This has allowed Mr Copeland to play video games, fight in a ‘lightsabre’ duel and even shake hands with former President Barack Obama.136 Neurotechnology can also lead to greater understanding of how memories are stored. This has led to neurotechnologies that are capable of improving memory performance by up to 20%.137 For patients suffering conditions such as Alzheimer’s disease, stroke or head injuries, this is a promising treatment. Neurotechnologies are capable of improving memory performance by up to While the medical capabilities of neurotechnologies can benefit people with disability, people with disability are also most at risk. Neurotechnology may create a power imbalance between those seeking treatment or improvement of life and those that develop, deploy and maintain the products. Such imbalances raise further questions around true, informed and ongoing consent. Negatives Despite the potentially positive impacts of medical neurotechnologies for people with disability, several pertinent risks arise when engaging with the technology: ƒ What processes are in place to ensure that neurotechnology users, who often receive implantable BCIs, are supported for the life of the device? ƒ Will medical devices be funded by the National Disability Insurance Scheme (NDIS) or other schemes? ƒ Will there be an increased disparity between those who can afford/utilise devices and those who cannot? ƒ How will updates be transmitted to the implanted BCI? ƒ What will happen to BCIs as they become replaced by more advanced BCIs? ƒ How can users be protected in the event of a neurotech company’s dissolution? The physical health risks of implantable BCIs are well noted and physical harms are already being realised. One example is Second Sight, which provided visually impaired users with a form of artificial vision to help them see again.138 With over 350 patients globally, this neurotechnology product initially assisted many people. However, in 2019–2020 Second Sight discontinued its product and nearly went insolvent. This resulted in some users literally having their implants ‘turned off’ as their artificial vision ‘went dark’. While some report that the implants still worked, at this stage there is little indication that users can have the devices fixed if it malfunctions.139 Difficulties may also arise when an implantable device is removed. NeuroVista was a company which made a device which signalled to users when an epileptic fit was about to occur, allowing users to take measures to avoid or minimise the impact.140 In 2013, NeuroVista ran into financial difficulties and began removing the implantable devices. One user spoke of her sense of deep trauma and grieving after having the device forcibly removed (as the device did not belong to her), claiming she would have done anything to keep it – she even attempted to re‑mortgage her house to buy the device to evade removal.141 The device had allowed her to live confidently and happily, but after its removal she stated: I have never again felt as safe and secure … nor am I the happy, outgoing, confident woman I was … I still get emotional thinking and talking about my device … I’m missing and it’s missing.142 The removal, decommissioning or end of life of an invasive BCI raises issues under article 25 CRPD to the enjoyment of the highest attainable standard of health rights – especially where removal results in disability or physical or mental injury returning or being experienced in a heightened manner undesirable to the user.143 Further, it is probable that first use cases fitted with BCIs will be monitored to develop and train future models and associated algorithms. This may enliven issues under article 15.1 CRPD which requires a user’s consent to medical or scientific experimentation.144 ƒ Can genuine informed consent truly be obtained? 20 Protecting Cognition: Background Paper on Human Rights and Neurotechnology

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