Ethical Aspects of ICT Implants in the Human Body

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Ethical Aspects of ICT Implants in the Human Body

• Rafael Capurro
• European Group on Ethics in Science and New
  Technologies (EGE) de la Comisión Europea EGE
  Opinion, March 16, 2005
• http//europa.eu.int/comm/european_group_ethics/in
  dex_en.htm
• Universidad de Ciencias Aplicadas, Stuttgart,
  Alemania www.capurro.de
• Workshop de Bioética en la Universidad de Talca
• 24-26 de enero de 2005, Talca, Chile

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Overview

• EGE Tasks and Opinions
• ICT Implants in the Human Body
• Categorisation of implantable devices
• Implantable devices on the market
• Implantable devices under development
• Ethical Aspects of ICT Implants
• Ethics and Public Policy

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The European Group on Ethics (EGE)

• The EGE is an independent, pluralist and
  multitisciplinary body which advises the European
  Commission on ethical aspects of science and new
  technologies in connection with the preparation
  and implementation of Community legislation or
  policies.

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EGE Members (2001-2005)

1. Prof. Göran HERMERÉN (Sweden), President,
   Philosopher, Professor of Medical Ethics, Faculty
   of Medicine, Lund University. 
2. Prof. Linda NIELSEN (Denmark), Vice-President,
   Professor of Law, Rector of the University of
   Copenhagen.  Prof. Nicos C. ALIVIZATOS (Greece),
   Professor of Constitutional Law, University of
   Athens.  Prof. Rafael CAPURRO (Germany),
   Professor of Information Management and
   Information Ethics at University of Applied
   Sciences.  Prof. Inez DE BEAUFORT (The
   Netherlands), Professor of Health Care Ethics at
   the Medical Faculty of the Erasmus University,
   Rotterdam.  Prof. Yvon ENGLERT (Belgium), Head
   of Fertility Clinic, Free University of Brussels
   (ULB), Professor of Medical Ethics and
   Deontology, ULB.  Prof. Catherine LABRUSSE-RIOU
   (France), Centre de recherche en droit privé,
   Université de Paris.  Dr. Anne McLAREN (United
   Kingdom), Geneticist, Research Associate at
   Wellcome CRC Institute, Cambridge.  Prof. Pere
   PUIGDOMÈNECH ROSELL (Spain), Research Professor
   at the Department for Molecular Genetics,
   Director of Institut de Biologia Molecular de
   Barcelona, CSIC  Prof. Stefano RODOTA (Italy),
   Professor of Civil Law, University of Rome,
   Chairman of the Italian Data Protection
   Authority, Chairman of the European Group of the
   Data Protection Authorities.  Prof. Günter VIRT
   (Austria), Professor of Theology, Institute of
   Catholic Moral Theology, University of Vienna. 
   Prof. Peter WHITTAKER (Ireland), Biologist,
   Professor of Biology, Institute of Environment,
   Philosophy and Public Policy, University of
   Lancaster, Furness College. 

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EGE Secretariat

• Dr. Michael D. Rogers, European Commission, BERL
  10/345,  rue de la Loi 200, B-1049 Brussels,
  Belgium.
• EGE-Website europa.eu.int/comm/european_group_eth
  ics 
• EGE-Newsletter "Ethically Speaking" providing
  also information on the activities of the
  National Ethics Committees.

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Opinions 2001-2005

• Opinion n. 16 (2002)Ethical aspects of patenting
  inventions involving human stem cells
• Opinion n. 17 (2003)Ethical aspects of clinical
  research in developing countries
• Opinion n. 18 (2003)Ethical aspects of genetic
  testing in the workplace
• Opinion n. 19 (2004)Ethical aspects of cord
  blood stem cells banks
• Opinion n. 20 (2005)Ethical Aspects of ICT
  implants in the human body

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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

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Implantable passive ICT medical devices

• Most passive implants are structural devices such
  as
• artificial joints
• vascular implants
• artificial valves
• Active medical implantable devices Directive
  90/385/EEC

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Current active medical ICT implants

• Cardiovascular pacers for patients with
  conduction disorders or heart failure
• Cochlear and brainstem implants for patients with
  hearing disorders
• Deep brain stimulation
• for tremor control in patients with Parkinson's
  disease
• for essential tremor
• for obsessive-compulsive disorders
• 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
• Implantable programmable drug delivery pumps
• Intrathecal administration of Baclofen for
  patients with Multiple Sclerosis with severe
  spasticity
• Insulin pump for Diabetes

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Future medical ICT implants

• Artificial vision
• Cortical implant for the blind bypassing the
  non-working retina or optic nerve
• BioMEMS Micro Electro-Mechanical Systems /
  Biosensors on the order of size of a human red
  blood cell
• collect data about the physiological parameters,
  communicate with an external diagnostic computer
  system (drug release, blood analysis, recovering
  cancer patients)
• Direct Brain Control BCI (Brain Computer
  Interfaces) BrainGate www.cyberkineticsinc.com
• Memory BrainChip (artificial hippocambus) an
  implantable brain chip could restore or enhance
  memory

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Other medical ICT implants/prostheses

• The German company Otto Bock Healthcare produces
  prostheses like the C-Leg which is a
  chip-controlled leg. See http//www.ottobock.de/d
  e

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Implantable Non-Medical Devices

• Passive devices An example of a passive device
  is the radio frequency identification (RFID)
  device.
• Active devices use electrical impulses to
  interact with the humans nervous system.

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Baja Beach Club

• http//www.bajabeach.es/
• Somos la primera discoteca del mundo en ofrecer
  el VIP VeriChip. Mediante un chip digital
  integrado, nuestros VIPs pueden identificarse
  como tal, así como pagar sus consumiciones sin la
  necesidad de aportar ningún tipo de documento.

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Baja Beach Club

• El objetivo de esta tecnología es llevar un
  sistema de identificación a nivel mundial que
  anule la necesidad de llevar documento de
  identidad y tarjeta de crédito. El Verichip que
  implantaremos en el Baja, no será sólo para el
  Baja, también es útil para cualquier otra empresa
  que haga uso de esta tecnología.

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Other non-medical applications

• Experiments as reported by Kevin Warwick
  (Department of Cybernetics,University of Reading,
  UK)
• In Mexico (August 2004) microchips were implanted
  in the arms of the Fiscal General and 160
  Fiscals employees to control their access to a
  confidential documentation centre and possibly
  track them in case of kidnapping.

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Other non-medical applications

• The UK Prime Minister announced (August 2004) a
  programme whereby the five thousand dangerous UK
  criminals would be tagged with electronic
  devices and thereby tracked continuously.

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Other non-medical applications

• In the Japanese prefecture of Wakayama (Osaka)
  children will use RFID-labels for entering school
  (2004).
• TraceCare (Wiesbaden, Germany) offers devices
  that allow to find the position of a person via
  internet through a Global Positioning System
  (GPS).

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Other non-medical applications

• The Bavarian company Ident Technology offers
  tracking devices using the human body
  (particularly the skin) as digital data
  transmitter. See http//www.ident-technology.com
  

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Other non-medical applications

• 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.

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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

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Legal Background

• 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
• -gt providing that the human body and its parts
  shall not give rise to financial gain (Principle
  of human dignity)

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Ethical Aspects of ICT Implants

• Anthropological background
• The unity of biological and psychic
  (intellectual, emotional) functions
• The body and the environment
• Social aspects
• Creativity, cultural aspects
• Some characteristics of ICT devices
• Chips (silicon, bio-chips)
• algorithms

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Ethical Aspects of ICT Implants

• Fundamental ethical principles
• Human Dignity
• Privacy (data protection)
• Autonomy
• Confidentiality
• Ethical conflict(s) to reduce freedom and
  autonomy vs. Increase health, security

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Ethical Aspects of ICT Implants

• In case of medical applications
• Prohibition of eugenic practices
• Respect of the informed consent of the patient
• Prohibition of making the human body and its
  parts a source of financial gain

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Ethical Aspects of ICT Implants

• In case of non-medical applications
• Privacy and surveillance
• Exclusionary practices
• Practices of domination
• Practices of privacy invasion
• -gt How far will ICT Implants (and tags) enlarge
  our individual and social choices and how far
  will they create a situation of social
  discrimination?

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Ethical Aspects of ICT Implants

• In case of enhancement(s)
• What does it mean to enhace human beings?
• What does perfectibility mean?
• Are ICT enhancements necessarily a new form of
  racism? -gt the post-human debate
• How clear is the distinction between therapeutic
  applications and enhancements?

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Ethics and Public Policy Historical Roots

• The relation between ethics, law, and public
  policy has a long tradition in Western thought
  and practice going back to Platos Nomoi (722d)
  where he stresses the importance of
  introductions (proimia) that should used in
  order to make laws more understandable and
  acceptable to the citizens. Aristotle makes a
  difference between individual and political
  virtues. Political and legal practice are
  supposed to rest on ethical counselling on the
  basis of morality (ethos).

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Ethics and Public Policy Historical Roots

• Since Modernity, and particularly since Thomas
  Hobbes, there is not just a difference but a
  split between morality, law and public policy.
• Since Hegel through Pierce and Rorty there is a
  (pragmatic) search for overcoming it.
• Todays mass media and particularly the internet
  have created new forms of mediation without
  eliminating the differences.

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Ethics and Public Policy Ethics Councils

• Ethics councils within the sphere of public
  policy have the function of reflecting on the
  moral and legal foundations of specific
  controversial issues without being itself neither
  a legal nor a moral authority.
• Their task is reflection, not decision-making or
  dogmatic proclamation.

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Ethics and Public Policy Ethics Councils

• They should counterbalance ethical arguments and
  give an opinion on matters that remain
  controversial and subject to revision.
• Todays public policy has a need for such
  counsels particularly with regard to new
  developments in science and technology.

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Ethics and Public Policy Ethics Councils

• Of course, such ethics bodies are not
  unproblematic not only concerning their
  legitimating body in some cases it is the
  parliament, in other cases the executive , but
  also with regard to possible controversial
  standpoints that may differ with present laws
  and/or directives.

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Ethics and Public Policy Ethics Councils

• In other words, it is important that such bodies
  are politically independent, pluralist, and
  multidisciplinary and that they view themselves
  not just as guarantee of an established morality
  or of current law, but as a critical space where
  an open debate on legally and morally
  controversial issues can take place.

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Ethics and Public Policy Ethics Councils

• Although they might look for consensual opinions,
  consensus should not be a conditio sine qua non
  of their proposals. It is also not their function
  to make public policy more moral, but to
  encourage ethical reflection within the public
  sphere.

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Ethics and Public Policy Ethics Councils

• Most European and non-European national and
  international ethics committees have been created
  in the nineties.
• UNESCOs International Bioethics Committee (IBC)
  was created in 1993. The Steering Committee on
  Bioethics of the Council of Europe dates from
  1992.
• US President George W. Bush created The
  Presidents Council on Bioethics on the basis of
  the Executive Order 13237 from November 28, 2001
  (http//www.bioethics.gov/).
• Most national and international ethics committees
  are in fact (until now) committees on bioethics.
  The EGE is the first international committee with
  a broader scope.

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Ethics and Public Policy Further Reading

• Rafael Capurro
• Ethics and Public Policy within a Digital
  Environment. In I. Alvarez, T. W. Bynum, J.A. de
  Assis Lopes, S. Rogerson (Eds.) The
  Transformation of Organisations in the
  Information Age Social and Ethical Implications,
  ETHICOMP 2002, Lisboa 2002, 319-327. Online
  http//www.capurro.de/ethicomp02.html
• Ethics Between Law and Public Policy. In Journal
  of International Biotechnology Laws (JIBL) Vol.
  1, Issue 2 / 2004, 62-66.Online
  http//www.degruyter.de/rs/280_7046_DEU_h.htm
• Ethik in Europa zwischen Forschung und Politik.
  In Wissenschaftszentrum Nordrhein-Westfalen ed.
  Jahrbuch 2002/2003, 200-211.
• Online http//www.capurro.de/wznrw.html

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