By Thiemo Benthien

Figure 1 – Source: Tumisu @ Pixabay

Imagine being able to enhance your cognitive abilities, boost your physical performance, and even expand your senses—all through implants and prostheses. Sounds like science fiction? In reality, performance-enhancing technologies are already a part of our world. While some celebrate the benefits of these advancements, there are also serious ethical concerns. Will we soon have a society of “superhumans”? What happens to those who cannot afford expensive implants? How will we ensure the safety of these technologies?

Technology Upgrade for the Body

Primarily, these technologies are used to enhance physical abilities or to support individuals with physical limitations. One of the most exciting developments in this field is implants. They are directly inserted into the body to enhance its functions. These include implants that can, for example, improve hearing or vision.

Another promising technology is prosthetics, which can improve the lives of people with amputations or other physical limitations. Advanced prostheses can imitate the movement of the limbs. In addition to implants and prostheses, there are other technologies that enhance physical performance. One example of this is exoskeletons, which can support the weight of an object. This enables users to lift and carry heavier objects than they would normally be able to.

In order to understand possible ethical concerns and gain a more comprehensive insight into the topic, we will first explain the most important categories.

Technology Upgrade for the Senses

The five senses of humans are sight, hearing, touch, taste, and smell. If one or more of these senses is impaired, implants could be a lifesaver.

Hearing aids and cochlear implants are used to assist with hearing. Hearing aids are usually the first choice for people with mild to moderate hearing loss. Cochlear implants are used for more severe hearing difficulties or even deafness.

Hearing aids are small devices that amplify sound waves and transmit them to the ears to improve hearing. They are worn behind the ear or in the auricle and can be adjusted to meet the user’s individual hearing needs. Hearing aids can also be equipped with various features, such as noise suppression and wireless connectivity with other devices like phones and televisions.

Cochlear implants, on the other hand, are implanted directly into the inner ear and are used by people with severe hearing loss or deafness. They convert sound waves into electrical signals that are transmitted directly to the auditory nerve to create a hearing experience. Unlike hearing aids, cochlear implants are inserted by a surgeon, and specialized training is required to use them properly.

Studies have shown that cochlear implants have helped improve hearing in many people with hearing loss. This is also demonstrated by a study from 2007. According to the study, cochlear implants also help children with hearing loss promote language development and improve quality of life [1].

To support the vision of people, glasses or contact lenses are usually the first options. This is followed by electronic glasses that improve the vision of people with various types of visual impairments by enlarging images or enhancing contrast. Retina implants, on the other hand, require a medical procedure. These implants are used for people with hereditary eye diseases to help improve their vision. In other diseases, such as diabetes, not only the retina but also the entire visual system can be affected. In such cases, the possibilities for restoring vision are limited.

However, there is also hope for these people through current research, such as in Bremen. Here, a consortium of five research groups from the EU and Canada is working on the “I See” project to develop improved visual prosthetics. The project also involves Dr. Udo Ernst and Dr. David Rotermund from the Institute of Theoretical Physics at the University of Bremen.

Figure 2  – The human eye. Could it look like this in the future? Source:  Victoria_Watercolor @ Pixabay

According to the scientists, the prostheses can be improved by taking into account the already existing activation of the visual cortex and by taking into account the type of information coding in the brain during stimulation. The research group from Bremen is developing advanced data analysis methods that aim to help analyze the “language of the brain” [2].

The abilities of the other senses can also be supported by electronic noses, tactile sensors or electronic tongues. However, these technologies are relatively rare. More common are dental implants, pacemakers, bladder pacemakers, and insulin pumps.

From Loss to Strength through Prostheses

Prostheses have been significantly developed in recent decades and have become essential in medical care for people with amputations. Prosthetics are artificial limbs, such as legs or arms, that replace body parts that have been completely or partially amputated.

Modern prostheses are typically designed to function as closely as possible to real body parts. They can be customized to meet the needs and abilities of the users. There are various types of prostheses, including arm prostheses, leg prostheses and prostheses for other body parts such as fingers and toes.

Performance-enhancing prostheses, also known as bionic prostheses, are a special type of prosthesis that use electronic components and artificial intelligence to enable greater functionality. For example, some bionic arm prostheses can be equipped with sensors. These provide feedback to the users about their movement and help them grasp objects with greater precision.

Figure 3 – Example of a bionic forearm prosthesis. Source: Stefan Dr. Schulz @ Pixabay

Although prostheses do not fully restore natural limbs, they have a significant impact on people with amputations. They enable them to regain their abilities and independence and lead an active life. Thanks to advances in technology and medicine, prostheses are becoming more powerful, precise and functional, and it is likely that they will be further improved in the future.

Planning and Manufacturing Technological Advancements

Additive manufacturing and artificial intelligence (AI) are playing an increasingly important role in the development of performance-enhancing prostheses and implants. Additive manufacturing, or 3D printing, makes it possible to create complex parts that would not be possible using traditional manufacturing methods. This enables the production of customized and individually tailored prostheses and implants that are better suited to the specific needs of each patient.

AI-based systems can help improve the functionality of prostheses and implants by optimizing the interaction between human movement and technology. For example, smart prosthetics can be equipped with AI-controlled sensors that allow the prosthetic to interact naturally with the user’s movements. AI-driven implants can also aid in improving the diagnosis and treatment of diseases by collecting and analyzing data to make better decisions. The combination of additive manufacturing and AI has the potential to make prosthetics and implants even more powerful and functional while also being cheaper and faster to produce.

Can You Help Me Move on Sunday?

Carrying a washing machine up to the third floor or, in the unfortunate case, moving heavy objects from point A to point B for eight hours a day in a warehouse is an enormous strain on the human body. Exoskeletons can provide relief in some places. Exoskeletons are wearable robotic suits that can support and reinforce the body. They are often used to assist workers in industry and in the rehabilitation of patients with neurological conditions. Exoskeletons consist of a combination of mechanical, electronic, and computer-based systems that allow the user to gain additional strength and support.

An exoskeleton can help improve the mobility and independence of people with disabilities or injuries. For example, exoskeletons can be used in the healing process of patients with strokes, spinal cord injuries, and Parkinson’s disease to regain movement and muscle strength. In industry, exoskeletons assist workers in lifting heavy loads and improving their work efficiency.

Some of the latest developments in the field of exoskeletons include smart sensors and artificial intelligence, which help optimize the interaction between users and the exoskeleton. In the future, exoskeletons could also be used to support elderly individuals, making daily life easier and improving mobility.

The Power of the Mind

The last technological development to mention here is the brain-computer interface. Brain-computer interfaces are an exciting new technology that is changing the way we interact with computers. These interfaces use electrodes to capture signals from the user’s brain and then convert them into actions that can be executed by a computer. This enables direct communication between the brain and a computer.

Brain-computer interfaces have a wide range of applications, including the control of wheelchairs, robots, and prostheses for people with disabilities. They can also be used to improve communication for people who are no longer able to speak due to injuries or illnesses such as amyotrophic lateral sclerosis (ALS) or a stroke. Additionally, brain-computer interfaces offer potential for applications in the gaming industry, where users can control their characters through their thoughts.

What are the Challenges?

The challenges in this field include several different areas. Safety is a crucial aspect of this discussion. One of the main concerns relates to the potential risks associated with surgical procedures for implanting or adjusting prostheses or implants. Surgery can entail a range of complications, such as infections, bleeding, and nerve damage.

Another safety risk pertains to the possibility of malfunctions in implants or prostheses, which could lead to injuries or damage. For instance, faulty sensor technology might provide inaccurate measurements, thereby impairing the device’s functionality. This also includes the limited lifespan of implants. The “Hermimplant” project, involving the research group led by Prof. Dr. Walter Lang from the Institute for Microsensors, Actuators, and Systems at the University of Bremen, addresses this issue. The project aims specifically to extend the lifespan of implants used for chronic diseases, which remain in the human body for extended periods [3].

Another aspect is the misuse of data collected by these devices. Such data can be intercepted by manufacturers or third parties and could potentially be misused for unethical purposes, such as surveillance or identity theft [4].

Societal and medical ethical issues are also part of the debate: Who has access to these technologies, which are often associated with enormous costs? Is it fair for healthy individuals to improve their physical abilities, or does this give them an unfair advantage?

When it comes to technologization and further development, consideration must be given to people who could be left behind. This aims to prevent further social and societal inequities.

Will We Soon Have a Society of “Superhumans”?

Firstly, it is important to recognize that performance-enhancing implants and prostheses alone are not enough to create a “superhuman”. Factors such as training, nutrition, and genetics play a crucial role in human performance.

Due to the cost factor alone, widespread application of these technologies across society is highly unlikely. However, it is conceivable that the use of performance-enhancing implants and prostheses will become more widespread in the future. If this is the case, we could potentially see a society of “enhanced” people. However, this enhancement would only relate to physical aspects, and there are many other factors that define a human being. However, it is important that we recognize how the use of performance-enhancing implants and prostheses could impact our society and ensure that we use these technologies responsibly.

References:

Studie zu Cochlea-Implantaten: [1] https://www.nejm.org/doi/full/10.1056/nejmct0706268

Projekt “I See”: [2] https://www.uni-bremen.de/universitaet/hochschulkommunikation-und-marketing/archiv/detailansicht/neurowissenschaftler-wollen-blinden-wieder-seheindruecke-ermoeglichen

Projekt “Hermimplant”: [3] https://www.uni-bremen.de/imsas/forschung/projekte-ag-lang/hermimplant

Beitrag zur ethischen Diskussion von Computer-Gehirn-Schnittstellen: [4] https://journalofethics.ama-assn.org/article/ethical-and-social-challenges-brain-computer-interfaces/2007-02