Being human in the time of neuroscience and artificial intelligence involve carefully exploring the nexuses of complexity where valid ideas are nevertheless in tension, manifesting subtleties and challenges that must not be overlooked. Each page expresses the existing tension(s) between ideas and within each theme, which emerged in the collective discussions, and are then complemented by insights from NHNAI network researchers.
Complexity on Health #5: Finding the right balance between innovation and safety
Some participants in the discussions pointed out that it is in the nature of humans to constantly seek to progress and improve. Participants also recognize that advances in AI and neuroscience in the healthcare field may enable us to increase our physical and mental capacities (notably with neurological prostheses or implanted brain-machine interfaces). These technologies could also prevent the loss of capacity associated with aging. Similar practices (with hip or articular prostheses) are already widely accepted in society. We can therefore imagine that more recent possibilities linked to AI and neuroscience (such as brain implants) could also eventually become acceptable.
Nevertheless, discussions also highlight risks of addiction, or other side effects such as changes in personality, or impaired decision-making abilities.
It is important to properly assess the benefits-risks balance.
Insights from NHNAI academic network:
As Brian P. Green suggests, this nexus of complexity, with its tension between a possible drive for humans to improve themselves and the asserted need for limitations when it comes to medical or neurological enhancement, raises deep questions such as: How do we know when an enhancement is justified or not? When does an intervention make us more human and when does an intervention make us less human? What role does “naturalness” play in this determination, and what is “natural” to humans?
To help exploring them, we may draw upon insights from neuroscience first, to then deepen some ethical issues.
A. A clarification from neuroscience
Most medical implants aim at compensating a specific mechanism that has been damaged by neurogenerative disease (ex: Parkinson’s) but have revealed to imply a dis-regulation on some other aspect of our behavior (addiction, impulsivity, identity-loss…). These interventions have been justified to compensate the loss of a capacity. Applying the same brain-implant devices for enhancing certain capacities is problematic, not only on an ethical perspective of equal access to these means, but also because it downplays the importance of effort in the achievement of learning for behavior. It shortcuts the rest of the body with whom our brain fully interacts and develops its functional specificities. The development of these implants for motor-handicap like tetraplegic patients is very appealing and is no doubt fully justified. But considering that other cognitive capacities could be boosted through these implants by short-cutting the body is against the modus-operandi of the nervous system. Engaging in these efforts has the risk of making belief to the general public that our mental/psychological capacities behave like independent modules in the brain, which is exactly what current neuroscience research is contradicting through its most recent findings. It is thus important to inform the public on how neurosciences show the intrinsic link between brain-body and that learning, and development of our mental and behavioral capacities require effort (and may entrain frustration in the process). The view of a brain with defined modules that manage independently certain high-level cognitive functions is false. And promoting neurotechnological artefacts with the false view of how the system works is equal to propagating fake scientific knowledge.
B. Ethical issues
The development of enhancement technologies carries with it a real risk of dependency, both psychological and physiological. Continuous use of implanted cognitive enhancement devices can lead to dependencies similar to those already observed today with stimulants. The constant quest for perfection may also blur the distinction between need and desire.[1] Such dependence not only raises medical issues but also questions about its long-term impact on autonomy and mental health.
The modification of brain function by external devices can also lead to disruptions in personality and behavior. Enhanced memory or decision-making via brain-machine interfaces (BMIs) could be accompanied by changes in self-perception, social interactions, personality traits, as well as identity in general.[2] These alterations could also concern critical thinking, judgment or emotional responses, with possible impacts on decision-making, thus opening up ethical questions regarding the maintenance of individuals’ personal responsibility.[3]
It is therefore extremely important to make the development of enhancement technologies conditional on precautionary measures and rigorous testing, both medically and psychologically/socially. The challenge is to ensure that these technologies do not undermine the autonomy and identity they are designed to reinforce.
[1] Schermer, M. (2009). The mind and the machine: On the conceptual and moral implications of brain–machine interaction. NanoEthics, 3(3), 217-230.
[2] Ienca, M., & Andorno, R. (2017). Towards new human rights in the age of neuroscience and neurotechnology. Life Sciences, Society and Policy, 13(1).
[3] Fukushi, T., Sakura, O., & Koizumi, H. (Eds.). (2007). The ethics of brain-computer interfaces and human enhancement. Dordrecht: Springer.
