Editing Neurotechnology (section)

==Ethical considerations==
{{See also|Neuroethics|Brain implant#Concerns and ethical considerations}}
Like other [[disruptive innovation]]s, neurotechnologies have the potential for profound social and legal repercussions, and as such their development and introduction to society raise a series of ethical questions.<ref name=":3">{{Cite news| vauthors = Al-Rodhan N |date=27 May 2021|title=The Rise of Neurotechnology Calls for a Parallel Focus on Neurorights|work=[[Scientific American]]|url=https://www.scientificamerican.com/article/the-rise-of-neurotechnology-calls-for-a-parallel-focus-on-neurorights/|access-date=25 Oct 2021}}</ref><ref name=":4">{{cite journal | vauthors = Bublitz C, Wolkenstein A, Jox RJ, Friedrich O | title = Legal liabilities of BCI-users: Responsibility gaps at the intersection of mind and machine? | journal = International Journal of Law and Psychiatry | volume = 65 | pages = 101399 | date = 2019-07-01 | pmid = 30449603 | doi = 10.1016/j.ijlp.2018.10.002 | url = https://www.sciencedirect.com/science/article/pii/S0160252718300852 | series = Neuroscience, Law, and Ethics | s2cid = 53950001 | url-access = subscription }}</ref><ref name="pmid29326561" />

Key concerns include the preservation of identity, agency, cognitive liberty and privacy as [[wikt:neuroright#Noun|neurorights]]. While experts agree that these core features of the human experience stand to benefit from the ethical use of neurotechnology, they also make a point of emphasizing the importance of preventively establishing [[Neurolaw|specific regulatory frameworks]] and other mechanisms that protect against inappropriate or unauthorized uses.<ref name=":12" /><ref name=":3" /><ref>{{cite journal | vauthors = Yuste R, Goering S, Arcas BA, Bi G, Carmena JM, Carter A, Fins JJ, Friesen P, Gallant J, Huggins JE, Illes J, Kellmeyer P, Klein E, Marblestone A, Mitchell C, Parens E, Pham M, Rubel A, Sadato N, Sullivan LS, Teicher M, Wasserman D, Wexler A, Whittaker M, Wolpaw J | display-authors = 6 | title = Four ethical priorities for neurotechnologies and AI | journal = Nature | volume = 551 | issue = 7679 | pages = 159–163 | date = November 2017 | pmid = 29120438 | pmc = 8021272 | doi = 10.1038/551159a | bibcode = 2017Natur.551..159Y }}</ref>

=== Identity ===
Identity in this context refers to [[Personal identity#Continuity of consciousness|personal continuity]], described as [[Bodily integrity|bodily]] and mental integrity and their persistence over time. In other words, it is the individual's [[Narrative identity|self-narrative]] and concept of self.

While disruption of identity is not a common goal for neurotechnologies, some techniques can create unwanted shifts that range in severity. For instance, deep brain stimulation is commonly used as treatment for [[Parkinson's disease]] but can have side effects that touch on the concept of identity, such as loss of voice modulation, increased impulsivity or feelings of self-estrangement.<ref name=":12" /><ref>{{cite journal | vauthors = Pham U, Solbakk AK, Skogseid IM, Toft M, Pripp AH, Konglund AE, Andersson S, Haraldsen IR, Aarsland D, Dietrichs E, Malt UF | display-authors = 6 | title = Personality changes after deep brain stimulation in Parkinson's disease | journal = Parkinson's Disease | volume = 2015 | pages = 490507 | date = 2015-01-29 | pmid = 25705545 | pmc = 4325225 | doi = 10.1155/2015/490507 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Pugh J, Maslen H, Savulescu J | title = Deep Brain Stimulation, Authenticity and Value | journal = Cambridge Quarterly of Healthcare Ethics | volume = 26 | issue = 4 | pages = 640–657 | date = October 2017 | pmid = 28937346 | pmc = 5658726 | doi = 10.1017/S0963180117000147 }}</ref><ref>{{Cite journal| vauthors = Gilbert F, Goddard E, Viaña JN, Carter A, Horne M |date=2017-04-03|title=I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation |journal=AJOB Neuroscience|volume=8|issue=2|pages=96–109|doi=10.1080/21507740.2017.1320319|s2cid=55652038|issn=2150-7740|doi-access=free}}</ref> In the case of neural prostheses and brain-computer interfaces, the shift may take the form of an extension of one's sense of self, potentially incorporating the device as an integral part of oneself or expanding the range of sensory and cognitive channels available to the user beyond the traditional [[sense]]s.<ref name=":12" /><ref>{{cite journal | vauthors = Hildt E | title = Multi-Person Brain-To-Brain Interfaces: Ethical Issues | journal = Frontiers in Neuroscience | volume = 13 | pages = 1177 | date = 5 Nov 2019 | pmid = 31827418 | pmc = 6849447 | doi = 10.3389/fnins.2019.01177 | doi-access = free }}</ref>

Part of the difficulty in determining which changes constitute a threat to identity is rooted in its dynamic nature: since one's personality and concept of self is expected to change with time as a result of emotional development and lived experience, it is not easy to identify clear criteria and draw a line between acceptable shifts and problematic changes.<ref name=":12" /><ref name=":2">{{cite journal | vauthors = Baylis F | title = "I Am Who I Am": On the Perceived Threats to Personal Identity from Deep Brain Stimulation | journal = Neuroethics | volume = 6 | issue = 3 | pages = 513–526 | date = 2013-12-01 | pmid = 24273621 | pmc = 3825414 | doi = 10.1007/s12152-011-9137-1  }}</ref> This becomes even harder when dealing with neurotechnologies aimed at influencing psychological processes—such as those designed to recude the symptoms of depression or post-traumatic stress disorder (PTSD) by modulating emotional states or saliency of memories to ease a patient's pain.<ref name=":5">{{cite journal | vauthors = Steinert S, Friedrich O | title = Wired Emotions: Ethical Issues of Affective Brain-Computer Interfaces | journal = Science and Engineering Ethics | volume = 26 | issue = 1 | pages = 351–367 | date = February 2020 | pmid = 30868377 | pmc = 6978299 | doi = 10.1007/s11948-019-00087-2  }}</ref><ref>{{cite journal | vauthors = Bassil KC, Rutten BP, Horstkötter D | title = Biomarkers for PTSD Susceptibility and Resilience, Ethical Issues | journal = AJOB Neuroscience | volume = 10 | issue = 3 | pages = 122–124 | date = 2019-07-03 | pmid = 31361197 | doi = 10.1080/21507740.2019.1632964 | s2cid = 198982833  | url = https://cris.maastrichtuniversity.nl/en/publications/789df5c5-dfda-44be-b7cb-12fb371e4742 }}</ref> Even helping a patient remember, which would seemingly help preserve identity, can be a delicate question: "Forgetting is also important to how a person navigates the world, since it allows the opportunity for both losing track of embarrassing or difficult memories, and focusing on future-oriented activity. Efforts to enhance identity through memory preservation thus run the risk of inadvertently damaging a valuable, if less consciously-driven cognitive process."<ref name=":12" />

=== Agency ===
Although the nuances of its definition are debated in [[Agency (philosophy)|philosophy]] and [[Agency (sociology)|sociology]],<ref>{{Cite book| vauthors = Wilson G, Shpall S |title=[[Stanford Encyclopedia of Philosophy|The Stanford Encyclopedia of Philosophy]]|publisher=Metaphysics Research Lab, [[Stanford University]]|year=2016| veditors = Zalta EN |edition=Winter 2016|chapter=Action|chapter-url= https://plato.stanford.edu/archives/win2016/entries/action/}}</ref> agency is commonly understood as the individual's ability to consciously make and communicate a decision or choice. While identity and agency are distinct, an impairment in agency can in turn undermine personal identity: the subject may no longer be able to substantially modify their own self-narrative, and may therefore lose their ability to contribute to the dynamic process of identity formation.<ref name=":2" />

The interplay between agency and neurotechnology can have implications for moral responsibility and legal liability.<ref>{{Cite journal| vauthors = Haselager P |date=2013-08-01|title=Did I Do That? Brain–Computer Interfacing and the Sense of Agency|journal=Minds and Machines|language=en|volume=23|issue=3|pages=405–418|doi=10.1007/s11023-012-9298-7|s2cid=7199782|issn=1572-8641|hdl=2066/116450|hdl-access=free}}</ref><ref name=":4" /> As with identity, devices aimed at treating some psychiatric conditions like depression or anorexia may work by modulating neural function linked with desire or motivation, potentially compromising the user's agency.<ref name=":5" /><ref>{{Cite journal| vauthors = Goering S, Klein E, Dougherty DD, Widge AS |date=2017-04-03|title=Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry |journal=AJOB Neuroscience|volume=8|issue=2|pages=59–70|doi=10.1080/21507740.2017.1320320|s2cid=6176406|issn=2150-7740}}</ref> This can also be the case, paradoxically, for those neurotechnologies designed to restore agency to patients, such as neural prostheses and BCI-mediated [[assistive technology]] like wheelchairs or [[computer accessibility]] tools.<ref>{{cite journal | vauthors = Sellers EW, Vaughan TM, Wolpaw JR | title = A brain-computer interface for long-term independent home use | journal = Amyotrophic Lateral Sclerosis | volume = 11 | issue = 5 | pages = 449–55 | date = October 2010 | pmid = 20583947 | doi = 10.3109/17482961003777470 | s2cid = 4713118  }}</ref><ref>{{cite journal | vauthors = Ajiboye AB, Willett FR, Young DR, Memberg WD, Murphy BA, Miller JP, Walter BL, Sweet JA, Hoyen HA, Keith MW, Peckham PH, Simeral JD, Donoghue JP, Hochberg LR, Kirsch RF | display-authors = 6 | title = Restoration of reaching and grasping movements through brain-controlled muscle stimulation in a person with tetraplegia: a proof-of-concept demonstration | journal = Lancet | volume = 389 | issue = 10081 | pages = 1821–1830 | date = May 2017 | pmid = 28363483 | pmc = 5516547 | doi = 10.1016/s0140-6736(17)30601-3}}</ref> Because these devices often operate by interpreting sensory inputs or the user's neural data in order to estimate the individual's intention and respond according to it, estimation margins can lead to inaccurate or undesired responses that may threaten agency: "If the agent's intent and the device's output can come apart (think of how the auto-correct function in texting sometimes misinterprets the user's intent and sends problematic text messages), the user's sense of agency may be undermined."<ref name=":12" />

===Privacy===
Finally, when these technologies are being developed society must understand that these neurotechnologies could reveal the one thing that people can always keep secret: what they are thinking. While there are large amounts of benefits associated with these technologies, it is necessary for scientists, citizens and policy makers alike to consider implications for privacy.<ref name="Wolpe2005">{{cite journal | vauthors = Wolpe PR, Foster KR, Langleben DD | title = Emerging neurotechnologies for lie-detection: promises and perils | journal = The American Journal of Bioethics | volume = 5 | issue = 2 | pages = 39–49 | year = 2005 | pmid = 16036700 | doi = 10.1080/15265160590923367 | url = https://repository.upenn.edu/cgi/viewcontent.cgi?article=1005&context=neuroethics_pubs | s2cid = 219640810 }}</ref> This term is important in many ethical circles concerned with the state and goals of progress in the field of neurotechnology (see [[neuroethics]]). Current improvements such as "brain fingerprinting" or lie detection using EEG or fMRI could give rise to a set fixture of loci/emotional relationships in the brain, although these technologies are still years away from full application.<ref name="Wolpe2005"/> It is important to consider how all these neurotechnologies might affect the future of society, and it is suggested that political, scientific, and civil debates are heard about the implementation of these newer technologies that potentially offer a new wealth of once-private information.<ref name="Wolpe2005"/> Some ethicists are also concerned with the use of TMS and fear that the technique could be used to alter patients in ways that are undesired by the patient.<ref name="Illes2006" />

===Cognitive liberty===
[[Cognitive liberty]] refers to a suggested right to [[self-determination]] of individuals to control their own mental processes, cognition, and consciousness including by the use of various neurotechnologies and psychoactive substances. This perceived right is relevant for reformation and development of associated laws.