Jens Clausen is lecturer and researcher at the institute of ethics and history of medicine at the University of Tubingen, Germany. COMPAMED.de talked with him about remote-controlled bulls, ethical doubts and the use of neuroprosthetics.
COMPAMED.de: Mr. Clausen, the behaviour of monkeys has already been controlled in experiments with neuro implants. Experts say that a person’s behaviour can also be changed by stimulating the brain. Thoughts are free - will they still be in future?
Jens Clausen: Thoughts should remain free. Of course, from a scientific view astonishing experiments with animals have already been made in the 1950s. In Spain, a bull was steered and stopped in an arena by a chip. Rats were also steered through a course. However, when it comes down to humans a quite different aim is of is importance - namely to help. Deep brain stimulation, for example, is used to alleviate disturbed motor skills and not to read ideas and thoughts. I am not concerned at all about controlling the patient’s will because I notice how serious neurologists are when deciding if a patient should receive neuroprosthetics.
COMPAMED.de: Neuroprosthetics raise hope for many neurological diseases like Parkinson’s, epilepsy and strong depressions. Besides the hopeful debate ethical questions are being considered. What exactly is this discussion about? What are the problems ethicians see?
Clausen: These problems are the same ones physicians also see. We should not only present the optimum results in public, for example concerning Parkinson’s. It should also be pointed out that such an intervention can cause depressions or aggressions. Moreover, each surgery bears a risk like bleeding or swellings when a chip is incorporated into the brain. A damaged vein can lead to disastrous results. Patients can die during such a surgery or be severely disabled afterwards. It is important that patients are informed about these risks. That is why neuroprosthetics are always the last choice after all other therapies and drugs have failed.
COMPAMED.de: Researchers in New York used a neuro implant for a patient who had been in vigilant coma for six years. Now he has gained partial consciousness, is able to speak fragmentally, to hold a cup and to swallow independently - and he is completely aware of his hopeless situation. Is this ethical?
Clausen: I have not heard about this case. But in clinical everyday life there are medical situations that ask for decisions to be made without prior agreement of the patient. Just imagine accidents or dementia. In these situations physicians try to determine what the patient would want and what its family thinks about it. Then a team of physicians decide whether the intervention has a chance to succeed. If not, it is rejected.
COMPAMED.de: How will tomorrow’s world look like with all the new possibilities of influencing a person’s brain?
Clausen: I do not know whether the world will change in the next years. There are already people living among us who carry implants. For decades patients have been living with deep brain stimulation or with Cochlea implants. I believe that one should not outline any horror scenarios. We should rather pay attention to the fact that prosthetics help.
The interview was conducted by Natascha Mörs.