The effects of closed-loop brain implants on autonomy and deliberation: what are the risks of being kept in the loop?

A new generation of implantable Brain Computer Interfaces (BCI) devices have been testedfor the first time in a human clinical trial with significant success. These intelligent implantsdetect specific neuronal activity patterns, like an epileptic seizure, then provide informationto help patients to respond to the upcoming neuronal events. By forecasting a seizure, thetechnology keeps patients in the decisional loop; the device gives control to patients on howto respond and decide on a therapeutic course ahead time. Being kept in the decisional loopcan positively increase patients quality of life; however, doing so does not come free ofethical concerns. There is currently a lack of evidence concerning the various impacts ofclosed‐loop system BCIs on patients' decision‐making processes, especially how being in thedecisional loop impacts patients' sense of autonomy. This article addresses these gaps byproviding data we obtained from a first‐in‐human clinical trial involving patients implantedwith advisory brain devices. This manuscript explores ethical issues related to the risksinvolved with being kept in the decisional loop