3 years – ERA-NET Neuron, CIHR
The project will address intelligent neuroprostheses, which represent the next phase in the evolution of devices integrated with the nervous system to assist, replace or alter human sensory, motor, cognitive, and affective functions. These devices include “read out” or output systems that detect, interpret and translate neural signals for various applications such as to move a robotic arm or cursor. They also include “write in” or input systems that deliver signals or stimulation to the brain to alter thinking, emotions, and the ability to move. The technology increasingly incorporates Artificial Intelligence (AI) to create devices characterized by mutual adaptation, in which both user and self-learning algorithm change over time to optimize system output. The integration of AI with human brains and minds into hybrid minds is a departure in terms of its complexity, unpredictability, and psychological impact. Our project pursues a unified theoretical approach to the ethical-legal assessment of intelligent neuroprostheses, informed by the perspectives of users, the neuroengineering community and other key stakeholders, culminating in the questions: Which AI-elements should future neuroprostheses incorporate or leave out? What technical design choices or regulatory measures are required to proceed safely? How can we support patients in clinical decision-making to avoid overblown hopes and to know, to borrow Thomas Nagel’s famous phrase, “what it’s like to have a hybrid mind”?
Neurosurgery for psychiatric disorders (NPD), also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This project considers NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law (what should be regulated), what types of regulations are required (eligibility criteria, approval procedures, data collection and oversight mechanisms), and how to approach international harmonization given the potential migration of researchers and patients.
A minority of patients treated with deep brain stimulation for Parkinson’s disease develop impulse control disorders that can be quite disruptive to personal and professional relationships and patient functioning. This can often be addressed by modifying stimulation parameters. However, as these treatments expand to other conditions and the technology shifts, the management of unintended mental and behavioural side effects becomes more and more important. In particular, changes that alter personality without making a person incapable pose real challenges because they may be welcome to the patient even if prior to the treatment-induced change the patient would not have welcomed the change and its effects on personal relationships. This project considers legal and technological means of adjudicating the temporal dispute between the patient prior to and after the personality change brought about by treatment.
Mind-reading technologies are a staple of dystopian fiction, particularly when applied to people either coercively or surreptitiously. At the same time, they could also offer help to people with severe communication impairments. The two-sided potential of these technologies points to the need to consider the social, ethical and legal questions that arise with the developing field of communication neurotechnology. Communication neurotechnology could assist those with severe mobility impairments that prevent speech production (e.g. people with ALS, locked-in syndrome). Those in this group with some preserved motor control can use technologies such as [spellers, eye-gaze trackers, augmentative and alternative communication AAC]. However, these may be quite cumbersome and restrictive depending upon the technology and degree of impairment. Those with no preserved voluntary motor function (e.g. late ALS, progressive supranuclear palsy, MCS) may lack effective communication options. The development of communication neurotechnologies that detect signals directly from the brain could be revolutionary for both groups and possibly also for other types of problems with speech production such as some types of aphasia. This project focuses on the detection of imagined speech and considers three key dimensions of communication that we regard as particularly consequential: communication as testimony or evidence, communication as means of agency and participation, and communication as a form of harm in itself (to the communicator or to others).
Increased use of machine learning in medical decision-making offers many potential advantages, including improved accuracy and efficiency. However, it is only as good as its models, and there are concerns that it could replicate or exacerbate existing patterns of bias in ways that are difficult to detect. This project examines the manner in which the laws of negligence and the legal protection against discrimination in the delivery of medical services provided by provincial human rights codes might apply in this context.
Increased use of machine learning in medical decision-making offers many potential advantages, including improved accuracy and efficiency. However, it is only as good as its models, and there are concerns that it could replicate or exacerbate existing patterns of bias in ways that are difficult to detect. This project examines the manner in which the laws of negligence and the legal protection against discrimination in the delivery of medical services provided by provincial human rights codes might apply in this context.
In addition to multiple policy contributions in the area of organ donation and transplantation (listed [here]), I am active in a range of policy forums related to the brain sciences and mental health.
