Social and Ethical Aspects of the Visual Neural Implant

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This section cites articles dealing with the social impact and ethical issues regarding the implantation of electrodes into the visual cortex to improve sight.

Abele, John E. "Ethics of Technology Introduction". Proceedings of SPIE -- Volume 2499. Health Care Technology Policy II: The Role of Technology in the Cost of Health Care: Providing the Solutions. Warren S. Grundfest (Ed.). October 1995: 354-355.

Aughan, H. G., Jr. "Some Reflections on Stimulation of the Human Brain". American Psychopathological Association. Proceedings of the Annual Meeting 58 (1969):66-77.
Beard, Marion. "Signs of the Times: Cochlear Implants May Not Be the Best Way to Help Deaf Children". New Scientist 162.2183 (24 Apr 1999): 52.

Blume, Stuart S. "The Rhetoric and Counter-rhetoric of a ‘Bionic' Technology". Science, Technology and Human Values 22.1 (Winter 1997): 31-56.

Blume examines the rhetoric used by those who favor, and oppose, the use of cochlear implants. The article will be of interest primarily to sociologists who want to think about "theoretical models of technological change in medecine". (Jadran Lee 2004)

Branwyn, Gareth. "The Desire to Be Wired". Wired 1.04 (Sept./Oct. 1993). Online. 46 pars. 22 December 2003.

Bruck, S. D. "Implant Retrieval, Analysis, and Database: A Challenge For the Medical Devices Industry". Journal of Long Term Effects of Medical Implants 2.2-3 (1992): 93-7.

Brusky, A.E. "Making Decisions for Deaf Children Regarding Cochlear Implants: The Legal Ramifications of Recognizing Deafness as a Culture Rather than a Disability". Wisconsin Law Review (1995): 237-270.

Burton, M. J. "The Biological Safety and Efficacy of Cochlear Implantation in Young Children. An Evaluation in an Animal Model". Diss. Oxford U., 1994.

Clark, Graeme M., Robert S. Cowan, and Richard C. Dowell. "Ethical Issues". Cochlear Implantation for Infants and Children: Advances. San Diego, CA: Singular Publishing Group, 1997. 241-249.

Cohen, N. L. "Cochlear Implants in Young Children: Ethical Considerations". Annals of Otology, Rhinology and Laryngology Suppl. 166 (Sept. 1995):17-19.

Cole-Turner, Ronald. "Do Means Matter? Evaluating Technologies of Human Enhancement". Philosophy and Public Policy 18.4 (Fall 1998): 8-12.

Crisp S. "The Medical Device Directives and Their Impact on the Development and Manufacturing of Medical Implants". Proc Institution of Mechanical Engineers Proceedings [H]: Journal of Engineering in Medicine 210.4 (1996): 233-9.

Crouch, Robert A. "Letting the Deaf be Deaf [sic]: Reconsidering the Use of Cochlear Implants in Prelingually Deaf Children". Hastings Center Report 27, no. 4 (1997) 14-21.

Crouch argues that prelingually deaf children are best left without cochlear implants. He says that the implants do not work particularly well, but concedes that this may soon change. His more important point is that when such a child is given an implant, her attempts to learn oral language will delay "her exposure to and engagement with the Deaf community". Delay in learning American Sign Language inhibits later fluency, so the child will fail to integrate fully into what is, says Crouch, a vibrant minority culture that has its own history, poetry, and theater. But won't this child be amply compensated by becoming fully members of mainstream culture? Crouch does not think so, though here his argument relies on what he earlier conceded was a problem that may soon be overcome: the poor performance of cochlear implants. Crouch's article represents a relatively moderate argument against cochlear implants. More radical authors focus on what they describe as the "cultural genocide" that would result from widespread adoption of cochlear implants. (Jadran Lee 2004)

Davis, Dena S. "Cochlear Implants and the Claims of Culture? A Response to Lane and Grodin". Kennedy Institute of Ethics Journal 7.3 (Sept. 1997): 253-258.

In this reply to Lane & Grodin (see below), Davis argues that it is not wrong for parents to choose cochlear implants for their deaf children. She makes her case by arguing for 3 claims: 1) that deafness is a disability because non-hearing people are irrevocably cut off from many parts of the hearing world, 2) that even if deafness were a culture rather than a disability, there would be "no reason to fault hearing parents who...prefer to have children who share their language and culture", and 3) that the value of preserving a minority culture cannot trump parents' interest in giving their own children happy lives. (Jadran Lee 2004)

Dertouzos, Michael L. What Will Be: How the New World of Information will Change our Lives. New York: HarperEdge, 1997.

Distinguishing Therapy and Enhancement [working paper]. [Washington, DC]: President's Council on Bioethics, 2002.

The Ethical Aspects of ICT Implants in the Human Body: Proceedings of the Roundtable Debate: Amsterdam, 21 December 2004. European Group on Ethics in Science and New Technologies to the European Commission. Luxembourg: Office for Official Publications of the European Communities, 2005.

Fielder, J. H. and J. Black. "But Doctor, It's My Hip!: The Fate of Failed Medical Devices". Kennedy Institute of Ethics Journal 5.2 (June 1995): 113-31.

Haggar, B. "How Do Regulatory Agencies Ensure the Release of a Safe Medical Device?" Clinical Performance and Quality Health Care 7.2 (Apr.-Jun. 1999): 100-3.

Hansson, S. O. "Implant Ethics". Journal of Medical Ethics 31.9 (2005): 519-525.

Harris, John. Wonderwoman and Superman: The Ethics of Human Biotechnology. Oxford: Oxford University Press, 1992.

Holley, L. K. and C. F. Hughes. "Medical Device Development Practices: Empirical Survey and Legal Implications". Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society Vol. 20, No. 6 (1998): 3327-3330.

Hyde, M. "Some Ethical Dimensions of Cochlear Implantation of Deaf Children". Annals of Otology, Rhinology and Laryngology Suppl. 166 (Sept. 1995):19-20.

Jonietz, Erika. "Picking Your Brain". Technology Review 107.9 (November 2004): 74-75.

Kilbreath, Eric. "Ethical Consideration in the Use of High-dependency Technology". Engineering Science and Education Journal February 2000.

This article focuses on the case of an elderly woman in a Persistent Vegetative State, and explores the ethical considerations pertinent to whether her life should be prolonged. These include questions whether "brain dead" people are truly dead, and whether artificial nutrition and hydration are beneficial to such patients. The author also asks whether it is useful to distinguish between ordinary and extraordinary means, and between killing and letting die. The article takes a very balanced approach, explaining arguments for and against prolonged treatment. It is written to be suitable for the general reader. (Jadran Lee 2004)

Lane, Harlan, & Grodin, Michael. "Ethical Issues in Cochlear Implant Surgery: An Exploration into Disease, Disability, and the Best Interests of the Child". Kennedy Institute of Ethics Journal 7.3 (Sept. 1997): 231-251.

This article rejects the interpretation of deafness as a disability. It proposes an alternative view, that deafness can be valuable insofar as it enables a person to enjoy participation in a linguistic and cultural community. The authors concede that a child may derive some benefit from receiving a cochlear implant, but maintain that this consideration is outweighed by the fact that cochlear implants commit "cultural genocide" on the deaf community. (Jadran Lee 2004)

Macklin, R. "Ethical Implications of Surgical Experiments". Bulletin of the American College of Surgeons 70.6 (June 1985): 2-5.

Maguire, G. Q. , Jr., and Ellen M. McGee. "Ethical Assessment of Implantable Brain Chips". Twentieth World Congress of Philosophy. Boston University. Boston, MA, 10-15 August, 1998. 19 pars. 22 December 2003.

---. "Implantable Brain Chips? Time for Debate". The Hastings Center Report 29. 1 (Jan.-Feb. 1999): 7-13.

---. "Implantable Brain Chips: Ethical and Policy Issues". Medical Ethics (Newsletter of the Lahey Clinic, in collaboration with Dartmouth-Hitchcock Medical Center). Winter 2001. 3 pgs. 22 December 2003.

A 2-page article that will stimulate further reflection, without necessarily resolving any issues. The authors distinguish focus on the possibility that implantable brain chips will, in the future, be used to enhance the powers of healthy human beings (rather than simply remedying problems such as blindness). Such enhancements might include radical changes to human powers, including the ability to see infra-red light, or to communicate telepathically. The authors argue that enhancements could cause a number of ethical problems. For instance, there would be the question of safety: should enhancement be held to a higher standard of safety than therapy? Another issue involve social justice. Should the poor be allowed to fall further behind the rich, who presumably will be the only ones who can afford such technology? Or should the government level the playing field by banning the technology, or paying for everyone to have it? Finally, the authors raise the possibility that enhancement technologies could be used to allow totalitarian control of people's minds.

McCaughey, J. D. "Cochlear Implants: Some Considerations of a More or Less Ethical Character". Annals of Otology, Rhinology and Laryngology Suppl. 166 (Sept. 1995):16-17.

Morgan, R. W. "Tracking and Surveillance of Patients with Medical Devices and Implants". Medical Device Technology 4.1 (Jan.-Feb. 1993): 38-43.

National Institutes of Health. "Improving Medical Implant Performance through Retrieval Information: Challenges and Opportunities". State of the Science Statements. NIH Consensus Development Program. NIH Technology Assessment Conference Summary, January 10-12, 2000. 15 sects. 22 December 2003.

Nunes, R. "Ethical Dimension of Paediatric Cochlear Implantation". Theoretical Medicine and Bioethics 22.4 (Aug. 2001): 337-349.

Parens, Erik. "The Enhancement Project: Is Better Always Good?" Hastings Center Report (Special Supplement) 28.1 (Jan.-Feb. 1998): S1-S17.

---, ed. Enhancing Human Traits: Ethical and Social Implications. Hastings Center Studies in Ethics series. Washington, D. C.: Georgetown University Press, 1998.

Posner, K. "Implantable Medical Devices and Products Liability". Medical Trial Technique Quarterly 28.3 (Winter 1982): 255-78.

Rothman, David. The Pursuit of Perfection: The Promise and Perils of Medical Enhancememt. New York: Pantheon Books, 2003.

Saha, Pamela S. and Subrata Saha. "Clinical Trials of Medical Devices and Implants: Ethical Concerns". IEEE Engineering in Medicine and Biology Magazine 7.2 (June 1988): 85-87.

Sound and Fury. Dir. Josh Aronson. Artistic License Films, 2000.

Strong, Carson. "What is the 'Inviolability of Person?'" Medicine Unbound: The Human Body and the Limits of Medical Intervention. Robert H. Blank and Andrea L. Bonnicksen. New York: Columbia University Press, 1994. 15-23.

Szeremet, M. "Seeing-eye Doc". Illinois Institute of Technology Magazine (Spring 2002): 2-7.

A short article describing the work of Dr. Philip Troyk, a researcher at the Illinois Institute of Technology who is developing an intracortical visual prosthesis. The article avoids exaggerated optimism about the prospects for this technology, and devotes significant attention to ethical issues. (Jadran Lee 2004).

Thoma, H. "Some Aspects of Medical Ethics from the Perspective of Bioengineering". Theoretical Medicine 7 (1986): 305-317.

Tucker, Bonnie Poitras. "Deaf Culture, Cochlear Implants, and Elective Disability". Hastings Center Report 28.4 (July-Aug. 1998): 6-14.

Van der Wilt, Gert Jan, Rob Reuzal and David H. Banta. "The Ethics of Assessing Health Technologies". Theoretical Medicine and Bioethics 21.1 (Jan. 2000): 103-115.

Williams, D. "Objectivity in the Evaluation of Biological Safety of Medical Devices and Biomaterials". Medical Device Technology 2.1 (Jan.-Feb. 1991): 44-8.

---. "Where Have All the Implants Gone? The Need for Surveillance and Tracking". Medical Device Technology 5.6 (Jul.-Aug. 1994): 8, 10.


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