ETHICAL LOOK INTO BRAIN MACHINE INTERFACE
Matthew Labashosky (mal223@pitt.edu)
AN ETHICAL SCENARIO
Imagine the following hypothetical scenario. Sitting in
my 4th floor office at the University of Pittsburgh Medical
Center, administrator of the development of brain machine
interface, my secretary enters my office and hands me a
letter. The letter is from a distressed husband and local
corporate executive of United Steelworkers, about his wife
who recently had a stroke, which paralyzed her right arm,
but, in addition, gave her minor brain damage. The husband
continued that he would pay a great sum in order to implant
a brain machine interface to try help her regain movement in
her arm. After reading, I think that I would immediately
love to help this family but, the decision is very large and I
must decide if the treatment of his wife would be ethical to
complete. In order to make my decision, I will refer to the
Code of Ethics of Engineers by the National Society of
Professional Engineers (NSPE) and the Biomedical
Engineering Society Code of Ethics along with canons and
case studies that are similar to the scenario at hand. The
codes of ethics will be the key to follow when deciding upon
this scenario since the Code of Ethics of Engineers is what
every engineer should refer to when faced with a
questionable ethical scenario. Along with the general code
of ethics, the Biomedical Engineering Society Code of
Ethics is specific to the biomedical engineering profession
and must be thoroughly examined. In order to understand
the components of the machine and how each specific part
of it is ethical in the first place, the mechanics of the unique
machine need to be understood. Noticing how much
research and different tests went into each trial of it is also
essential because it will show how long the development of
the machine initially took just to get it to the position it is in
now.
SCIENCE AND ETHICAL COMPONENTS
OF BRAIN MACHINE INTERFACE
According to the Chris and Dana Reeve
Foundation, some type of paralysis affects 5.5 million
people [1]. Presently, a newly researched invention in the
field of biomedical engineering, the brain machine interface,
is trying to lower that number. The brain machine interface
is a computer chip that is placed on the brain of a person and
is relayed to a series of computer chips located on either a
paralyzed or prosthetic limb. Before this, people with
paralysis were confined to wheelchairs and amputees would
have to go through months of physical therapy in order to
learn how to use a prosthetic limb. The brain machine
interface allows a single thought to be used in order to
control the appendage.
The brain machine interface was first developed
using rats as test subjects and allowed the rats to control a
pitch of a specific machine coupled with the brain machine
interface on their brain. Every time a pitch was lowered or
heightened, the rat was rewarded with food, and slowly, the
rat began to be able to change the pitch more quickly [2].
These trials showed the plasticity of the brain, which is
critical to the use of the machine. The BMI must master the
brain’s learning ability in order to function [2]. After the
rats were able to control the pitch machine, a group of
scientists from the University of Washington switched the
focus from rats to monkeys. Electrodes were planted on the
monkeys’ motor cortex in order to measure the activity of
the neurons used to produce movement in the body. When a
specific movement was made, the electrode would pick up
the signal to the brain and release a small chirp. After a
specific movement and chirp, the monkey was rewarded
with food. The feedback to connect the sound with the
movement showed the possibility of the brain controlling an
external body part [1]. When examining the ethical scenario
and making the decision about the machine being ethical, the
amount of research that was done in order to create this
invention in the first place needs to be taken into account.
After this discovery, the focus was slowly switched
to using the brain machine interface to improve the quality
of life. The BMI is placed on the brain in one of two ways:
an invasive approach or a noninvasive approach. The
noninvasive way places electrodes openly on the skull and is
called electroencephalography (EEG). The EEG is a safer
alternative and has had success in the past, but the resolution
of information from the brain of an EEG is limited. The
invasive approach, electrocorticography (ECoG), where the
electrodes are placed on the open cortex, is less safe but the
resolution of information from the brain is much higher. In
comparison, the resolution of the EEG can reach around 50
Hz while the ECoG can reach up around 600 Hz [3]. For
distinct interfaces, the only approach that may give a
solution will be the invasive approach [4].
The EEG, which sits on the skull, almost in the
form of a cap, controls specific neurons that are fired and
gives feedback based on the neural activity that was used.
Since the ECoG is on the motor cortex, it is much more
complex. A computer chip, approximately 4 micrometers in
size, can be placed inside the cerebrum and can conform
itself to the specific folds of the brain [2]. The signals read
by the chip from the brain are implanted in a computer
called a decoder. The decoder is a mathematical machine,
which places the thousands of neural inputs and transforms
them to a small amount of outputs. The decoder first
monitors neurons while test subjects move their arms in
predetermined motions. Using that information, the outputs
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are used to create parameters for the machine. The decoder
would then be able to transform those signals to movements
and work, in some sense, as the spinal cord. The “spinal
cord” will take about 100,000 inputs from the neural
interface and the decoder will present 15 outputs [1]. A
scientific problem with the BMI arises because over time,
the BMI degrades and is not as strong, so it would need to be
reprogrammed often [1].
The development of the BMI is moving at a quick
pace, though, as shown by research at Northwestern
University, which illustrated how the brain machine
interface was actually able to move the paralyzed hand of a
subject [5]. The BMI will, in the future, not only have visual
feedback by allowing the subject to see his/her arm move,
but also have tactile feedback. This would be possible by
implanting a chip in the paralyzed limb or prosthetic which
sends a signal back up to the brain, giving the subject the
idea of feeling in their limb. This would put life back into
the lifeless component of the body by giving the person the
ability to feel the movement in a prosthetic arm [1].
Although the uniqueness of the brain machine
interface is a promising look into biomedical engineering
and the possibilities it encompasses, the machine has been
questioned ethically. The questions of ethics that have
arisen with this machine are safety of the device, security of
information it can hold, and the amount of time the machine
can work for. The safety is always in question since the chip
is implanted on such a fragile part of the human body. Also
the issue as stated before about the use of invasive and
noninvasive approaches is always open to questioning. The
security is also an ethical concern. Since it is placed on the
brain, the holder of all information in the body, a computer
chip may be able to access private information from the
brain [6]. Furthermore, the time it can work before needing
to be reprogrammed is unethical at times because it
frequently needs adjusting. At points, the machine needs to
be reprogrammed after individual uses [1]. Now, the
scenario mentioned in the beginning will be examined in
depth using codes of ethics and case studies in the past,
along with other sources that can help decide if the scenario
is ethical.
BREAKDOWN OF SCENARIO WITH
CODES OF ETHICS
The most important thing to realize when looking at
codes of ethics is that codes of ethics are based on moral
rules rather than legal rules. This leads to a more difficult
examination [7]. To look more in depth at these rules,
official codes of ethics of engineering as a profession and as
a specialty must be explored in detail. The statements in
code of ethics are guidelines of moralities and instructions to
assess different scenarios that have not arisen in that exact
fashion before.
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The main professional ethical obligation of a
biomedical engineer, according to the Biomedical
Engineering Society Code of Ethics is to “use their
knowledge, skills, and ability to enhance safety, health, and
welfare of the public [8].” In the case being examined, the
man’s wife has minor brain damage. This becomes a huge
ethical question because BMI, being a more recent
invention, never being tested on anyone with brain damage,
can jeopardize the health of a person where consequences
are unknown. The code also states that biomedical engineers
must “comply fully with legal, ethical, institutional,
governmental, and other applicable research guidelines [8].”
Testing a new invention on a patient with very little
experimental research would not comply with ethical
research guidelines, as stated above. As stated before, the
amount of research needed to get the machine to the place it
is now was already an incredible amount as shown by doing
research on two different animals before even considering
testing on humans. Now, if it were taken into account that a
machine like this would be used on humans in a manor not
tested before, it would obviously appear unethical. To make
this situation ethical, I would need to prolong the
implantation of the chip in order to do more background
research and tests to ensure the safety of the device. The
Code of Ethics of Engineers also states the “engineers shall
advise their clients when they believe a project will not be
successful [9].” Based on the limited research, I would
immediately inform the man that the project may not be
successful.
In my position, I would reference back to see if any
other similar cases arose in the past. Case histories are of
major importance when engineers are trying to meet their
ethical obligations [10]. In one source found in research of
this topic, many case studies were reviewed [11]. The
source was examined to see if any similar studies were
found. One case was found in which a patient named Ben
also had a stroke and suffered minor cognitive impairment.
The case is stated to need extra care because the man was
suffering from an illness and more sensitive [11]. After
further review of the case and its details, the scenario was
not deemed ethical or unethical. Many aspects were brought
up but were not enough to sway the decision to ethical or
unethical. To make this an ethical scenario, after the
research is done and the BMI is ready to be implanted, a
legal representative for the test subject would need to be
present in order to sign off on the procedure.
In Ben’s case, the question of coercion is brought up
since his cognitive impairment does not make him the most
suitable to sign off on himself to be a subject of the
experiment [11]. Although the same thing happens in the
case of the man and his wife, their case is more ethical since
the man is a better representative for his wife. However,
even though the part of the man in this scenario seems
ethical as well, it is indeed not. According to the Code of
Ethics for Engineers, Part Five of Rules of Practice states the
“Engineers shall not offer, give, solicit, or receive, either
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directly or indirectly accept any contribution to influence the
award by public authority [9].” The man, being the
corporate executive of a local big business, is considered a
public authority figure, and accepting his sum of money to
do his job, would be unethical. The job of an engineer is to
serve the public to enhance the quality of their life.
Although this scenario would enhance the quality of life for
the public if it is successful, the Biomedical Engineering
Society Code of Ethics states that the engineer must
“consider the larger consequences of their work in regard to
cost, availability, and delivery of health care [8].” The
scenario is, at this point unethical, because the cost would be
fairly expensive, the equipment not available in full, and the
health care was never delivered at this level before, making
the consequences unknown. To make this scenario ethical,
the man could fund research of the new invention working
on a person with minor brain damage to contribute to its
success but there would be no promises that the piece of
equipment will be a success.
After further review of the scenario, it would be
deemed unethical at this point in time. It does not obey
some of the rules of Codes of Ethics for Engineers and the
Biomedical Society Code of Ethics. The main point of the
code of ethics is to keep the people safe and to use honesty
and morals when completing a job [9]. According to the
rules and the details represented from the codes of ethics and
other case studies of similar nature, I made a decision to tell
the man, that without further research, there would be
nothing I could do to help him at this time. Since one of the
number one rules about ethics is honesty, although I would
love to help his wife, I would need to tell him the truth and
not accept his large sum.
CONCLUSION
An ethical review of scenarios is the key to keeping
morals within a profession such as engineering. Guidelines
must be met to perfect the hard work and dedication of
engineers in translating it to the people. The goal of an
engineer is to improve some aspect of life. Engineering is a
job of the people, and moral codes keep the projects in line
to make sure too much power does not become gained from
the profession at the expense of the people, since the
engineers are working on new, innovative technologies.
Most of the time, an engineer can deem certain scenarios as
ethical or unethical strictly from past happenings and old
case studies. When new situations arise, the codes of ethics
allow engineers to make decision with help from their
interpretations and attempts at solving the problems.
Regardless if a scenario is deemed ethical or unethical at one
point in time, the innovative thinking strategies of engineers
will find ways to work through an unethical scenario and
make it an improvement in the quality of life of a vast
amount of human beings.
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ACKNOWLEDGEMENTS
The author would like to thank Beth Newborg for giving me
information about topics along with various case studies and
examples, and, Lindsey Osborne, from the writing center,
for reading my paper and helping me with various aspects of
it.
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