Ethical Implications of Brain-Computer Interfaces: A Comparison of Public and Provider Perceptions

Brain-Computer Interfaces (BCIs) are computer-based systems that enable communication between the brain and a device. BCIs hold promise for improving the lives of people with neurotrauma and cognitive and movement disorders, either directly or in conjunction with assistive and rehabilitation technologies. As knowledge regarding computational modeling of brain function advances, BCIs will continue to become more prevalent in clinical therapeutics. Given BCI technology is an “iterative, goal-directed intervention in the nervous system,” BCIs raise ethical concerns regarding who (i.e. clinicians, patients, etc.) controls the device. While individual perceptions on BCIs and technical expectations have been explored, limited data comparing perspectives regarding ethical implications among clinicians, patients, and the public exists. Since a concordance or discordance of attitudes about BCI use affects trust and transparency within the patient-physician relationship, the lack of exploration in this area poses challenges for physicians and patients alike. In this study, we are investigating the similarities and differences in ethical perceptions of BCI usage between two groups of stakeholders: providers who implant and adjust BCI devices and the general public who may have a different understanding of BCI technology. We presented clinical vignettes of BCI use. Survey participants representing the general public group evaluated various ethical considerations in the presented scenarios using Likert scales. Based upon their responses, we observed group perceptions regarding domains of autonomy, informed consent, and privacy and compared whether there is overlap in perceptions between the two groups. We are currently working on our survey dissemination for healthcare provider participants. The results of this study will provide key insights for clinical use and education regarding BCIs. If ethical perceptions of BCIs are divergent between stakeholder groups, then it is crucial that physicians re-evaluate current BCI education practices to establish a united understanding of BCIs moving forward to improve acceptance and adoption of these devices, which hold tremendous potential to improve quality of life. With this project, we can provide greater clarity on current BCI perspectives and move towards reconciling the stances of BCI stakeholders to improve patient care