The following text is an extract from the
European Group on Ethics and New Technologies with the Swedish Professor Goran Hermerén as chairman, adopted and delivered to the
EU-Commission in March 2005.
The original text of approx 30 pages can be read here
Information and communication technologies (ICT) pervade our lives. Thus far, this pervasive influence has mainly involved devices that we use for private purposes or at the work place such as personal computers, mobile phones, laptops and the like. Due to new developments these devices are becoming more and more part of our bodies, either because we wear them (wearable computing) or because they are implanted in our bodies.
The idea of letting ICT devices get under our skin in order not just to repair but even to enhance human capabilities gives rise to science fiction vision with threat and/or benefit characteristics.
ICT devices are the products of human invention. The functions they achieve are based on algorithmic calculation mostly using non-biological substances such as silicon. This allows a simulation of some biological and psychic functions…Ethical awareness and analysis must take place now in order to ensure an appropriate and timely impact on the various technological applications.
SCIENTIFIC AND TECHNICAL BACKGROUND
This section contains information about implants in the human body that are available in commercial form and have been researched, in some cases, for decades.
- The term neurostimulation relates to technologies that do not directly stimulate a muscle as a functional electrical stimulation device. Rather neurostimulation technologies modify electrical nerve activity.
With a micro chip implant, constant monitoring would be possible. If each chip emitted a signal of a unique identity frequency, implanted individuals could be tracked by simply dialling up the correct signal. Because the receiver is mobile, the tagged individual could be tracked anywhere.
Medical devices
Biosensors or MEMS (Micro Electro-Mechanical System) devices are sensors implanted inside the human body for accurate monitoring of inaccessible parts of the body. The biosensors form a network and collectively monitor the health condition of their host…The information to be transmitted is crucial medical information that is required by law to be secure. Consequently, information technology is a critical component of these biological implants that, with the energy, memory and computational capabilities, present challenging research issues.
Brain-computer interface (BCI) or direct brain control: the technologies involved above are communication technologies: they take information from the brain and externalize it. There are internalizing technologies whose purpose is to take information from the outside and provide individual access to it.
Enhancement or commodity devices
Computer scientists have predicted that within the next twenty years neural interfaces will be designed that will not only increase the dynamic range of sensors, but will also enhance memory and enable cyber think – invisible communication with others.
Artificial Vision: according to recent research undertaken to develop an artificial retina, it will be possible, one day, to see light in the infrared.
Human Dignity
One can therefore reach the conclusion that dignity is a universal, fundamental and inescapable term of reference even though it should always be seen against a specific cultural background. This conclusion might be supported nowadays by underlining that dignity is referred to with ever-increasing frequency in the instruments adopted by international organisations representing all world cultures – such as UNESCO (indeed, dignity is mentioned fifteen times in the Universal Declaration on the Genome). From this standpoint, dignity is bound to become a cross cultural concept. However, one should take into account that there is also a message of ambiguity in the reference made to this word. Dignity is used both to convey the need for absolutely respecting an individual’s autonomy and rights and to support the claim to controlling individuals and their behaviour for the sake of values that someone plans to impose on other individuals.
- Non-instrumentalisation: The ethical requirement of not using individuals merely as a means but always as an end of their own.
- Privacy: The ethical principle of not invading a person’s right to privacy.
- Informed Consent: The ethical principle that patients are not exposed to treatment or research without their free will and informed consent.
- The Precautionary Principle: … This principle entails the moral duty of continuous risk assessment with regard to the not fully foreseeable impact of new technologies as in the case of ICT implants in the human body. This assessment concerns particularly the analysis of present and future situations in which the use of ICT implants in the human body may be considered as a potential risk, or even as a potential threat to human dignity or to other ethical principles. It should be stressed that there are no reliable scientific investigations concerning the long-term health aspect of ICT implants in the human body.
Autonomy and Limits on ICT Implants
As regards external controls and influence, autonomy of the individual becomes especially important in connection with the right to rule out that a person’s conduct may be determined and/or influenced by the entities managing electronic links – if the latter give rise to permanent connections with external entities.
ETHICAL BACKGROUND
Contemporary society is confronted with changes that have to do with the anthropological essence of individuals. There is a stepwise shift in progress – after being observed, via video surveillance and biometrics, individuals are being modified, via various electronic devices, under skin chips and smart tags, to such an extent that they are increasingly turned into networked individuals. Thus we might be continuously connected and could be configured differently so that from time to time we would transmit and receive signals allowing movements, habits and contacts to be traced and defined. This would be bound to modify the meaning and contents of an individuals’ autonomy and to affect their dignity.
This unrelenting erosion of personal prerogatives – going as far as transforming the body – co-exists not only with the growing attention paid to dignity, but also with the already mentioned fact that the person is at the centre of the constitutional order.
Value Conflicts
There could be a conflict between the personal freedom to use one’s economic resources to get an implant that will enhance one’s physical and mental capabilities and what society at large considers desirable or ethically acceptable. Another value conflict concerns the potential conflicts between limiting the freedom of people dangerous to others by surveillance and promoting the safety of others. Freedom of researchers may conflict with the obligation to safeguard the health of research subjects. Concern for economic competiveness and other economic values may come in conflict with respect for human dignity. The unrestricted freedom of some may endanger the health and safety for others…As in other areas, the freedom to use ICT implants in ones own body, i.e. the principle of freedom itself might collide with potential negative social effects. In these cases ethical counselling as well as social and political debate might be necessary…Legislation is necessary in order to avoid a situation in which society is becoming more and more dependent on such intrusive technology in order to provide social security while at the same time the technical perfection of such implants is helpful for all kinds of medical purposes as well as for legitimate social applications. Consequently, the EGE stresses the need for a continuing, inclusive debate on which kinds of enhancement should be allowed – under what conditions and in which situations.
It is clear from the preceding sections that there are important knowledge gaps that are relevant both to future research programmes and to the primary ethical concerns. These include:
Human Dignity, Integrity and Autonomy
- How far can such implants be a threat to human autonomy particularly when they are implanted in our brains?
- How far can such implants have irreversible impacts in the human body and/or in the human psyche and how can reversibility be preserved?
- How will they influence human memory?
- Does a human being cease to be such a ’being’ in cases where some parts of his or her body – particularly the brain – are substituted and/or supplemented by ICT implants? Particularly as ICT implants can contribute to creating ’networked persons’ that are always connected and could be configured differently so that from time to time they can transmit and receive signals allowing movements, habits and contacts to be traced and defined. This is bound to affect their dignity.
Privacy and Surveillance
- How far can ICT implants become a threat to privacy?
- How far can ICT implants give an individual, or a group, specific capabilities that could become a threat to society?
- What are the potential invasions of privacy through ICT implants as sources and/or receivers of information in a network environment?
- How far should we be subject to the control of such devices or by other people using these devices?
Enhancement and Human Self Awareness
- What lies behind the idea of an ’enhanced’ human being?
- What does perfectibility of human beings mean?
- Does the creation of an improved ’race’ on the basis of ICT enhancements mean necessarily a new form of racism? The potential industrial use of ICT implants raises the question of the limits of such implants for the creation of more efficient bodies and brains for economic purposes. The question of the use of ITC implants as a cultural leap in human evolution, similar to the invention of machines or to the invention of devices complementing and enhancing such devices as human memory (though writing, printing, digital technology) or other human capabilities.
- How far should the use of such implants to enhance human capabilities be allowed?
- How far can such implants be considered as a part of what can be called ’body design’ including the personal free design of one’s (enhanced) bodily and psychic capabilities?
Social Aspects
- How far do we transform our social and cultural environment through ICT implants.
- To what extent does this technology allow manipulation by and for advertising?
- To what extent might this technology be misused by the military?
ICT Implants for which Special Caution is Necessary
- ICT implants that cannot be removed easily.
- ICT implants that influence, determine or change psychic functions.
- ICT implants that due to their network capability could be misused in several ways for all kinds of social surveillance and manipulation, such as for instance in the case of children or disabled persons.
- ICT implants influencing the nervous system and particularly the brain and thus human identity as a species as well as individual subjectivity and autonomy.
- Military applications.
- ’Intrusive’ technology by-passes normal sensory experience.
-Implants that will influence biologically and/or culturally future generations.
Opinion No 17 on the ethical aspects of clinical research in developing countries
Most of the recommendations made in EGE Opinion No 17 on the ethical aspects of clinical research in developing countries are relevant to this Opinion is respect of clinical trials of ICT implants. This is particularly important as medical devices are not covered by Directive 200120EC of the European Parliament and of the Council of 4 April 2001 on the approximation of the laws, regulations and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of clinical trials on medicinal products for human use.
General Ethical Questions Relating to ICT Implants in the Human Body
In former Reports and Opinions such as ’Citizens Rights and New Technologies: A European Challenge’ (23 May 2000), and ’Ethical Issues of Healthcare in the Information Society’ (Opinion No 13, 30 July 1999), the Group has identified key ethical values with regard to information and communication technologies in particular.
- to improve the protection of privacy (data protection), respecting people’s right to maintain boundaries and also to preserve privacy, autonomy and confidentiality; and - to empower individuals against the introduction of systems likely to reduce their freedom and autonomy (video surveillance, behaviour control and personal profiling based on internet transactions) are likely to increase people’s dependency on selection and decision mechanisms which are not transparent or understandable.
Human beings are neither purely natural nor purely cultural beings. Indeed our very nature depends on the possibility of transforming ourselves. Information technologies have been considered under this anthropomorphic bias as extensions of man. However, the transformation of the human body has consequences also on the cultural human environment. Under these premises, human beings are seen as parts of a complex system of natural and artificial messages that function on a digital basis…In this sense the human body can be seen as data. This view has large cultural effects particularly as it precludes higher level phenomena such as human psyche and human language or conceives them mainly under the perspective of its digitalization, giving rise to reductionism that oversimplifies the complex relations between the human body, language and imagination…Extrapolating into the future, this logic might even lead to the transformation of the human race.
How far should we let ICT devices get ’under our skins’? When do ICT implants threaten the dignity of the human body, its identity and its basic capabilities?…When might such devices be used for instance for surveillance and in which cases would this be legitimate? Where are the threats related to the hopes of enhanced capability based on ICT implants?
The question of ITC implants in the human body is thus located between two extremes. On the one hand, the protection of the natural human body, that is to say, the medical use of ICT implants for health care, and, on the other hand, the elimination of the human body as we know it today and its substitution by an artificial one – with all possibilities in between. Human dignity concerns the human self as an embodied self. Thus the question of autonomy and respect of the self cannot be separated from the question of bodily care and the possible changes due to ICT implants.
EGE OPINION:
Against this background, the European Group on Ethics of Science and New Technologies submits the following Opinion:
At the same time, this is a permanently unfinished body. It can be manipulated to restore functions that either were lost or were never known – only think of maiming blindness, deafness; or, it can be stretched beyond its anthropological normality by enhancing its functions and/or adding new functions – again, for the sake of the person’s welfare and/or social competiveness, as in the case of enhanced sport skills or intelligence prostheses. We have to content with both repairing and capacity enhancing technologies, the multiplication of body-friendly technologies that can expand and modify the concept of body care and herald the coming of ’cyborgs’ – of the post-human body…The possibilities of customised configuration undoubtedly increase, and so do the opportunities for political measures aimed at controlling the body by means of technology.
The downright reduction of our body to a device does not only enhance the trend – already pointed out – towards turning it increasingly into a tool to allow continuous surveillance of individuals. Indeed, individuals are dispossessed of their own bodies and thereby of their own autonomy. The body ends up being under others’ control. What can a person expect after being dispossessed of his or her own body?
ICT IMPLANTS AND HUMAN DIGNITY
The respect for the human dignity must be the fundamental basis of discussions of where the limits should be drawn for different uses of ICT implants.
However, even in these cases, the use of such implants should not result in any discrimination or abuse contrary to human rights.
To the extent that an individual via an ICT implant has become part of an part of an ICT network, the operation of this whole network – not just the ICT implant – needs to be considered. It is particularly important that the power over this network is transparent. This is based on the principle of respect for persons, as well as the principle of avoiding harm.
Freedom of Research
Although the necessity for research can sometimes be questioned, new knowledge is essential for the development of individuals and societies. However, the freedom of research has to be restricted by respect for other important values and ethical principles, for example respect for persons and the obligation to avoid physical, mental and economic harm as a result of participation in research.
Participation in Research on ICT Implants
Informed consent is required when research on e.g. the effects of ICT implants is carried out on healthy volunteers or on patients. This information should not only concern possible benefits and present health risks, but also long term risks as well as risks that such implants can be used to locate people and/or obtain access to information stored in these devices without the permission of the person in whom the devices are implanted. The right to discontinue participation in a research project should always be respected, and it should be made clear to participants how this right will be respected, in practice.
Informed consent is an ethical principle which applies also in the field of ICT implants in the human body. However, this needs specification particularly in cases in which persons due to their age (children, elderly people) and/or psychic constitution are supposed to submit to ICT implants for reasons of health surveillance. ICT devices should be implanted in minors and legally incapacitated only if this is done in accordance with the principles set out in the Council of European Convention on Biomedicine and Human Rights.
There should be fair access to ICT implants for health purposes. This means that such access should be based on health care needs rather than on economic resources or social position.
Irreversible ICT Implants
The requirements of informed consent and data protection need to be strictly enforced in cases where the ICT implants are irreversible and cannot be removed from the body without risk of severe damage or the individual’s life. Such implants should not be used for research purposes unless the objective of the research is to provide a clear therapeutic benefit for the individual research subject.
Mental Functions and Personal Identity
Personal identity is crucial for the attribution of moral responsibility according to many ethical theories. ICT devices should therefore not be used to manipulate mental functions or change personal identity. The right to respect human dignity, including the right to respect of physical and mental integrity, is the basis for this.
The principles of data protection need to be applied to this area, since data about the human body can be generated via such implants. The privacy and confidentiality of such data need to be guaranteed. The individual has a right to determine what data about oneself is to be processed, by whom and for what purposes. In particular the right of the individual to decide who should have access to such data and for what purpose is crucial…The use of ICT implants in order to have a remote control over the will of people should be strictly prohibited.
The EGE stresses that the following possibilities should be banned:
- ICT implants used as a basis for cyber-racism.
- ICT implants used for changing the identity, memory, self perception and perception of others.
- ICT implants used to enhance capabilities in order to dominate others.
ICT Implants for Surveillance Purposes
ICT implants for surveillance in particular threaten human dignity. They could be used by state authorities, individuals and groups to increase their power over others. The implants could be used to locate people (and also to retrieve other kinds of information about them). This might be justified for security reasons (early release for prisoners) or for safety reasons (location of vulnerable children).
Development of the Information Society
The EGE considers that the ethical questions related to ICT implants in the human body are intimately related to the development of the Information Society as a whole. The EGE strongly supports the vision of a people-centred, inclusive and development-oriented Information Society as proclaimed in the Declaration of the World Summit on the Information Society (Geneva 2003).
Public Debate and Information
A broad social and political debate is needed as to what kind of applications should be accepted and legally approved, particularly concerning surveillance and enhancement. A precautionary approach is recommended by the EGE. The Member States and their national ethics councils have a responsibility to create conditions for education and constructive, well-informed debates in this area.
The European Group on Ethics in Science and New Technologies
The Chairperson: Göran Herméren
The Members:
Nicos C. Alivizatos, Inez de Beuaufort, Rafael Capurro, Yvon Englert, Catherine Labrusse-Riou, Anne M cLaren, Linda Nielsen, Pere Puigdomenech-Rosell, Stefano Rodota, Günter Virt and Peter Whittaker.
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