“What keeps the world together? It’s rules… people abiding by the terms” –’Repo Man’
This past May, I had the great privilege of being invited to lecture at NYU’s Steinhardt Department of Media, Culture, and Communication as a LeBoff Distinguished Visiting Scholar. While there, I taught an interdisciplinary seminar called ‘Building Better Humans’ which focused on the legal and ethical implications of new and emerging technologies in the context of what I call the ‘human-machine merger’. This presentation addresses some of the core concepts discussed during our time together.
After several decades of rapid technological innovation we have reached a point at which it is possible to transcend traditional biological limitations through the implantation of microchips, digital body parts and artificial organs. Devices such as fully integrated cochlear implants, retinal inserts and various neural and bionic prosthetics promise to transform the sensory and motor abilities of those who adopt them, ostensibly giving patients greater ‘Security, Adaptability, [and] Freedom’ (Ossur).
However, surprisingly little thought has been given to the ethical and legal aspects of their design and use. Using the cochlear implant as a case study, I elaborate upon some of the key cultural, legal, and ethical issues that are all too often eclipsed by the glamour of scientific innovation. Echoing criticisms voiced by scholars such as Neil Postman, Langdon Winner and Mara Mills, I argue that artificial organs are more than exciting, flashy gadgets that correct unwanted defects. In the context of broader society they become socio-technical-political-artefacts. For instance, to members of the deaf community who do not consider themselves as having any defect in need of correcting, the cochlear implant raises a potential threat of ‘cultural genocide’, among other concerns.
I also examine current ethical and regulatory approaches that govern medical devices and argue that the existing paradigm of mass-market consumer goods is not particularly well suited for the domain of implantable devices. My primary concern here is that individuals will increasingly be roped into a complex set of legal obligations that diminish individual autonomy over the use of their body parts as well as shifting the focus of healthcare from that of patient care to business profit.
Drawing on lessons learned in the field of information technology law, I conclude that special considerations are required in the healthcare context to ensure that patient autonomy and privacy are adequately protected in an era where our bodies are becoming inextricably tethered by devices and software owned by health care providers.