Implants in the Human Body

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30 Νοε 2013 (πριν από 3 χρόνια και 7 μήνες)

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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

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Overview


EGE: Tasks and Opinions


ICT Implants in the Human Body:


Categorisation of implantable devices


Implantable devices on the market


Implantable devices under development


Ethical Aspects of ICT Implants


Ethics and Public Policy

Rafael Capurro: Ethical Aspects of ICT Implants

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The European Group on Ethics (EGE)


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

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EGE Members (2001
-
2005)

1.
Prof. Göran HERMERÉN (Sweden),
President
, Philosopher, Professor of Medical Ethics, Faculty
of Medicine, Lund University.



2.
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 McLAREN (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

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Rafael Capurro: Ethical Aspects of ICT Implants

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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

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Opinions 2001
-
2005


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

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Categorisation of ICT Implants


Implantable devices can be categorised as:


medical



non
-
medical



Both as:


passive



active


Reversible or non reversible


Stand
-
alone or online


ICT implants and
tags

Rafael Capurro: Ethical Aspects of ICT Implants

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Implantable passive ICT medical devices


Most passive implants are structural
devices such as


artificial joints


vascular implants


artificial valves


Active medical implantable devices
Directive 90/385/EEC

Rafael Capurro: Ethical Aspects of ICT Implants

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Current active medical ICT implants


Cardiovascular pacers

for patients with conduction disorders or heart
failure


Cochlear and brainstem implants

for patients with hearing disorders


Deep brain stimulation


for tremor control in patients with
Parkinson's disease



for
essential tremor



for obsessive
-
compulsive disorders


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


Insulin pump

for Diabetes

Rafael Capurro: Ethical Aspects of ICT Implants

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Future medical ICT implants


Artificial vision:


Cortical implant for the blind: bypassing the non
-
working retina
or optic nerve


BioMEMS: 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):
BrainGate
™:
www.cyberkineticsinc.com


Memory BrainChip (artificial hippocambus) an
implantable brain chip could restore or enhance memory

Rafael Capurro: Ethical Aspects of ICT Implants

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Other medical ICT implants/prostheses


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

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Implantable Non
-
Medical Devices


Passive devices: An example of a passive
device is the radio frequency identification
(RFID) device.


Active devices use electrical impulses to
interact with the human’s nervous system.

Rafael Capurro: Ethical Aspects of ICT Implants

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Baja Beach Club


http://www.bajabeach.es/


„Somos la primera discoteca del mundo
en ofrecer el VIP VeriChip. 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

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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.“

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Other non
-
medical applications


Experiments as reported by Kevin
Warwick (Department of
Cybernetics,University of Reading, UK)


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.

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Other non
-
medical applications


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

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Other non
-
medical applications


In the Japanese prefecture of Wakayama
(Osaka) children will use RFID
-
labels for
entering school (2004).


TraceCare (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

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Other non
-
medical applications


The Bavarian company Ident Technology
offers tracking devices using the human
body (particularly the skin) as digital data
transmitter. See:
http://www.ident
-
technology.com



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Other non
-
medical applications


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

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Future personal tracking devices


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

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Legal Background


Universal Declaration of Human Rights


EU Charter of Fundamental Rights of 2000


Convention on Human Rigts and Biomedicine of
the Council of Europe


EU Directives


European Constitution, National Constitutions

-
> providing that the human body and its parts
shall not give rise to financial gain (Principle of
human dignity)

Rafael Capurro: Ethical Aspects of ICT Implants

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Ethical Aspects of ICT Implants


Anthropological background:


The unity of biological and psychic (intellectual,
emotional) functions


The body and the environment


Social aspects


Creativity, cultural aspects


Some characteristics of ICT devices:


Chips (silicon, bio
-
chips)


algorithms

Rafael Capurro: Ethical Aspects of ICT Implants

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Ethical Aspects of ICT Implants


Fundamental ethical principles:


Human Dignity


Privacy (data protection)


Autonomy


Confidentiality


Ethical conflict(s): to reduce freedom and
autonomy vs. Increase health, security…


Rafael Capurro: Ethical Aspects of ICT Implants

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Ethical Aspects of ICT Implants

In case of medical applications:


Prohibition of eugenic practices


Respect of the informed consent of the
patient


Prohibition of making the human body and
its parts a source of financial gain

Rafael Capurro: Ethical Aspects of ICT Implants

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Ethical Aspects of ICT Implants


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

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Ethical Aspects of ICT Implants


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?

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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” (722d)
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

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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

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Ethics and Public Policy: Ethics Councils


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.


Their task is reflection, not decision
-
making or dogmatic proclamation.


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Ethics and Public Policy: Ethics Councils


They should counterbalance ethical
arguments and give an opinion on matters
that remain controversial and subject to
revision.


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

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Ethics and Public Policy: Ethics Councils


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

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Ethics and Public Policy: Ethics Councils


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

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Ethics and Public Policy: Ethics Councils


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

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Ethics and Public Policy: Ethics Councils


Most European and non
-
European national and
international ethics committees have been created in the
nineties.


UNESCO’s International Bioethics Committee (IBC) was
created in 1993. The Steering Committee on Bioethics of
the Council of Europe dates from 1992.


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/
).


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.

Rafael Capurro: Ethical Aspects of ICT Implants

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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/ethicomp02.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




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