Today's mail brings a catalog advertising a sweatshirt emblazoned with the slogan, In my next life I'm going to have more memory installed." Most of us can relate to this desire. As it happens, it might not be so farfetched. Computer visionaries predict that within our lifetimes, implantable computer chips acting as sensors, or actuators, may not only assist failing memory but even bestow a variety of capacities. With their aid, we may acquire fluency in new languages or "recognize" people we have never met. The possibility exists that the increasingly common replacement of body parts with mechanical items will lead eventually to the creation of cybernetic organisms--beings that intimately mix man and machine. If this trend is taken to its limit, computer chips and other electronic equipment implanted within human bodies might replace, augment, and enhance those most human of faculties, our memory and our ability to reason. We could see the coming to be of science fiction's cyborg, a person who has an intimate, perhaps necessary relationship with a machine.
The fantastic depictions of bionic man in science fiction tend to deflect serious discussion of this possibility. Robocop's enhanced humans and The Terminator's stainless steel robots with living human skin make the topic seem laughable. Star Trek's depiction of the evil race of cyborgs known as "The Borg" prejudices reasoned discussion of the "cyborgization" of humankind. The possibilities envisioned by William Gibson's novel Neuromancer of a world where the human mind and electronic technology interface in a seamless continuum of consciousness seem remote. Hence, while cyborgs get attention in science fiction, scholarly analysis of the media, and in the writings of a few bold pioneers, for the most part there has been no serious discussion of whether we should move in the direction of such interfaces, whether we can control this technology, whether it will be progress or peril, and who should control it. It is the purpose of this paper to awaken the consciousness of the bioethics community to this field, to urge that a forum for societal deliberation be created, and to pose some preliminary questions.
A Quiet Revolution
Bioelectronics combines advances in prosthetic technology and in computer science. Given this origin, it has a long pedigree, since the use of prosthetic devices to rehabilitate and restore function spans human history, proceeding in stages from simple external extensions of the human body--crutches and peg legs--through "energy storing" feet and devices controlled by muscle contraction to the current work involving direct brain interfaces. Worldwide there are at least three million people living with artificial implants. They use breast, penile, pectoral, testicular, chin, calf, hair, hormonal, medicinal, and dental prostheses. They also use bionic limbs, cardiac pacemakers, small implantable pumps to assist in pulmonary or systemic circulation of blood, and automatic biochemical pumps that either replace or augment parts of the nervous or neuroendocrine systems and also provide sensory substitution.
These bioelectronic developments, combined with progress in facilitating interfaces between neural tissues and substrate micro probes, are setting the stage for implantable brain chips. The first steps have already been taken in research on the cochlear implant and on retinal vision. Cochlear implants enable totally deaf people to hear sound by directly stimulating the auditory nerve. In a similar way, retinal implantable chips for prosthetic vision may restore vision to the blind. Work on prosthetic vision was begun in the 1960s, when Giles Brindley attached eighty electrodes to miniature radio receivers and implanted them into a sightless volunteer's brain, hoping to remotely stimulate the visual cortex. In the 1970s, William Dobelle carried the work a step further. The subjects of Dobelle's experiments reported seeing phosphenes, or points of light, akin to the signals received by a functioning visual system. …