Mapping Ethical Challenges in Emotional Retraumatization in Cognitive Bionics Research

Paul Marasco, PhD – Director, Laboratory for Bionic Integration, Cleveland Clinic; Lauren Sankary – UT Southwestern

Abstract: There is an ethical obligation to anticipate and plan for the negative emotional experiences of research participants in studies where they will regain and re-lose parts of their embodied selves. Beyond simple function, research has demonstrated bionic limb systems can be accepted within the users’ embodied experiences. These embodied bionics are felt to be part of the user’s body (ownership) and the actions of the bionics are felt as the user’s own actions (agency). One of the authors (a biomedical engineer) conducts neural-machine interface research that induces feelings of ownership and agency for the prosthetic limbs of individuals with amputation. Unexpectedly, participants spontaneously shared that they experienced a retraumatization, akin to again having an amputation, at the end of research sessions. We now are in uncharted territory for understanding risk. A new generation of bionic limbs that function by integrating into the user’s embodied experiences are revealing a host of questions related to how participants experience regaining the senses of ownership and agency over the replacements of their missing limbs. There is an ethical imperative to further characterize and transparently disclose adverse effects participants may experience during experimental modulation of ownership and agency through manipulation of bionic device’s cognitive/perceptual/intentional neurorobotic feedback and control architecture. In this paper we (philosopher, biomedical engineer, and legal scholar) analyze what proper attention and mitigation will be needed in research development and design for future bionics projects that may disrupt or interrupt participants’ embodied experiences.

Keywords: Research ethics, Neuroethics, Trauma