Ethical Aspects of ICT Implants in the Human Body

1
Ethical Aspects of ICT Implants in the Human Body

• Rafael Capurro
• Distinguished Researcher in Information Ethics,
  School of Information Studies, University of
  Wisconsin-Milwaukee, USA
• IEEE Symposium on Technology and Society
  (ISTAS10)
• University of Wollongong, New South Wales,
  Australia
• June 7-9, 2010

2
Overview

• Introduction
• EGE Opinion No 20
• Scientific and technical background
• Legal Aspects
• Ethical Aspects
• Prospects

3
Introduction

• The European Group on Ethics in Science and New
  Technologies to the European Commission

4
Introduction

• The Group is a neutral, independent, pluralist
  and multidisciplinary body, composed of fifteen
  experts appointed by the Commission for their
  expertise and personal qualities.

5
Introduction

• The task of the Group is to examine ethical
  questions arising from science and new
  technologies and on this basis to issue Opinions
  to the European Commission in connection with the
  preparation and implementation of Community
  legislation or policies.

6
Introduction

• In order to face the ethical issues that are
  arising with the rapid advances in science and
  technology, the Members represent a broader range
  of professional competences in different
  disciples such as, inter alia, biology and
  genetics, medicine, pharmacology, agricultural
  sciences, ICT, law, ethics, philosophy, and
  theology.

7
Introduction

• For every full Opinion to be issued by the
  Group, a roundtable is held before the Opinion is
  adopted, to which representatives of the
  Institutions of the European Union, experts of
  the fields, parties representing different
  interests, including NGOs, patients and consumer
  organisations and industrial stakeholders, are
  invited to participate in the debate.

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9
Opinion No 20

• Ethical aspects of ICT implants in the human body
  (16 March 2005).
• Opinion produced on the direct initiative of the
  EGE
• Rapporteurs Prof. Stefano Rodotà and Prof.
  Rafael Capurro
• http//ec.europa.eu/european_group_ethics/avis/ind
  ex_en.htm
• Important Notice This PP presents pictures,
  videos and links that are NOT part of the EGE
  Opinion. Please, do not quote the text of the
  Opinion from this PP but do it directly from the
  official text.

10
Introduction

• At first sight ICT implants are ethically
  unproblematic if we think for instance about
  cardiac pacemakers. However, although ICT
  implants may be used to repair deficient bodily
  capabilities they can also me misused,
  particularly if these devices are accessible via
  digital networks.

11
Introduction

• 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 visions with threat and/or benefit
  characteristics.

12
Introduction

• The intimate relation between bodily and psychic
  functions is basic to our personal identity.

13
Introduction

• Consequently the objective of this Opinion is
  primarily to raise awareness and questions
  concerning the ethical dilemmas created by a
  range of implants in this rapidly expanding
  field.

14
Scientific and Technical Background

• Current Applications and Research
• Applications ICT Implants on the market
• Active medical devices

15
Scientific and Technical Background

• Cardiovascular pacers for patients with
  conduction disorders or heart failure
• Cochlear and brainstem implants for patients with
  hearing disorders
• Implantable programmable drug delivery pumps for
  patients with Multiple Sclerosis or Diabetes
• Implantable Neurostimulation Devices
• Spinal cord stimulation for chronic pain
  management
• Sacral nerve stimulation for control of urinary
  incontinence
• Vagus nerve stimulation (VNS) for seizure control
  in epilepsy and mood control in severe depression
  cases
• Deap brain stimulation (DBS) for patients with
  Parkinsons disease, for essential tremor
• Artificial chip-controlled leg

16
Scientific and Technical Background

• Identification and location devices
• Read-Only for example allowing to identify
  Alzheimers patients or children
• Read-Write carrying a set of information (such
  as a persons medical history)
• Devices with tracking capabilities a device that
  can emit a radio signal which could be tracked
  (RFID, VeriChip)

17
Scientific and Technical Background

• Research on ICT Implants
• Medical Devices
• Biosensors
• Artificial Hippocampus
• Cortical implant for the blind
• Ocular implant or artificial retina
• Brain-computer interfaces (BCI)

18
Scientific and Technical Background

• Surveillance or tracking devices
• Wearable ICT
• Subdermal GPS
• Enhancement or commodity devices
• Prosthetic cortical implant (intelligence or
  sensory amplifiers)
• Artificial vision
• Audio tooth implant
• Artificial hippocampus (to enhance memory)

19
Scientific and Technical Background

• Other potential uses
• Microsoft patent Number 6,754,472 June 22, 2004
  concerns the human body as a medium for
  transmission of data (or energy) to other
  devices like PDAs, cellular phones, medical
  devices, RFID, making possible to localize
  persons. The patent does not describe any
  specific device.

20
Scientific and Technical Background

• Smart guns weapons that can be fired only if
  operated by their owner with a RFID-chip
  implanted in his or her hand.

21
Categorisation of ICT Implants

• Implantable devices can be categorised as
• medical
• non-medical
• Both as
• passive
• active
• Reversible or non reversible
• Stand-alone or online
• ICT implants and tags

22
Future personal tracking devices

• Integration and miniaturization of three
  technologies www.digitalangel.com
• Biosensor read a persons vital signs by
  touching the skin (implanted into a wristwatch)
• Pager device takes the data from the biosensor
  by using a cellular packet module
• Position location technology using radio signal
  to stay in contact with a persons pager device
• -gt this information is sent through cellular data
  packets to a data centre (Digital Angel)
• -gt The first Digital Angel was launched in
  November 2001
• -gt Medical emergency purposes
• -gt Identification/Location purposes

23
Legal Background

• General Principles
• Universal Declaration of Human Rights
• EU Charter of Fundamental Rights of 2000
• Convention on Human Rigts and Biomedicine of the
  Council of Europe
• EU Directives
• European Constitution
• National Constitutions

24
Legal Background

• Human Dignity providing that the human body and
  its parts shall not give rise to financial gain
• Human Inviolability
• Privacy and Data Protection
• The Precautionary Principle
• Data Minimisation, Purpose Specification,
  Proportionality Principle and Relevance
• Autonomy and Limits of ICT Implants

25
Legal Background

• ICT implants may
• allow individuals to be located on a permanent
  and/or occasional basis
• Allow the information contained in electronic
  devices to be changed remotely without the date
  subjects knowledge.

26
Legal Background

• These risks are bound to increase with the
  adoption of unified technical standards, which
  may allow data to be read and modified also by
  entities other than the data subject and the
  bodies/organizations lawfully managing the
  relevant plant or connection.

27
Legal Background

• Both circumstances are clearly in conflict with
  data protection rules concerning collection and
  processing of the information.

28
Legal Background

• For the legal background, it should be noted
  that
• the existence of a recognised serious but
  uncertain risk, currently applying ot the
  simplest types of ICT implant in the human body
  ()
• The purpose specification principle mandates at
  least a distinction between medical and
  non-medical applications ()

29
Legal Background

• the data minimisation principle rules out the
  lawfulness of ICT implants that are only aimed at
  identifying patients, if they can be replaced by
  less invasive andequally secure tools
• the proportionality principle rules out the
  lawfulness of implants such as those that are
  used, for instance, exclusively to facilitate
  entrance to public premises

30
Legal Background

• the principle of integrity and inviolability of
  the body rules out that the data subjects
  consent is sufficient to allow all kinds of
  implant to be deployed and
• the dignity principle prohibits transformation of
  the body into an objet that can be manipulated
  and controlled remotely into a mere source of
  information.

31
Ethical Background

• Contemporary society is confronted with changes
  that have to do with the anthropological essence
  of individuals.

32
Ethical Background

• 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.

33
Ethical Background

• 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.

34
Ethical Background

• Fundamental ethical principles
• Human Dignity
• Non-instrumentalisation
• Privacy
• Non-discrimination
• Informed Consent
• Equity
• The precautionary principle

35
Ethical Background

• Value conflicts
• There could be conflict between the personal
  freedom to use ones economic resources to get an
  implant that will enhance ones physical
  capabilities and what society at large considers
  desirable or ethically acceptable.

36
Ethical Background

• Another value conflict concerns the potential
  conflict between limiting freedom of people
  dangerous to others by surveillance and promoting
  the safety of others.

37
Ethical Background

• Freedom of researchers may conflict with the
  obligation to safeguard the health of research
  subjects.

38
Ethical Background

• Concern for economic competitiveness and other
  economic values (economic growth) may come into
  conflict with respect for human dignity.

39
Ethical Background

• Some Important Knowledge Gaps Regarding ICT
  Implants in the Human Body

40
Ethical Background

• 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 they have irreversible impacts in the
  human body and in the human psyche?
• 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?

41
Ethical Background

• Privacy and Surveillance
• How far con 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?

42
Ethical Background

• Enhancement and Self Awareness
• What does perfectibility of human beings mean?
• How far should the use of such implants to
  enhance human capabilities be allowed?

43
Ethical Background

• Social Aspects
• How do we relate to persons with ICT implants
  that are connected online?
• How far should ICT implants remain invisible to
  an external observer?
• How far can they be used to track human beings
  and in which cases should this be legally
  allowed?

44
Ethical Background

• ICT Implants for which special caution is
  necessary
• ICT implants that cannot be removed easily
• ICT implants that influence, determine of change
  psychic functions
• ICT implants that could be misused for social
  surveillance and manipulation
• Military applications

45
Opinion

• Scope This Opinion focuses on the question of
  ICT implants in the human body. It does not deal
  with the whole field of ICT devices or with
  wearable computing in general, although there
  may be cases in which such devices could be
  considered as quasi implants.

46
Opinion

• We shall not lay hand upon thee. This was the
  promise made in the Magna Carta to respect the
  body in its entirety Habeas Corpus.
• In this new world, data protection fulfils the
  task of ensuring the habeas data required by
  the changed circumstances.

47
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 () again, for the sake of the persons
  welfare and/or social competitiveness, as in the
  case of enhanced sports skills or intelligence
  prostheses.

48
Opinion

• ICT Implants for health purposes
• The objective is important
• The implant is necessary to achieve this
  objective, and
• There is no other less invasive and more
  cost-effective method of achieving this
  objective.

49
Opinion

• The individual and the network
• To the extent that an individual via an ICT
  implant has become part of an ICT network, the
  operation of the whole network not just the ICT
  implant needs to be considered.

50
Opinion

• Freedom of Research
• The freedom of research in this field should be
  subjected not only to the informed consent of the
  persons willing to participate in new experiments
  aiming at health recovery but also to the
  awareness of the possibility of damaging not only
  bodily but also psychic functions of the people
  participating in clinical trials.

51
Opinion

• Irreversible ICT implants
• The requirements of informed consent and data
  protection (privacy and confidentiality of the
  data in particular) need to be strictly enforced
  in cases where the ICT implants are irreversible
  and cannot be removed from the body without
  severe damage of the individuals life.

52
Opinion

• ICT implants for non-medical purposes
• Mental functions and personal identity ICT
  devices should not be used to manipulate mental
  functions or change personal identity
• ICT implants and personal data the principles of
  data protection need to be applied to this area

53
Opinion

• Privacy and ICT implants Provided that ICT
  devices are implanted in accordance with the
  principles outlined in this Opinion there is no
  need to declare these implants. They could and
  should remain unrecognizable to an external
  observer. The right to privacy includes the right
  to have an ICT implant.

54
Opinion

• ICT Implants and Enhancement of Physical and
  Mental capabilities
• Access to ICT implants for enhancement should be
  used only
• To bring children or adults into the normal
  range of the population, if they so wish and give
  their informed consent, or,
• To improve health prospects

55
Opinion

• The following possibilites should be banned
• ICT implants 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 used for coercion towards others who
  do not use such devices

56
Opinion

• ICT Implants, Commercialisation and Consumer
  Interests
• It is essential that ICT devices are not put on
  the market without adequate control. For
  instance, products that can be regarded as
  medical products should be controlled according
  to the relevant legal framework.

57
Opinion

• ICT Implants for Surveillance Purposes
• ICT implants for surveillance in particular
  threaten human dignity. They 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).

58
Opinion

• However, the EGE insists that such surveillance
  applications of ICT implants may only be
  permitted if the legislator considers that there
  is an urgent and justified necessity in a
  democratic society (Article 8 of the Human Rights
  Convention) and there are no less intrusive
  methods.

59
Opinion

• Nevertheless the EGE does not favour such uses
  and considers that surveillance applications,
  under all circumstances, must be specified in
  legislation. Surveillance procedures in
  individual cases should be approved and monitored
  by an independent court.
• The same general principles should apply to the
  use of ICT implants for military purposes.

60
Opinion

• General Considerations
• 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.

61
Opinion

• The EGE strongly supports the vision of a
  people-centred, inclusive and development
  oriented Information Society as proclaimed in the
  Declaration of Principles of the World Summit on
  the Information Society (Geneva 2003).

62
Opinion

• 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.

63
Opinion

• The Member States and their national ethics
  councils (or corresponding institutions) have a
  responsibility to create conditions for education
  and constructive, well-informed debates in this
  area.

64
Opinion

• Democracy and Power
• Public debate and education are essential to
  ensure transparency and the Member States have a
  responsibility to ensure that the power of
  development and access to ICT implants are
  decided through democratic processes.

65
Opinion

• Need for Regulation
• It is clear that this field needs regulation.
  Currently, non-medical ICT implants in the human
  body are not explicitly covered by existing
  legislation, particularly in terms of privacy and
  data protection.

66
Opinion

• In the EGEs view, implantable devices for
  medical purposes should be regulated in the same
  way as drugs when the medical goal is the same,
  particularly as such implants are only partly
  covered by Council Directive 90/385/EEC on the
  approximation of the laws of the Member States
  relating to active implantable medical devices.

67
Opinion

• Impact Research and ICT Devices
• More research on the long term social, cultural
  and healt impact of different types of ICT
  implants needs to be carried out, with a
  particular focus on risk characterisation, risk
  assessment, risk management and risk
  communication. The EGE considers that this should
  be kept in mind for the Seventh EU Research
  Framework Programme. This sort of precautionary
  research in a rapidly developing field is of
  crucial importance.

68
Opinion

• Need for review
• The field of ICT implants is in its infancy and
  rapid developments are taking place that raise
  societal fears as well as hopes. Consequently,
  the EGE has addressed the key ethical issues
  regarding developmentsthat are current or can be
  foreseen at the present time.

69
Opinion

• However, it is clear that the EGE will have to
  return to this subject to update our advice in
  the light of future applications of ICT implants.
  () Consequently, we consider that a review of
  this Opinion by the EGE may be necessary in about
  three to five years time.

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Conclusion and Prospects

• The EGE recommended
• More research on the long term social, cultural
  and healt impact of different types of ICT
  implants needs to be carried out, with a
  particular focus on risk characterisation, risk
  assessment, risk management and risk
  communication. The EGE considers that this should
  be kept in mind for the Seventh EU Research
  Framework Programme. This sort of precautionary
  research in a rapidly developing field is of
  crucial importance.

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Conclusion and Prospects

• Selection of EU projects that have been / are
  dealing with this matter
• ETHICBOTS (2006-2007) (FP 6)
• ICTethics (2009-2011) (FP 7)
• EGAIS (2009-2011) (FP 7)
• ETICA (2009-2011) (FP 7)
• For a complete list of Research Programmes
  dealing with ethical questions of ICT under FP7
  see CORDIS Databank
• http//cordis.europa.eu/pf7

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• FP 6 2006-2008
• http//ethicbots.na.infn.it/index.php
• Three kinds of integration were analized
• Human-softbot integration, as achieved by AI
  research on information and communication
  technologies
• Human-robot, non-invasive integration, as
  achieved by robotic research on autonomous
  systems inhabiting human environments
• Physical, invasive integration, as achieved by
  bionic research.

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• Crucial ethical issues in these areas include
  the preservation of human identity, and
  integrity applications of precautionary
  principles economic and social discrimination
  artificial system autonomy and accountability
  responsibilities for (possibly unintended)
  warfare applications nature and impact of
  human-machine cognitive and affective bonds on
  individuals and society.

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Conclusion and Prospects

• The ICTethics project ICT that makes the
  difference
• The basis of the work is an investigation of the
  ESLA (Ethical, Social and Legal Aspects) of
  Ambient Intelligence
• ICT for Security
• http//www.ictethics.eu/

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Conclusion and Prospects

• Ambient Intelligence
• Intelligent Environments Personal Health Systems
  (PHS)
• Convergence of Physical, Mental and Virtual
  Personal Humanoid Assistent (PHA)
• Internet of Things Radio-Frequency
  Identification (RFID)
• ICT for Security Biometrics

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Conclusion and Prospects

• ICT that makes the difference. The future of
  Ambient Intelligence and ICT for Security.
  International Conference, Brussels, Nov. 22-25,
  2009
• http//www.ictthatmakesthedifference.eu/index.html
  

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• Legal aspects
• 1. RFID. Implants and the human body
• Legal aspects of ICT implants Stefano Rodotà1,
  Diane Whitehouse2, Penny Duquenoy3 1 La
  Sapienza, Fondazione Basso, Rome (Italy) 2 The
  Castlegate Consultancy, (CITY) (United Kingdom)
  3 Middlesex University (United Kingdom)

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• 2. Privacy. Toward an electronically identity?
• Legal concepts of human identity? Stefano
  Rodotà, La Sapienza, Fondazione Basso, Rome
  (Italy)
• On Interpreting and Constructing (Non-) Human
  Identities Rafael Capurro International Center
  for Information Ethics, Karlsruhe (Germany)
• DNA barcoding and personal genomics Giuseppe
  Novelli1 Tor Vergata University (Italy)

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Conclusion and Prospects

• EGAIS (Ethical GovernAnce of emergIng
  technologieS) (2009-2011)
• Aim of the project to overcome the existent
  limitations of the current approaches to ethical
  governance in projects with technical
  development.
• http//www.egais-project.eu/?qnode/3

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Conclusion and Prospects

• ETICA (2009-2011)
• Aim of the project to identify ethical issues
  arising from information and communication
  technologies in the coming 10 to 15 years.
• http//www.etica-project.eu/

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• How far should we let ICT devices geht under our
  skins?