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An Analysis of the Impact of Brain-Computer Interfaces on Autonomy

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Abstract

Research conducted on Brain-Computer Interfaces (BCIs) has grown considerably during the last decades. With the help of BCIs, users can (re)gain a wide range of functions. Our aim in this paper is to analyze the impact of BCIs on autonomy. To this end, we introduce three abilities that most accounts of autonomy take to be essential: (1) the ability to use information and knowledge to produce reasons; (2) the ability to ensure that intended actions are effectively realized (control); and (3) the ability to enact intentions within concrete relationships and contexts. We then consider the impact of BCI technology on each of these abilities. Although on first glance, BCIs solely enhance self-determination because they restore or improve abilities, we will show that there are other positive, but also negative impacts on user autonomy, which require further philosophical and ethical discussions.

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Notes

  1. In the following we will refer to the more direct/invasive feedback methods when discussing closed loop BCIs.

  2. While it makes sense conceptually to distinguish between passive and (re-)active BCIs, this distinction might not be clear in real-world applications [35]. Implications of passive BCIs become especially troubling in settings where signals like a P300 might be used to extract information from a user that she or he does not actively want to share, see [40, 41].

  3. The term ‘self-determination’ indicates less strong conditions because a rule or law is absent, contrary to ‘autonomy’. A strong and normatively not neutral conception of autonomy as moral self-rule can be traced back to Kant’s account of autonomy, where moral reasoning according to principles that allow for universalizing the maxims of actions is required [44]. We think that the distinction between ‘self-determination’ and ‘autonomy’ is reasonable in many discussions of bioethics and should be made clear more often. Nevertheless, we will use both terms synonymously here, since the distinction is not relevant for the specific aim of this paper. Further, we do not discuss here, how Kant’s understanding of autonomy and of human dignity that must be ascribed to all beings capable of reason, can be reconciled with considering sub-abilities of autonomy. We presuppose that they can build two compatible perspectives on human autonomy.

  4. Volitions usually refer to some ‘inner activity’, with the power of producing changes of the world, usually including bodily movements [45]. Acting in accordance with one’s own reasons is a common presumption in current philosophical discussions about autonomy [46]. In the following, we will mostly refer to the term reasons, but we would like to avoid misunderstandings, which might result from the well-known controversy between philosophical traditions emphasizing the motivating force of reasons (e.g., Kant), or that of emotions or rather passions (e.g., Hume). Reasons can justify, motivate or explain an action; for many authors, reasons include the mental states of a pro-attitude and of a belief [47]. We do not use ‘reasons’ as a normatively laden term (as e.g., Kant) and do not want to neglect the role of emotions in motivating actions in the right way. The question what role emotions play and of how to control and cultivate the ‘right’, ethically appropriate emotions or affective states has been a key issue of discussions about autonomy throughout the history of philosophy, from Aristotle to Stoics, to Kant, etc. There is also a philosophical history, e.g., in the work of Husserl or Sartre, of conceptualizing emotions as intentional, as an important aspect of being in the world, and sometimes even as acts. We assume that emotions can influence non-consciously the attentional focus and decision-making, or the way an action is performed, and they can influence the modulation of behavioral dispositions [48, p. 58–63]. We won’t discuss it here, but we would say that emotions can not only influence in a non-conscious way (e.g., desires), but also inform our critical reflection, our evaluative judgments in important ways [48, 49]. Therefore, emotions also can be a relevant source of autonomous actions in reason-responsive conceptions of autonomy.

  5. Competence is a necessary condition in the conception of Beauchamp and Childress e.g., [57], which in accordance with the classic belief-desire model by Hume, is a property that is present when a person transforms her reasons into actions without external circumstances getting in the way, granted that these reasons are based on that person’s true beliefs. For Hume, it is clear that reasons have instrumental value and are the “slaves” of desires (or passions, in his terminology), which alone motivate our actions [62]. The endorsement of a person’s own reasons and the causal efficacy of her own reasons is also highly relevant, e.g., for coherentist conceptions of autonomy [50, 58, 59].

  6. There is an extensive and old debate about whether akratic actions exist at all and if so, how we can conceptualize them, see e.g., [63, 64].

  7. If we consider persons only as the product of social or external relations, there is little place for the ideas of the internalist conceptions of autonomy. It seems uncontroversial to suggest that individuals are influenced by social and external circumstances and to search for the autonomy-enabling external conditions is important in our view. Yet we grant space for the subject to gain distance from such influences, we find moderate accounts that still allow also for internalist conceptions of autonomy.

  8. As mentioned in Footnote 4, we do not use ‘reasons’ as a normatively laden term and furthermore do not exclude emotions in motivating actions in the right way.

  9. There are other activities where we focus on our brain activity (neuro-feedback training e.g.) in order to gain better results for a certain action.

  10. BCI applications that allow for a better perception of emotions compared to unaided humans is speculative. Nevertheless, emotion perception via BCI already is an aim of current research [39].

  11. Such BCIs could be described for all types, active, reactive and passive and such intelligent systems are under development; see e.g., [67].

  12. There are strong similarities here to the recent discussions of nudging, see e.g., [68, 69] and to discussions of restrictions of choice due to (non-conscious) manipulation [70].

  13. Similar questions have recently been discussed for closed-loop scenarios in BCIs [34, 72]. Goering et al. have pointed out that the user’s agency and autonomy can be undermined if she doubts her authorship of an action due to the way the machine operates [34].

  14. This is analogous to cases where DBS patients sometimes have to choose between symptom relief and neurological or psychological side effects [73].

  15. BCIs could then also be interpreted as an unusual technological option for ‘technologies of the self’, i.e. practices that are supposed to allow a person to gain a productive distance from her passions and desires, in order to augment the ability to carry out intended actions. Practices (usually not in combination with technologies like BCI) to control desires and passions in order to live a self-determined life have been discussed in philosophy since the ancient times, e.g., by Aristotle, the Stoics and in the last century by Foucault.

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Acknowledgments

Writing of this article was supported by a joint grant from the Federal Ministry of Education and Research (BMBF) in Germany, the Canadian Institutes of Health Research and the Fonds de recherche du Québec – Santé (European Research Projects on Ethical, Legal, and Social Aspects (ELSA) of Neurosciences) as well as a career award from the Fonds de recherche du Québec – Santé (ER). We would like to thank the anonymous reviewers for their in depth and constructive review of our paper and for very helpful comments, further we thank Stephanie Simpson, Rose Richards, Mary Clare O’Donnell and Christoph Bublitz for providing helpful comments on a previous version of this manuscript.

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  1. Institute for Ethics, History and Theory of Medicine at Ludwig Maximilian University (LMU), Lessingstr. 2, 80336, Munich, Germany

    Orsolya Friedrich, Steffen Steinert, Johannes Pömsl & Ralf J. Jox

  2. Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada

    Eric Racine

  3. Department of Medicine and Department of Social and Preventative Medicine, Université de Montréal, Montréal, QC, Canada

    Eric Racine

  4. Division of Experimental Medicine and Department of Neurology and Neurosurgery, McGill University, 110 avenue des Pins Ouest, Montréal, QC, H2W lR7, Canada

    Eric Racine

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Friedrich, O., Racine, E., Steinert, S. et al. An Analysis of the Impact of Brain-Computer Interfaces on Autonomy. Neuroethics 14, 17–29 (2021). https://doi.org/10.1007/s12152-018-9364-9

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