Wednesday, May 26, 2021

Brain Implants and Who We Become After

Environmental & Science Education, STEM, Health, Medicine, Brain, Ethics

Ed Hessler

It turns out that implanted neural devices can influence a person's identity.

In The New Yorker article by Christine Kenneally, the experience of two patients is told. One is discussed in detail and tells the story of a patient who underwent neurosurgery to have a silicone strip...studded with sixteen electrodes...:wires from then" were placed under her skin, "behind her ear and down her neck to connect with a device...implanted in her chest. This device would receive the data recording (her) neural activity and transmit it wirelessly to an external processing unit." Signals from this device would alert the patient to an imminent episode (providing a 15 minute window).

The simple goal of improving her life seems simple but "the effect," made her "feel like an entirely new person. She had never had a self that she could trust before." She described this experience to Kenneally. "'We were calibrated together. We became one.'" Unfortunately three years after the surgery this ended. The company ran "out of funding and ceased operations." The device had to be removed.

The device had done its job well, telling her "'what I needed to know.' If the warning light came on, she took anti-seizure medication; the algorithm's predictive power was such that there was enough time for the medication to be absorbed. As a result, she didn't have seizures."

Two years later, philosopher Frederic Gilbert (University of Tasmania) called her and ultimately went to interview her. Based on interviews with her and other patients, Gilbert has come to believe that brain-computer interfaces "work together," creating "a new person...--a de-novo identity, a symbiosis of machine and mind."

Gilbert has also talked with other patients in the trial who did not love "their device" in the same way, in fact in one patient reported on in the essay, "her antipathy to her device was almost instant." She hated everything about it: the implants-brain and chest, carrying "the external unit around," and "worst of all, the unit's warning light (which) flashed at her all the time." She thought it was faulty but "it was correctly prediciing as many as a hundret tiny seizures a day. Neither she nor her doctors had had any idea that she was so affected." She "sank again into depression" and "when it was finally removed, she was enormously relieved."

Gilbert says "that we are only just starting to understand how a person's selfhood can affect--and be affected by--an intelligent neural device." These devices affect patients and are affected by the patient." After a period of acclimitization the unit begins to learn, allowing "the fine-tune the algorithm to the unique electrical signatures of "the patient's brain, ' reading the interface to move from observation to prediction.

Kenneally's essay is fine-grained, nuanced and rich with details about the patients, the use of neural implants, the brain, Gilbert's research, including his personal history, and more about invasive brain technologies and for these reasons you must read the article which is endlessly fascinating. There is a discussion of Gilbert's worries such as "the medical-device industry" having "too much influence on how trials have been run.. "All trials should express interest in the autonomy of a patient after implantation."  And, obviously, patients should be helped in understanding the risks involved.

The patient who loved the device and the person she became as a result notes that "'losing (the device) was terrible, but, looking back on it now, what I've gained from it is valuable. Would I have another one? Yes, I would love it.'"

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