Minding Rights: Mapping Ethical and Legal Foundations of 'Neurorights'.

The rise of neurotechnologies, especially in combination with artificial intelligence (AI)-based methods for brain data analytics, has given rise to concerns around the protection of mental privacy, mental integrity and cognitive liberty - often framed as "neurorights" in ethical, legal, and policy discussions. Several states are now looking at including neurorights into their constitutional legal frameworks, and international institutions and organizations, such as UNESCO and the Council of Europe, are taking an active interest in developing international policy and governance guidelines on this issue. However, in many discussions of neurorights the philosophical assumptions, ethical frames of reference and legal interpretation are either not made explicit or conflict with each other. The aim of this multidisciplinary work is to provide conceptual, ethical, and legal foundations that allow for facilitating a common minimalist conceptual understanding of mental privacy, mental integrity, and cognitive liberty to facilitate scholarly, legal, and policy discussions.

Intelligent decision support in medical triage: are people robust to biased advice?

BACKGROUND: Intelligent artificial agents ('agents') have emerged in various domains of human society (healthcare, legal, social). Since using intelligent agents can lead to biases, a common proposed solution is to keep the human in the loop. Will this be enough to ensure unbiased decision making? METHODS: To address this question, an experimental testbed was developed in which a human participant and an agent collaboratively conduct triage on patients during a pandemic crisis. The agent uses data to support the human by providing advice and extra information about the patients. In one condition, the agent provided sound advice; the agent in the other condition gave biased advice. The research question was whether participants neutralized bias from the biased artificial agent. RESULTS: Although it was an exploratory study, the data suggest that human participants may not be sufficiently in control to correct the agent's bias. CONCLUSIONS: This research shows how important it is to design and test for human control in concrete human-machine collaboration contexts. It suggests that insufficient human control can potentially result in people being unable to detect biases in machines and thus unable to prevent machine biases from affecting decisions.

Reflection Machines: Supporting Effective Human Oversight Over Medical Decision Support Systems.

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain "on the loop," by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes "reflection machines" (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM's functionality and the experiences of users working with it.

Intentional machines: A defence of trust in medical artificial intelligence.

Trust constitutes a fundamental strategy to deal with risks and uncertainty in complex societies. In line with the vast literature stressing the importance of trust in doctor-patient relationships, trust is therefore regularly suggested as a way of dealing with the risks of medical artificial intelligence (AI). Yet, this approach has come under charge from different angles. At least two lines of thought can be distinguished: (1) that trusting AI is conceptually confused, that is, that we cannot trust AI; and (2) that it is also dangerous, that is, that we should not trust AI-particularly if the stakes are as high as they routinely are in medicine. In this paper, we aim to defend a notion of trust in the context of medical AI against both charges. To do so, we highlight the technically mediated intentions manifest in AI systems, rendering trust a conceptually plausible stance for dealing with them. Based on literature from human-robot interactions, psychology and sociology, we then propose a novel model to analyse notions of trust, distinguishing between three aspects: reliability, competence, and intentions. We discuss each aspect and make suggestions regarding how medical AI may become worthy of our trust.

Superethics Instead of Superintelligence: Know Thyself, and Apply Science Accordingly.

The human species is combining an increased understanding of our cognitive machinery with the development of a technology that can profoundly influence our lives and our ways of living together. Our sciences enable us to see our strengths and weaknesses, and build technology accordingly. What would future historians think of our current attempts to build increasingly smart systems, the purposes for which we employ them, the almost unstoppable goldrush toward ever more commercially relevant implementations, and the risk of superintelligence? We need a more profound reflection on what our science shows us about ourselves, what our technology allows us to do with that, and what, apparently, we aim to do with those insights and applications. As the smartest species on the planet, we don't need more intelligence. Since we appear to possess an underdeveloped capacity to act ethically and empathically, we rather require the kind of technology that enables us to act more consistently upon ethical principles. The problem is not to formulate ethical rules, it's to put them into practice. Cognitive neuroscience and AI provide the knowledge and the tools to develop the moral crutches we so clearly require. Why aren't we building them? We don't need superintelligence, we need superethics.

Cognitive and affective probing: a tutorial and review of active learning for neuroadaptive technology.

OBJECTIVE: The interpretation of neurophysiological measurements has a decades-long history, culminating in current real-time brain-computer interfacing (BCI) applications for both patient and healthy populations. Over the course of this history, one focus has been on the investigation of cortical responses to specific stimuli. Such responses can be informative with respect to the human user's mental state at the time of presentation. An ability to decode neurophysiological responses to stimuli in real time becomes particularly powerful when combined with a simultaneous ability to autonomously produce such stimuli. This allows a computer to gather stimulus-response samples and iteratively produce new stimuli based on the information gathered from previous samples, thus acquiring more, and more specific, information. This information can even be obtained without the explicit, voluntary involvement of the user. APPROACH: We define cognitive and affective probing, referring to an application of active learning where repeated sampling is done by eliciting implicit brain responses. In this tutorial, we provide a definition of this method that unifies different past and current implementations based on common aspects. We then discuss a number of aspects that differentiate various possible implementations of cognitive probing. MAIN RESULTS: We argue that a key element is the user model, which serves as both information storage and basis for subsequent probes. Cognitive probing can be used to continuously and autonomously update this model, refining the probes, and obtaining increasingly detailed or accurate information from the resulting brain activity. In contrast to a number of potential advantages of the method, cognitive probing may also pose a threat to informed consent, our privacy of thought, and our ability to assign responsibility to actions mediated by the system. SIGNIFICANCE: This tutorial provides guidelines to both implement, and critically discuss potential ethical implications of, novel cognitive probing applications and research endeavours.

Free Wally: Where motor intentions meet reason and consequence.

To investigate the neural preparation and awareness of an intention to act, neuroscientists typically examine spontaneous movements: self-paced flexions of the hand or foot. However, these movements may not present a straightforward case of intended action as they are performed in absence of reasons to act and without the evaluation of action consequences. Therefore, a common criticism of these studies is that they lack ecological validity, because the results do not generalize to the more societally relevant deliberate actions that we perform in daily life. We agree that research on intended action should include reason-based deliberate actions in order to be more relevant for debates about human agency and free will. Therefore, we have developed a computer game called "Free Wally", which invites players to perform deliberate actions to achieve a goal. Free Wally provides a controlled environment for studying deliberate intended action, by presenting information for deciding whether or not to act, what action to perform and when to perform it, incorporating all basic components of an ecologically valid intended act. As a first step to validate our setup, we compare this game to a second computer game that measures spontaneous actions in a traditional way. While playing either game, the timing of the experienced intentions to act is measured using a real-time probing method. Moreover, the neural preparation for action is measured in terms of the (lateralized) readiness potential and alpha/beta event-related desynchronization across the motor cortex. No differences were found between the games in these last stages of action preparation, suggesting that the Free Wally game can be used to study intended action. However, differences in earlier stages during intention formation are to be expected. With Free Wally as a tool, we hope to encourage further research into the formation and content of ecologically valid motor intentions.

Author Correction: Brain leaks and consumer neurotechnology.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Probing for Intentions: Why Clocks Do Not Provide the Only Measurement of Time.

Having an intention to act is commonly operationalized as the moment at which awareness of an urge or decision to act arises. Measuring this moment has been challenging due to the dependence on first-person reports of subjective experience rather than objective behavioral or neural measurements. Commonly, this challenge is met using (variants of) Libet's clock method. In 2008, Matsuhashi and Hallett published a novel probing strategy as an alternative to the clock method. We believe their probe method could provide a valuable addition to the clock method because: it measures the timing of an intention in real-time, it can be combined with additional (tactile, visual or auditory) stimuli to create a more ecologically valid experimental context, and it allows the measurement of the point of no return. Yet to this date, the probe method has not been applied widely - possibly due to concerns about the effects that the probes might have on the intention and/or action preparation processes. To address these concerns, a 2 × 2 within-subject design is tested. In this design, two variables are manipulated: (1) the requirement of an introspection report and (2) the presence of an auditory probe. Three observables are measured that provide information about the timing of an intention to act: (1) awareness reports of the subjective experience of having an intention, (2) neural preparatory activity for action, and (3) behavioral data of the performed actions. The presence of probes was found to speed up mean action times by roughly 300 ms, but did not alter the neural preparation for action. The requirement of an introspection report did influence brain signals: reducing the amplitude of the readiness potential and increasing the desynchronization in the alpha and beta bands over the motor cortex prior to action onset. By discussing the strengths and weaknesses of the probe method compared to the clock method, we hope to demonstrate its added value and promote its use in future research.

Identifying Criteria for the Evaluation of the Implications of Brain Reading for Mental Privacy.

Contemporary brain reading technologies promise to provide the possibility to decode and interpret mental states and processes. Brain reading could have numerous societally relevant implications. In particular, the private character of mind might be affected, generating ethical and legal concerns. This paper aims at equipping ethicists and policy makers with conceptual tools to support an evaluation of the potential applicability and the implications of current and near future brain reading technology. We start with clarifying the concepts of mind reading and brain reading, and the different kinds of mental states that could in principle be read. Subsequently, we devise an evaluative framework that is composed of five criteria-accuracy, reliability, informativity, concealability and enforceability-aimed at enabling a clearer estimation of the degree to which brain reading might be realistically deployed in contexts where mental privacy could be at stake. While accuracy and reliability capture how well a certain method can access mental content, informativity indicates the relevance the obtainable data have for practical purposes. Concealability and enforceability are particularly important for the evaluation of concerns about potential violations of mental privacy and civil rights. The former concerns the degree with which a brain reading method can be concealed from an individual's perception or awareness. The latter regards the extent to which a method can be used against somebody's will. With the help of these criteria, stakeholders can orient themselves in the rapidly developing field of brain reading.

Cyclic Incrementality in Competitive Coevolution: Evolvability through Pseudo-Baldwinian Switching-Genes.

Coevolving systems are notoriously difficult to understand. This is largely due to the Red Queen effect that dictates heterospecific fitness interdependence. In simulation studies of coevolving systems, master tournaments are often used to obtain more informed fitness measures by testing evolved individuals against past and future opponents. However, such tournaments still contain certain ambiguities. We introduce the use of a phenotypic cluster analysis to examine the distribution of opponent categories throughout an evolutionary sequence. This analysis, adopted from widespread usage in the bioinformatics community, can be applied to master tournament data. This allows us to construct behavior-based category trees, obtaining a hierarchical classification of phenotypes that are suspected to interleave during cyclic evolution. We use the cluster data to establish the existence of switching-genes that control opponent specialization, suggesting the retention of dormant genetic adaptations, that is, genetic memory. Our overarching goal is to reiterate how computer simulations may have importance to the broader understanding of evolutionary dynamics in general. We emphasize a further shift from a component-driven to an interaction-driven perspective in understanding coevolving systems. As yet, it is unclear how the sudden development of switching-genes relates to the gradual emergence of genetic adaptability. Likely, context genes gradually provide the appropriate genetic environment wherein the switching-gene effect can be exploited.

Detecting traces of consciousness in the process of intending to act.

An intention to act has different onsets when it is measured in different ways. When participants provide a self-initiated report on the onset of their awareness of intending to act, the report occurs around 150 ms prior to action. However, when the same participants are repeatedly asked about their awareness of intending at different points in time, the onset of intending is found up to 2 s prior to action. This 'probed' awareness has its onset around the same time as the brain starts preparing the act, as measured using EEG. First of all, this undermines straightforward interpretations about the temporal relation between unconscious brain states and conscious intentions and actions. Secondly, we suggest that these results present a problem for the view that intentions are mental states occurring at a single point in time. Instead, we suggest the results to support the interpretation of an intention to act as a multistage process developing over time. This process of intending seems to develop during the process of acting, leaving reportable traces in consciousness at certain points along the road.

A Young Scientists' Perspective on DBS: A Plea for an International DBS Organization.

Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation (DBS) for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a centralized DBS organization. Such an organization makes it possible to 1) set up and maintain a repository, 2) facilitate DBS studies with a larger sample size, 3) improve communication amongst researchers, clinicians and ethical committees, and 4) improve communication between DBS experts and the public at large.

Lost in time...: The search for intentions and Readiness Potentials.

In 1983 Libet et al. found that the Readiness Potential (RP) precedes the intention to act by 350ms and the actual movement by 500ms on average. Using our own replication study, we illustrate how seemingly innocuous technical details are actually crucially relevant to the debate surrounding the interpretation of Libet-style experiments. For instance, using one specific method for determining the RP onset actually led to a reversal of Libet's results (i.e., the intention preceded the RP onset) for one of the participants. Claims regarding the causal relation between RP and intention cannot be based on averages, but require individual, case by case analyses, which show no exceptions in the temporal relation between RP and intention. We conclude that, properly speaking, Libet-style results in themselves cannot yet be taken as proof for the type of conclusions that are often formulated regarding the non-existence of free will.

Why we may not find intentions in the brain.

Intentions are commonly conceived of as discrete mental states that are the direct cause of actions. In the last several decades, neuroscientists have taken up the project of finding the neural implementation of intentions, and a number of areas have been posited as implementing these states. We argue, however, that the processes underlying action initiation and control are considerably more dynamic and context sensitive than the concept of intention can allow for. Therefore, adopting the notion of 'intention' in neuroscientific explanations can easily lead to misinterpretation of the data, and can negatively influence investigation into the neural correlates of intentional action. We suggest reinterpreting the mechanisms underlying intentional action, and we will discuss the elements that such a reinterpretation needs to account for.

Did My Brain Implant Make Me Do It? Questions Raised by DBS Regarding Psychological Continuity, Responsibility for Action and Mental Competence.

Deep brain stimulation (DBS) is a well-accepted treatment for movement disorders and is currently explored as a treatment option for various neurological and psychiatric disorders. Several case studies suggest that DBS may, in some patients, influence mental states critical to personality to such an extent that it affects an individual's personal identity, i.e. the experience of psychological continuity, of persisting through time as the same person. Without questioning the usefulness of DBS as a treatment option for various serious and treatment refractory conditions, the potential of disruptions of psychological continuity raises a number of ethical and legal questions. An important question is that of legal responsibility if DBS induced changes in a patient's personality result in damage caused by undesirable or even deviant behavior. Disruptions in psychological continuity can in some cases also have an effect on an individual's mental competence. This capacity is necessary in order to obtain informed consent to start, continue or stop treatment, and it is therefore not only important from an ethical point of view but also has legal consequences. Taking the existing literature and the Dutch legal system as a starting point, the present paper discusses the implications of DBS induced disruptions in psychological continuity for a patient's responsibility for action and competence of decision and raises a number of questions that need further research.

The Asilomar Survey: Stakeholders' Opinions on Ethical Issues Related to Brain-Computer Interfacing.

Brain-Computer Interface (BCI) research and (future) applications raise important ethical issues that need to be addressed to promote societal acceptance and adequate policies. Here we report on a survey we conducted among 145 BCI researchers at the 4th International BCI conference, which took place in May-June 2010 in Asilomar, California. We assessed respondents' opinions about a number of topics. First, we investigated preferences for terminology and definitions relating to BCIs. Second, we assessed respondents' expectations on the marketability of different BCI applications (BCIs for healthy people, BCIs for assistive technology, BCIs-controlled neuroprostheses and BCIs as therapy tools). Third, we investigated opinions about ethical issues related to BCI research for the development of assistive technology: informed consent process with locked-in patients, risk-benefit analyses, team responsibility, consequences of BCI on patients' and families' lives, liability and personal identity and interaction with the media. Finally, we asked respondents which issues are urgent in BCI research.