Reexamining the ethical, legal, social, and cultural implications for cochlear implants through a novel neuroethics framework

In the last few decades humanity has experienced a true technological revolution. The discoveries of this Information Era have found applications in myriad domains. Most recently, there has been an explosion of new information technologies designed to directly communicate with our bodies, and most notably, our brains. These so-called neurotechnologies might fundamentally transform the way we interact with the external world, and promise to revolutionize the medical field. Neurological and psychiatric conditions have been identified as some of the most pressing public health challenges of this century, given that relatively little is known about their causes, and that they are becoming a major concern among an increasingly aging population. Therefore, there is a tremendous incentive to promote the development of more advanced neurotechnologies. However, there has not been a similar drive to analyze the implications that such technologies might have on both individuals with these disorders, their caregivers and society in general. Here, as part of the IEEE Brain Neuroethics Initiative, we present a framework to analyze issues that might arise when designing and using a wide range of medical neurotechnologies. To illustrate the utility of our framework, we apply it to one of the most established medical neurotechnologies to date, cochlear implants. We highlight a range of ethical implications on safety, wellbeing, and agency, among other factors, as well as potential legal, societal and cultural considerations. Through this case study, we exemplify the benefits of analyzing neurotechnologies using our ethical framework, and encourage neurotechnology stakeholders such as researchers, engineers, clinicians, funding agents and end users to apply it in order to guide responsible development and deployment of neurotechnologies.¹Authors contributed equally and both should be recognized as first author