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Abstract
The direct-to-consumer (DTC) neurotechnology market, which includes some brain-computer interfaces, neurostimulation devices, virtual reality systems, wearables, and smartphone apps is rapidly growing. Given this technology’s intimate relationship with the brain, a number of ethical dimensions must be addressed so that the technology can achieve the goal of contributing to human flourishing. This paper identifies safety, transparency, privacy, epistemic appropriateness, existential authenticity, just distribution, and oversight as such dimensions. After an initial exploration of the relevant ethical foundations for DTC neurotechnologies, this paper lays out each dimension and uses examples to justify its inclusion.
Notes
1 While this paper uses the prefix ‘neuro-‘ to describe the technology with which it is concerned, this is not intended as a delineation between neurological and psychological applications. The scope of this paper includes ethical considerations of technologies that are most naturally described as pertaining to the ‘mind’, rather than the ‘brain’. Arguing for a metaphysical reductionism about the mind is beyond the scope of this paper, but a fundamental assumption shared by this paper is that the mind is either identical to or overwhelmingly instantiated by the brain, and thus that it makes sense to consider technologies described as being concerned with psychological and neurological function in a unified fashion.
2 As pointed out by an anonymous reviewer, it seems appropriate to include DTC nutritional supplements such as ‘nootropics’ or ‘smart drugs’ that claim to enhance cognitive performance. While it is plausible that nootropics may fall within the scope of the technologies circumscribed here and thus should be subject to the same ethical analysis, I will (admittedly artificially and expediently) bracket nootropics or smart drugs for the purposes of this paper, in order to limit the scope. There has been a substantial amount of work on the ethics of nootropics and future work will be required to identify whether nootropics are subject to the same ethical considerations as the DTC neurotechnology identified here.
3 As noted by an anonymous reviewer, given the broad definition of DTC neurotechnology employed in this paper, the term risks becoming semantically or pragmatically vacuous. There is certainly a tension between being semantically circumspect and possibly missing relevant phenomena on one hand, and being semantically latitudinarian and possibly including too many instances on the other. The definition as it is provided here errs on the latter side. However, in the previous paragraph and Figure 1 I have attempted to provide enough of a description of the term ‘DTC neurotechnology’ in order for the term to have meaning, and throughout the paper I show through the use of examples how the class identified as DTC neurotechnology can coherently be subject to certain ethical constraints.
4 In this paper the modifier ‘consumer’ and ‘DTC’ are used interchangeably.
5 I thank an anonymous reviewer for this objection.
6 I say “does not tend to interfere” because for some individuals, the accessibility of certain consumer products may interfere with their human flourishing in some cases. For instance, people who enjoy a quiet camping experience may feel that their flourishing is being interfered with by the loud generators that others bring to the campground in a pursuit of their human flourishing. But the solution is not to ban the sale of generators, but rather to engage in democratic deliberation to attempt to satisfy the desires of individuals in a varied population, for instance by determining rules as to whether generators ought to be permitted throughout the campground at all times, or just in certain areas or during certain hours, etc. As long as a deliberative democratic process finds that access to the product does not interfere with human flourishing on the whole (and allows for the flourishing of some), it should be viewed as contributing to human flourishing. This stance is broadly in line with Mill’s harm principle. It also allows that there are certain consumer products that in fact do tend to interfere with human flourishing on the whole, such as, for example, the 1950s Gilbert U-238 home nuclear reactor science kits for children that contained actual uranium ore, and should be banned.
7 I thank an anonymous reviewer for suggesting this term instead of ‘veracity’.
8 Such a requirement for transparency will also serve to motivate developers to actively work towards ensuring the validity and effectiveness of their product. Transparency can also be a method to set themselves apart from other companies. For instance, developers could make a point of tracking adverse events and reporting these transparently to consumers, thereby engendering trust. (I thank an anonymous reviewer for this suggestion.)
9 Whether embodied cognition or ‘classicism’ or some combination is the correct view of human cognition remains a hotly contested question. However, the publications referenced in this section provide justification that at least some cognition is embedded and embodied.
10 Gilbert, Cook, O’Brien and Illes (Citation2019) explore the phenomenological shifts in embodiment precipitated in patients with invasive BCI. Such invasive BCIs, often used to treat epilepsy, are beyond the scope of DTC neurotechnology.
11 This may be especially problematic once use of VR becomes widespread, particularly amongst children.
12 It is even imaginable that design solutions may be brought in to mitigate such issues. For instance, factitious information can be presented to the user at a lower frequency. Or it may be conveyed without explicit representations that do not require conscious processing.
13 If DTC neurotechnology bestows no benefit, then it also need not be justly distributed.
14 For example, developers might rethink the frequency of information delivery for tracking DTC neurotechnologies, or alter the mode with which such information is presented.