Neuron

NeuroView

From Healthcare to Warfare and Reverse:

How Should We Regulate
Dual-Use Neurotechnology?
Marcello Ienca,1,2,* Fabrice Jotterand,1,3 and Bernice S. Elger1,4
1Institutefor Biomedical Ethics, Faculty of Medicine, University of Basel, Basel, Switzerland
2Health Ethics and Policy Lab, Department of Health Sciences and Technology (HEST), ETH Zurich, Zurich, Switzerland
3Center for Bioethics and Medical Humanities, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
4University Center for Legal Medicine, University of Geneva, Geneva, Switzerland

*Correspondence: [email protected]
https://doi.org/10.1016/j.neuron.2017.12.017

Recent advances in military-funded neurotechnology and novel opportunities for misusing neurodevices
show that the problem of dual use is inherent to neuroscience. This paper discusses how the neuroscience
community should respond to these dilemmas and delineates a neuroscience-specific biosecurity frame-
work. This neurosecurity framework involves calibrated regulation, (neuro)ethical guidelines, and aware-
ness-raising activities within the scientific community.

Introduction: Dual-Use sources for the development of threats and muscular system. Medical ap-
Neurotechnology to public health, individual safety, or plications of BCI have shown clinical
In the ethics of (bio)technology, the dual- national security. The DURC label was effectiveness in repairing, assisting, or
use problem refers primarily to the coop- introduced to prevent the malicious augmenting cognitive or sensory-motor
tation of civilian technology for military application of life science research, and functions in patients experiencing neuro-
aims. This expression is also used to refer although this framing has recently faced logical impairments including spinal-cord
to the possibility of utilizing the same criticism among researchers (e.g., for injury, stroke, motor neuron disease,
technology for both beneficial (e.g., clin- not clearly demarcating the range of and, more recently, even though with sig-
ical) applications and harmful misuse dual-use applications and providing only nificant limitations, age-related cognitive
(e.g., bioterrorism). While nearly any limited oversight), it is still in place as a decline and Alzheimer’s disease (AD).
technology holds a potential for dual guidance mechanism among national Outside the clinics, non-invasive direct-
use in the broad sense, recent reports and international organizations. to-consumer BCIs are gaining increasing
for the British Royal Society and the In the past two decades, new concerns popularity as portable (often smart-
Dutch Research Council have provided have been raised as several emerging phone-compatible) tools for device con-
a narrower definition and distinguished neurotechnologies have shown dual-use trol, self-neuromonitoring, and personal-
‘‘intentional misuse’’ from the general potential, causing the inclusion of various ized entertainment.
domain of repurposing activities with un- areas of neuroscience into the DURC Using the same technological para-
intended harmful consequences. Dual- domain. Tennison and Moreno (2012) digm, national security uses of BCI
use technologies are originally designed have extensively reviewed the domain include the acquisition of neural infor-
and developed for a wide spectrum of of neurotechnology tools with applica- mation gathered from warfighters’
civilian purposes, among which biomed- tions in both civilian and national security brains to adaptively modify their equip-
ical research and healthcare often play contexts with special focus on projects ment and the development of Threat
a prominent role. funded via the Pentagon’s Defense Warning Systems that convert sub-
Until recent times most attention to Advanced Research Projects Agency conscious, neurological responses to
dual-use technology emerged in the (DARPA). Their state-of-the-art review danger into consciously available infor-
fields of molecular and cell biology, espe- identified three main categories of dual- mation (Miranda et al., 2015). Warfighter
cially in those areas involving research on use neurotechnology: brain-computer in- enhancement applications include phar-
pathogens such as virology, bacteri- terfaces (BCIs), neurotechnologies for macological and non-pharmacological
ology, and other subdivisions of microbi- warfighter enhancement, and neurotech- (especially transcranial direct current
ology. Security-sensitive research in nological systems for deception detec- stimulation [tDCS]) technologies for se-
these fields of science is classified as tion and interrogation (Tennison and lective cognitive enhancement in tar-
Dual Use Research of Concern (DURC). Moreno, 2012). The first category en- geted brain areas. Finally, the deception
DURC is a United States government’s compasses systems that establish a detection domain encompasses devices
oversight label identifying research in direct connection channel between the such as the so-called ‘‘brain-finger-
the life sciences that can be anticipated human brain and an external computer prints’’ capable of accessing concealed
to provide informational or technical re- device, bypassing the peripheral nervous information in response to a stimulus.

Neuron 97, January 17, 2018 ª 2017 Elsevier Inc. 269

 Neuron

NeuroView

While these applications, especially to that, neuroengineers have called for reverse dual-use potential. A paradigmatic
those based on functional magnetic enhancing the security of current neurode- example is the DARPA-funded Restor-
resonance (fMRI) and electroencepha- vices and incorporating protective mea- ative Encoding Memory Integration Neural
lography (EEG), hold a great potential sures such as encryption technology into Device (REMIND) (http://ieeexplore.ieee.
for medical diagnostics, they are power- the product design (Bonaci et al., 2015). org/document/6090905) program. Under
ful surveillance and enhancement tools this program, researchers were able to
for national security, judicial, and mil- The Bidirectional Character of Dual detect patterns of functional brain con-
itary purposes due to their dual-use Use in Neurotechnology nectivity in the hippocampus and prefron-
character. Although no deception detec- As dual use appears inherent to neuro- tal cortex associated with successful
tion technology is being currently used technology, the progressive increase in memory encoding and retrieval. After
in official security operations, several the number of civilian—both clinical and identifying hippocampal firing patterns
devices are either directly DARPA consumer-grade—neurotechnology ap- associated with correct encoding of a spe-
commissioned or are able to market plications will likely determine a propor- cific event, they translated these outputs
their services to national security and tionate increase in dual-use opportunities. into electrical stimulation in animal models
law enforcement agencies (http://www. With global population aging, an impor- with rodents. Their results show that,
truthfulbrain.com/martkets/). tant portion of neurotechnological applica- when applied to the hippocampus during
The dual-use problem is often pre- tions is being developed with the purpose memory encoding, the stimulation signifi-
sented as an ethical dilemma since it iden- of assisting or providing novel therapeutic, cantly improved the ability of rodents to
tifies a conflict between two fundamental diagnostic, and assistive solutions for subsequently remember an event (Hamp-
ethical duties: the promotion of good and older adults with cognitive or physical dis- son et al., 2012). These promising results,
the prevention of possible collateral abilities. Researchers have observed that obtained in the context of military-oriented
harm, e.g., between the promotion of the number of technology applications neuroengineering research, hold the po-
health through effective clinical applica- for older adults and people with dementia tential of leaking into the civilian sector
tions and the provision of resources for is nearly tripling every 5 years (Ienca et al., with beneficial impacts. With recent unmet
the killing of civilians through military oper- 2017). In parallel, a growing number of expectations in pharmacological research
ations. Marchant and Gullant have noted portable diagnostic tools are under devel- on memory restoration, neurostimulation
that, in some research contexts, including opment. For example, virtual reality tech- studies could complement or even create
neurotechnology, the complexity of the niques and mobile apps (http://www. new avenues of therapeutic research for
dual-use dilemma is increased by its bidi- seaheroquest.com/site/en/) can be used memory disorders such as AD and other
rectional character. While classical dual- to detect navigational deficits in cognitive dementias, post-traumatic amnesia, and
use problems are concerned with the aging and AD. even normal aging.
cooptation of beneficial, civilian technol- Many technologies currently used for In some circumstances, dual-use in
ogy for military or nefarious purposes, seniors and the cognitively disabled neurotechnology can generate a circular
neurotechnology also raises the reverse have a dual-use potential. Notably, near- dynamic. As mentioned previously,
problem as several neurotechnologies infrared spectroscopy (NIRS) is used in several non-invasive, direct-to-consumer
developed by the military for national se- medical and physiological diagnostics to BCIs have made their way onto the con-
curity purposes are likely to spill over into assess loss of functional hemispheric sumer market. However, as Miranda
the civilian sector with a disruptive impact asymmetry or verbal fluency in AD, as et al. (2015) observed, ‘‘the signal-to-
on healthcare, communication, or other well as to comparatively measure cogni- noise ratio of these systems is often too
fields (Marchant and Gulley, 2010). tive function in, respectively, normal low to reliably detect many EEG compo-
The dual-use character of neurotech- cognitive aging and prodromal dementia. nents of interest for neuroscience efforts
nology makes it also a potential target for Similarly, transcranial magnetic stimula- aimed at improving human training and
non-State actors. In fact, as many neuro- tion (TMS) techniques can help enucle- performance, particularly when single trial
technologies are based on computation ating the neurophysiological profile of analysis is required’’ (Miranda et al.,
and information processing, they are vascular dementia and understanding 2015). DARPA-funded programs such
potentially vulnerable to cyber risks. Even the role of different neurotransmission as the CT2WS (https://www.forbes.com/
though there are no confirmed cases of pathways. Today, DARPA-funded NIRS sites/katiedrummond/2012/09/18/darpa-
malicious attacks in non-experimental set- applications are being tested for military threat-recognition/#6ef840d12728) aim
tings, information security researchers purposes to detect deficiencies in a war- precisely at developing reliable EEG-
have experimentally demonstrated the fighter’s neural processes and feed that based BCIs for applications such as
actual feasibility of performing side-chan- information into a device utilizing in-hel- threat detection and non-invasively
nel attacks and extracting private informa- met or in-vehicle transcranial magnetic recording of operators’ neural activity
tion from users of EEG-based BCIs stimulation (TMS) to suppress or enhance (Miranda et al., 2015). These efforts are
without their authorization (Lange et al., individual brain functions (Tennison and an example of a civilian technology that
2017). These experiments have shown Moreno, 2012). is coopted for military research and may
that neurotechnology is subject to similar Vice versa, given the bidirectional subsequently spillover into the civilian
privacy vulnerabilities and cyber risks as character of dual-use in neurotechnol- sector through more reliable clinical or
other computer systems. In response ogy, several applications have shown commercial applications (Figure 1).

270 Neuron 97, January 17, 2018