Prosthetic Ethics James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford CT [email protected]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
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Prosthetic Ethics James J. Hughes Ph.D. Executive Director, Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford.
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Prosthetic Ethics
James J. Hughes Ph.D.Executive Director, Institute for Ethics and Emerging Technologies
Public Policy Studies, Trinity College, Hartford CT
Committee on Ethical and Societal Issues in National Security Applications of Emerging TechnologiesNovember 2-3, 2011Beckman Center, National Academy of SciencesIrvine, CA
Institute for Ethics and Emerging Technologies 2011
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
Institute for Ethics and Emerging Technologies 2011
Are military IRBs’ reviews adequate to protect soldiers from experimental technologies
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
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
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
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
Privacy and Cybersecurity
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
Institute for Ethics and Emerging Technologies 2011
National security secrecy and corporate IP inhibit open source innovation, translation to application
See: 2005 EU Report “Ethical Aspects of ICT Implants in the Human Body”
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
Timing of Implants
Accelerating pace of innovationEspecially rapid
advances in biocompatible materials
Cochlear implantsCritical language windowDestruction of cochlear
tissue
Institute for Ethics and Emerging Technologies 2011
Institute for Ethics and Emerging Technologies 2011
Artificial Pancreas
Diabetes growing rapidly
Realtime blood sugar monitoring
Automated release of insulin
Implanted
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
Institute for Ethics and Emerging Technologies 2011
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
Implants for Depression & OCD
DepressionObsessive-compulsive
disorder
Institute for Ethics and Emerging Technologies 2011
Brain-Computer Interfaces
Institute for Ethics and Emerging Technologies 2011