.ama-assn.org/2007/02/msoc2-0702.html
Acknowledgements
I would like to thank Mr. Scott Olshaker of introducing me
to the world of the brain and Mrs. Maryann Byrne for being
my guide through that world. I would also like to thank the
librarians at the University of Pittsburgh for introducing me
to the research databank that the university has to offer. I
would also like to thank my mother, Robin Scott, and my
father, Chis Scott, for raising me to question and explore and
always being with me.
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