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Ethical Aspects of ICT Implants in the Human Body Rafael Capurro European Group on 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/index_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 Rafael Capurro: Ethical Aspects of ICT Implants

Overview l EGE: Tasks and Opinions l ICT Implants in the Human Body: ¡ Overview l EGE: Tasks and Opinions l ICT Implants in the Human Body: ¡ Categorisation of implantable devices ¡ Implantable devices on the market ¡ Implantable devices under development l Ethical Aspects of ICT Implants l Ethics and Public Policy Rafael Capurro: Ethical Aspects of ICT Implants 2

The European Group on Ethics (EGE) l The EGE is an independent, pluralist and The European Group on Ethics (EGE) l 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. Rafael Capurro: Ethical Aspects of ICT Implants 3

EGE Members (2001 -2005) 1. 2. Prof. Göran HERMERÉN (Sweden), President, Philosopher, Professor of EGE Members (2001 -2005) 1. 2. Prof. Göran HERMERÉN (Sweden), President, Philosopher, Professor of Medical Ethics, Faculty of Medicine, Lund University. 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 Mc. LAREN (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. Rafael Capurro: Ethical Aspects of ICT Implants 4

Rafael Capurro: Ethical Aspects of ICT Implants 5 Rafael Capurro: Ethical Aspects of ICT Implants 5

EGE Secretariat Dr. Michael D. Rogers, European Commission, BERL 10/345, rue de la Loi 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_ethi cs EGE-Newsletter "Ethically Speaking": providing also information on the activities of the National Ethics Committees. Rafael Capurro: Ethical Aspects of ICT Implants 6

Opinions 2001 -2005 l l l Opinion n. 16 (2002) Ethical aspects of patenting Opinions 2001 -2005 l l l 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 Rafael Capurro: Ethical Aspects of ICT Implants 7

Categorisation of ICT Implants l Implantable devices can be categorised as: ¡ ¡ l Categorisation of ICT Implants l Implantable devices can be categorised as: ¡ ¡ l medical non-medical Both as: ¡ ¡ passive active Reversible or non reversible l Stand-alone or online l ICT implants and tags l Rafael Capurro: Ethical Aspects of ICT Implants 8

Implantable passive ICT medical devices l Most passive implants are structural devices such as Implantable passive ICT medical devices l Most passive implants are structural devices such as ¡ artificial joints ¡ vascular implants ¡ artificial valves l Active medical implantable devices Directive 90/385/EEC Rafael Capurro: Ethical Aspects of ICT Implants 9

Current active medical ICT implants Cardiovascular pacers for patients with conduction disorders or heart Current active medical ICT implants Cardiovascular pacers for patients with conduction disorders or heart failure l Cochlear and brainstem implants for patients with hearing disorders l Deep brain stimulation l ¡ ¡ for tremor control in patients with Parkinson's disease for essential tremor for obsessive-compulsive disorders l 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 l Insulin pump for Diabetes l l Rafael Capurro: Ethical Aspects of ICT Implants 10

Future medical ICT implants l Artificial vision: ¡ l Cortical implant for the blind: Future medical ICT implants l Artificial vision: ¡ l Cortical implant for the blind: bypassing the non-working retina or optic nerve Bio. MEMS: 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): Brain. Gate™: www. cyberkineticsinc. com l Memory Brain. Chip (artificial hippocambus) an implantable brain chip could restore or enhance memory l Rafael Capurro: Ethical Aspects of ICT Implants 11

Other medical ICT implants/prostheses l The German company Otto Bock Healthcare produces prostheses like Other medical ICT implants/prostheses l The German company Otto Bock Healthcare produces prostheses like the „C-Leg“ which is a chip-controlled leg. See: http: //www. ottobock. de/de Rafael Capurro: Ethical Aspects of ICT Implants 12

Implantable Non-Medical Devices l Passive devices: An example of a passive device is the Implantable Non-Medical Devices l Passive devices: An example of a passive device is the radio frequency identification (RFID) device. l Active devices use electrical impulses to interact with the human’s nervous system. Rafael Capurro: Ethical Aspects of ICT Implants 13

Baja Beach Club l http: //www. bajabeach. es/ l „Somos la primera discoteca del Baja Beach Club l http: //www. bajabeach. es/ l „Somos la primera discoteca del mundo en ofrecer el VIP Veri. Chip. 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. “ Rafael Capurro: Ethical Aspects of ICT Implants 14

Baja Beach Club „El objetivo de esta tecnología es llevar un sistema de identificación 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. “ Rafael Capurro: Ethical Aspects of ICT Implants 15

Other non-medical applications l Experiments as reported by Kevin Warwick (Department of Cybernetics, University Other non-medical applications l Experiments as reported by Kevin Warwick (Department of Cybernetics, University of Reading, UK) l In Mexico (August 2004) microchips were implanted in the arms of the Fiscal General and 160 Fiscal‘s employees to control their access to a confidential documentation centre and possibly track them in case of kidnapping. Rafael Capurro: Ethical Aspects of ICT Implants 16

Other non-medical applications l The UK Prime Minister announced (August 2004) a programme whereby Other non-medical applications l 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. Rafael Capurro: Ethical Aspects of ICT Implants 17

Other non-medical applications l In the Japanese prefecture of Wakayama (Osaka) children will use Other non-medical applications l In the Japanese prefecture of Wakayama (Osaka) children will use RFID-labels for entering school (2004). l Trace. Care (Wiesbaden, Germany) offers devices that allow to find the position of a person via internet through a Global Positioning System (GPS). Rafael Capurro: Ethical Aspects of ICT Implants 18

Other non-medical applications l The Bavarian company Ident Technology offers tracking devices using the Other non-medical applications l The Bavarian company Ident Technology offers tracking devices using the human body (particularly the skin) as digital data transmitter. See: http: //www. identtechnology. com Rafael Capurro: Ethical Aspects of ICT Implants 19

Other non-medical applications l Microsoft patent Number 6, 754, 472 June 22, 2004 concerns Other non-medical applications l 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. Rafael Capurro: Ethical Aspects of ICT Implants 20

Future personal tracking devices l Integration and miniaturization of three technologies: www. digitalangel. com Future personal tracking devices l Integration and miniaturization of three technologies: www. digitalangel. com Biosensor: read a person‘s 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 person‘s pager device -> this information is sent through cellular data packets to a data centre (Digital Angel™) -> The first Digital Angel was launched in November 2001 -> Medical emergency purposes -> Identification/Location purposes ¡ Rafael Capurro: Ethical Aspects of ICT Implants 21

Legal Background Universal Declaration of Human Rights l EU Charter of Fundamental Rights of Legal Background Universal Declaration of Human Rights l EU Charter of Fundamental Rights of 2000 l Convention on Human Rigts and Biomedicine of the Council of Europe l EU Directives l European Constitution, National Constitutions -> providing that the human body and its parts shall not give rise to financial gain (Principle of human dignity) l Rafael Capurro: Ethical Aspects of ICT Implants 22

Ethical Aspects of ICT Implants l Anthropological background: ¡ The unity of biological and Ethical Aspects of ICT Implants l Anthropological background: ¡ The unity of biological and psychic (intellectual, emotional) functions ¡ The body and the environment ¡ Social aspects ¡ Creativity, cultural aspects l Some characteristics of ICT devices: ¡ Chips (silicon, bio-chips) ¡ algorithms Rafael Capurro: Ethical Aspects of ICT Implants 23

Ethical Aspects of ICT Implants l Fundamental ethical principles: ¡ Human Dignity ¡ Privacy Ethical Aspects of ICT Implants l Fundamental ethical principles: ¡ Human Dignity ¡ Privacy (data protection) ¡ Autonomy ¡ Confidentiality l Ethical conflict(s): to reduce freedom and autonomy vs. Increase health, security… Rafael Capurro: Ethical Aspects of ICT Implants 24

Ethical Aspects of ICT Implants In case of medical applications: l Prohibition of eugenic Ethical Aspects of ICT Implants In case of medical applications: l Prohibition of eugenic practices l Respect of the informed consent of the patient l Prohibition of making the human body and its parts a source of financial gain Rafael Capurro: Ethical Aspects of ICT Implants 25

Ethical Aspects of ICT Implants l In case of non-medical applications: ¡ Privacy and Ethical Aspects of ICT Implants l In case of non-medical applications: ¡ Privacy and surveillance ¡ Exclusionary practices ¡ Practices of domination ¡ Practices of privacy invasion -> How far will ICT Implants (and tags) enlarge our individual and social choices and how far will they create a situation of social discrimination? Rafael Capurro: Ethical Aspects of ICT Implants 26

Ethical Aspects of ICT Implants l In case of enhancement(s) ¡ What does it Ethical Aspects of ICT Implants l 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? -> the „post-human“ debate ¡ How clear is the distinction between therapeutic applications and enhancements? Rafael Capurro: Ethical Aspects of ICT Implants 27

Ethics and Public Policy: Historical Roots The relation between ethics, law, and public policy 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 Plato’s “Nomoi” (722 d) 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). Rafael Capurro: Ethical Aspects of ICT Implants 28

Ethics and Public Policy: Historical Roots Since Modernity, and particularly since Thomas Hobbes, there 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. Today’s mass media and particularly the internet have created new forms of mediation without eliminating the differences. Rafael Capurro: Ethical Aspects of ICT Implants 29

Ethics and Public Policy: Ethics Councils l Ethics councils within the sphere of public Ethics and Public Policy: Ethics Councils l 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. l Their task is reflection, not decisionmaking or dogmatic proclamation. Rafael Capurro: Ethical Aspects of ICT Implants 30

Ethics and Public Policy: Ethics Councils l They should counterbalance ethical arguments and give Ethics and Public Policy: Ethics Councils l They should counterbalance ethical arguments and give an opinion on matters that remain controversial and subject to revision. l Today’s public policy has a need for such counsels particularly with regard to new developments in science and technology. Rafael Capurro: Ethical Aspects of ICT Implants 31

Ethics and Public Policy: Ethics Councils l Of course, such ethics bodies are not Ethics and Public Policy: Ethics Councils l 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. Rafael Capurro: Ethical Aspects of ICT Implants 32

Ethics and Public Policy: Ethics Councils l In other words, it is important that Ethics and Public Policy: Ethics Councils l 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. Rafael Capurro: Ethical Aspects of ICT Implants 33

Ethics and Public Policy: Ethics Councils l Although they might look for consensual opinions, Ethics and Public Policy: Ethics Councils l 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. Rafael Capurro: Ethical Aspects of ICT Implants 34

Ethics and Public Policy: Ethics Councils Most European and non-European national and international ethics Ethics and Public Policy: Ethics Councils Most European and non-European national and international ethics committees have been created in the nineties. l UNESCO’s International Bioethics Committee (IBC) was created in 1993. The Steering Committee on Bioethics of the Council of Europe dates from 1992. l US President George W. Bush created The President’s Council on Bioethics on the basis of the Executive Order 13237 from November 28, 2001 (http: //www. bioethics. gov/). l 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. l Rafael Capurro: Ethical Aspects of ICT Implants 35

Ethics and Public Policy: Further Reading Rafael Capurro: - Ethics and Public Policy within 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/ethicomp 02. 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 - Rafael Capurro: Ethical Aspects of ICT Implants 36

¡GRACIAS POR SU ATENCIÓN! Rafael Capurro: Ethical Aspects of ICT Implants 37 ¡GRACIAS POR SU ATENCIÓN! Rafael Capurro: Ethical Aspects of ICT Implants 37