Neuroprosthetic Speech: The Ethical Significance of Accuracy, Control and Pragmatics.

Neuroprosthetic speech devices are an emerging technology that can offer the possibility of communication to those who are unable to speak. Patients with 'locked in syndrome,' aphasia, or other such pathologies can use covert speech-vividly imagining saying something without actual vocalization-to trigger neural controlled systems capable of synthesizing the speech they would have spoken, but for their impairment.We provide an analysis of the mechanisms and outputs involved in speech mediated by neuroprosthetic devices. This analysis provides a framework for accounting for the ethical significance of accuracy, control, and pragmatic dimensions of prosthesis-mediated speech. We first examine what it means for the output of the device to be accurate, drawing a distinction between technical accuracy on the one hand and semantic accuracy on the other. These are conceptual notions of accuracy.Both technical and semantic accuracy of the device will be necessary (but not yet sufficient) for the user to have sufficient control over the device. Sufficient control is an ethical consideration: we place high value on being able to express ourselves when we want and how we want. Sufficient control of a neural speech prosthesis requires that a speaker can reliably use their speech apparatus as they want to, and can expect their speech to authentically represent them. We draw a distinction between two relevant features which bear on the question of whether the user has sufficient control: voluntariness of the speech and the authenticity of the speech. These can come apart: the user might involuntarily produce an authentic output (perhaps revealing private thoughts) or might voluntarily produce an inauthentic output (e.g., when the output is not semantically accurate). Finally, we consider the role of the interlocutor in interpreting the content and purpose of the communication.These three ethical dimensions raise philosophical questions about the nature of speech, the level of control required for communicative accuracy, and the nature of 'accuracy' with respect to both natural and prosthesis-mediated speech.

Identity and conflicts in the ethics of neural implants / Identidad y conflicto en la ética de los implantes neuroprostéticos

The development of neuroprosthetics has given rise to significant theoretical and practical challenges concerning personal identity. The Extended Mind Theory (EMT) attempts to provide an answer to these challenges by arguing that the mind and the external world are co-extensive to the point that both can make a seamless unified entity. The EMT also proposes that physical states determine the nature of mental states. Here, we propose a non-deterministic and less locationist view of mental states that we will call iEMT. The iEMT articulates, firstly, that the co-extensivity of the mind and the world does not justify the dissolution of the mind in the objects of the external world with which the mind interacts. Consequently, the agent’s mind is still part of his unique personal identity. Secondly, neural implants cannot be regarded as mere replacement parts in the context of a weak concept of personal identity. Thirdly, there are no compelling reasons to believe or to fear that neuroprosthetics can alter personal identity at the profound level

El desarrollo de la tecnología neuroprostética está generando importantes problemas teóricos y prácticos relacionados con la identidad personal. En este contexto, la Extended Mind Theory (EMT) es una teoría que da una respuesta a dichos problemas señalando que la mente es coextensa con el mundo, y que como tal, la mente y el mundo se entremezclan hasta forman una única entidad. La EMT también presupone que los estados físicos determina la naturaleza de los estados mentales. En este artículo, proponemos una versión no determinista y aún menos locacionista de los estados mentales que la de la EMT a la que llamaremos iEMT. Defendemos, primero, que la coextensión de mente y mundo no justifica la disolución de la mente, y como consecuencia, de la identidad humana en el medio; segundo, que no está justificado pensar que los neuro-implantes constituyan simples piezas de reemplazo en el contexto de una identidad que llamamos débil; y tercero, que no hay razones de peso para creer, y en esa medida, para temer, que el uso de tecnología neuroprostética pueda alterar la identidad personal

Public understanding of neural prosthetics in Germany: ethical, social, and cultural challenges.

Since the development of the first neural prosthesis, that is, the cochlear implant in 1957, neural prosthetics have been one of the highly promising, yet most challenging areas of medicine, while having become a clinically accepted form of invasiveness into the human body. Neural prosthetic devices, of which at least one part is inserted into the body, interact directly with the nervous system to restore or replace lost or damaged sensory, motor, or cognitive functions. This field is not homogenous and encompasses a variety of technologies, which are in various stages of development. Some devices are well established in clinical practice and have become routine, such as cochlear implants. By comparison, other technologies are in experimental phases and still need to be further developed to achieve the desired results.