Neurorights Training of a Multidisciplinary Studentship Based on Realistic Neuroscience

As is usually the case with other topics addressed by neuroethics, a rigorous analysis of neurorights requires an interdisciplinary approach. In response to this need and in the context of the global expansion of regulatory initiatives on neurorights, we coordinated, under the auspices of the International Center for Neuroscience and Ethics (CINET), an introductory course on neurorights from a neuroscientific perspective. The course, aimed at sixty students from diverse backgrounds (neuroscience, psychology, and law, among others), consisted of a 10-hr training that showed the current approaches and discussions on neurorights and outlined cutting-edge technologies to register, analyze, and manipulate human brain activity from a realistic stance. The course succeeded in discarding some concerns and uncovering others not frequently found in the neurorights discussions. The most pressing issues identified were protecting brain data privacy, combating bias in algorithms used in neurotechnology, and improving informed consent mechanisms for interventions with invasive neuroscientific techniques.

At the turn of this century, Boire (Citation2000) and Sententia (Citation2004) set the stage for the debate on the profound impact of neurotechnology on fundamental and human rights. Their analysis centered on cognitive liberty, an updated version of the right to freedom of thought that can be defined as “every person’s fundamental right to think independently, to use the full spectrum of his or her mind, and to have autonomy over his or her own brain chemistry” (Sententia Citation2004, 223).

However, the possibility of revising the human rights framework in light of neurotechnologies took off definitively following a seminal paper by Ienca and Andorno (Citation2017) and the work of the NeuroRights FoundationFootnote¹, which gave rise to so-called neurorights, defined as “the ethical, legal, social, or natural principles of freedom or entitlement related to a person’s cerebral and mental domain; that is, the fundamental normative rules for the protection and preservation of the human brain and mind” (Ienca, Citation2021, 1).

The neurorights Ienca and Andorno (Citation2017) proposed include cognitive liberty, mental privacy, mental integrity, and psychological continuity. On the other hand, the NeuroRights Foundation advocates for mental privacy, personal identity, free will, fair access to neuroenhancement technologies, and protection against algorithmic bias in neurotechnology. Neurorights proposals have attracted several criticisms from scholars who argue that the personal interests the proposed rights aim to protect are already enshrined in the current human rights law instruments (e.g. Muñoz Citation2019; Bublitz Citation2022; Fins Citation2022; Ligthart, Bublitz, and Alegre Citation2023). In short, three different views about the convenience of neurorights can be identified: “1. Novel rights for specifically protecting the brain and mind (“neurorights”) are necessary. […] 2. Adaptive interpretations and applications of existing rights are necessary, but novel neurorights are not. […] 3. No novel rights, reforms, or new interpretations are necessary” (Ligthart, Ienca, et al. Citation2023, 464–465; also Muñoz and Marinaro Citation2023).

Be that as it may, neurorights proposals have attracted notable attention from policymakers, leading to bills and even proposed constitutional amendments in several Latin American countries such as ChileFootnote², BrazilFootnote³, ArgentinaFootnote⁴, and MexicoFootnote⁵ (Herrera-Ferrá et al. Citation2024). Regional organizations have also incorporated neurorights into their agendas, as demonstrated by the Organization of American States (OAS) Declaration of Inter-American Principles on Neurosciences, Neurotechnologies, and Human RightsFootnote⁶ and the Latin American Parliament’s Model Law on Neurorights.Footnote⁷ Finally, the United Nations has decided to focus on the ethical and legal implications of neurotechnologies—including the analysis of neurorights—through the parallel work developed by: (1) its Human Rights Council, whose advisory committee is working on a report “on the impact, opportunities and challenges of neurotechnology with regard to the promotion and protection of all human rights”Footnote⁸; and (2) UNESCO, which is working on a draft of Recommendations on the Ethics of Neurotechnology.Footnote⁹

As is usually the case with other topics addressed by neuroethics, a rigorous analysis of neurorights requires an interdisciplinary approach that integrates advances in neuroscience and issues traditionally studied not only by ethics but also—and importantly—by theoretical philosophy. A quick reading of the list of proposed neurorights indicates that they are related to concepts of longstanding philosophical tradition, such as autonomy, privacy, and identity. For example, the theoretical foundation of the neuroright to mental privacy should be based on a solid explanation of how information about the mental activity can be inferred from brain data (see Ienca et al. Citation2022). Another notable example is the neuroright to free will, a highly problematic concept that has been widely debated throughout the history of philosophy and whose neurobiological basis has been studied since the 20th century (e.g. Libet et al. Citation1983; Soon et al. Citation2008).

In response to this interdisciplinary need and in the context of the global expansion of regulatory initiatives on neurorights, the authors of this article coordinated, under the auspices of the International Center for Neuroscience and Ethics (CINET, created in 2021 by the Tatiana Foundation), an introductory course on neurorights from a neuroscientific perspective. The course, aimed at 60 students from diverse backgrounds (neuroscience, law, and psychology, among others), was developed in five sessions spread between April and May 2024, online and in Spanish.

Discussions on neurorights usually emerge from one of the following perspectives: law/policy regulation (e.g. Bublitz Citation2022; Fins Citation2022), philosophy (e.g. Lavazza and Giorgi Citation2023; Muñoz, Bernácer, and Güell Citation2023), or neuroscience (e.g. Yuste et al. Citation2017; Ienca et al. Citation2022). The main concerns for each case converge, but they are different at the inception. The first perspective has a practical aim; its primary concern is implementing novel policies to safeguard specific human issues. The second takes the opposite direction and attempts to define precisely those human issues that the first perspective wants to protect. Finally, the neuroscientific perspective concerns the ethical challenges of neuroscience techniques, how they relate to the concepts discussed in philosophy, and how they can be incorporated into the policies defined by the first perspective.

Our course emerged from this neuroscientific perspective. The main aim was to show the actual scope, including achievements and limitations, of the most common techniques to study and manipulate the human brain and its interaction with artificial interfaces. Discussions on neurorights stemming from neuroscience are usually based on hypothetical advances in current methods. Mental reading from brain recording, unconsented and unnoticed behavioral manipulation, thought insertion, intelligence or memory augmentation through brain implants, are still closer to science-fictional scenarios than to current neuroscientific advances. We admit that precautions are essential to promote the implementation and deployment of specific experimental approaches, but also the need for realistic learning about the current significance of neurotechnologies. As shown below, the course succeeded in discarding some concerns and uncovering others not frequently found in the neurorights discussions.

The course was structured as five 2-hr weekly sessions conducted online in Spanish. The common methodology consisted of a 60–70-min technical explanation by an expert followed by a 50–60-min discussion led by the course coordinators (the authors of this manuscript).

The first session, “What are neurorights?,” was given by José M. Muñoz (PhD in Philosophy)Footnote¹⁰. He explained how the neurorights proposals are framed into neuroethics and neurotechnologies, their impact on public research and private companies, and the different approaches. Briefly, three initiatives were mentioned: Yuste’s proposal for the inclusion of new human rights,Footnote¹¹ Farahany’s description of cognitive liberty as the only required neuroright (Farahany Citation2023; see also Muñoz Citation2023), and Bublitz and Ienca’s expansive view that suggests enriching current human rights instead of including new ones (Ienca Citation2021; Bublitz Citation2022). As challenges, Muñoz proposed establishing consensus definitions, taxonomy, and interdependences and clarifying whether neurorights should be absolute or relative rights. Also, future discussions should address their legal appropriateness and the risk of regulatory inflation, considering cultural, regional, and national contexts.Footnote¹² For this purpose, adequate discussion forums should be established.

The second session, “Brain activity decoding and privacy,” was given by Arnau Espinosa (neuro-engineer at the Wyss Center for Bio and Neuroengineering).Footnote¹³ He explained cutting-edge techniques for intracranial recordings, focusing on speech reconstruction through signal decoding from motor brain areas, arm muscles involved in writing, and tongue movements related to speech. With the advance of private companies that promise the application of intracranial devices for non-medical uses, Espinosa emphasized that these cases are highly restricted and international efforts are focused on alleviating pathological conditions. The main ethical concern was privacy since the safety of medical data is currently lousy. Fortunately, brain devices do not need to connect to the Internet, so this risk is mitigated nowadays. Finally, his opinion was that brain data is not exceptional compared with other biological data, at least with current temporal and spatial resolutions.

The third session, “Brain-computer interfaces and autonomy,” was given by José M. Azorín (Director of the BRAIN-UMH Center and the Brain-Machine Interface Systems Lab, Miguel Hernandez University).Footnote¹⁴ Whereas the second session addressed invasive brain recordings, Azorín explained how noninvasive electroencephalography was automatically decoded and processed to improve neurorehabilitation and communicate with prostheses or exoskeletons. This is less costly and more convenient for the patient than invasive procedures. He showed different bottom-up approaches in ictus patients where the prosthesis enhances the movement initiated by the patient and can even promote neuroplasticity by coupling with electrical transcranial stimulators. Also, top-down approaches involve detecting brain activity related to the intention to move, which initiates the exoskeleton movement. Concerning ethical issues, Azorín stressed the need for data privacy, although clarified that “mental contents” are not recorded: detecting motor or premotor signals such as the intention to move is challenging enough. Finally, he stated that ethical concerns are more substantial for invasive techniques.

The fourth session, “Neuroscience-applied AI: Implications to avoid discrimination,” was given by Jordi Solé-Casals (engineer at the Universitat de Vic-Universitat Central de Catalunya and the University of Cambridge).Footnote¹⁵ The strength of AI applied to neuroscience is the possibility of handling vast amounts of data, allowing better interpretations and uncovering interactions between different modalities. This is useful for identifying biomarkers, diagnosis, and therapy development. He explained in depth the intricacies of machine learning and deep learning as data classification tools, as well as the role of the researcher in the process. Again, one ethical concern was data privacy and protection. Specific to this topic, the main challenge is the data fed into algorithms: if they have a bias in their collection, aggregation, or evaluation, outcomes will also be biased. Further, the unknowns of algorithm functioning raise concerns about trusting in the results. When human lives and well-being are at stake, “black boxes” pose a serious risk.

The final session, “Brain stimulation and neuroenhancement: Implications for identity and integrity,” was given by Cristina Nombela (psychologist and neuroscientist at the Universidad Autónoma of Madrid).Footnote¹⁶ She explained the intricacies of electric and magnetic invasive and transcranial manipulation to alleviate the symptoms of several neurological and psychiatric disorders. Her first warning was that the brain is a complex system always seeking equilibrium, so any “local” change will cause a global reconfiguration at the micro, meso, and macro levels. For example, the main target of deep brain stimulation in Parkinson’s disease is the subthalamic nucleus: no matter how small the electrodes are, all functional territories of the nucleus—associative, sensorimotor, and limbic—will be affected. The core of the session was to underscore the changes in personality, identity, autonomy, authenticity, agency, and self that occur in disorders such as depression, obsessive-compulsive disorder, borderline personality, schizophrenia, Parkinson’s and Alzheimer’s diseases, and sclerosis. Remarkably, these changes not only occur in the course of the disease but also due to treatment with brain stimulation. The main ethical concern was whether informed consent before surgery clearly explained these common procedure risks to patients.

In conclusion, this 10-hr training showed the current approaches and discussions on neurorights and outlined cutting-edge technologies to register, analyze, and manipulate human brain activity from a realistic stance. Sixty students were selected from over eighty applications. Their backgrounds were different, but neuroscience, psychology, and law were predominant. On average, 55 joined the sessions, and about 45 stayed up to 90 min after starting. This was the announced duration of the sessions, but they were extended to 120 min due to the interest in discussions. Approximately 35 students stayed during the whole session. Remarkably, the number of students connected did not decay between sessions. Regarding the Q&A section, we encouraged them to raise their hands virtually and ask orally, establishing a dialogue with the speaker if necessary. Some students preferred to ask in the chat box, and one of the coordinators read the question. The questions were mainly related to clarifying technical issues and discussing the ethical scope of neuroscientific procedures.

Six months after finishing the course, the 60 students who initially signed up for it were invited to anonymously complete a survey to assess its impact on learning. The survey instrument is included as Supplementary Material, in Spanish (as it was sent to students) and a version translated into English. Forty individuals completed the survey (response rate, 66.7%). 82.5% declared to have joined all the sessions (12.5% four sessions, 5% three), and 74.4% responded that, on average, they were online until the class finished. The overall satisfaction with the course was 8.45 out of 10, and it was above expectations for 62.5% of respondents (as expected for 35%, below expectations for 2.5%). The adequacy of professors was, on average, 4.63 (out of 5). Students were also satisfied with the structure of the sessions (60-min presentation plus discussion led by the directors: 4.48 out of 5). Regarding the impact of learning, we summarize the results in Table 1.

Further, most respondents (52.5%) declared that the course offered a more realistic view of neurorights than other forums (32.5% were unaware of other views). Half of them have not engaged in discussions regarding neurorights since the course (35% did it once or twice, 15% frequently or very frequently), and 45% have looked once or twice for scientific literature on the topics of the course (47.5% frequently or very frequently, 7.5% have not looked for it). Finally, 70% considered the topic interesting and the course met their expectations, whereas 17.5% were not previously interested and the course aroused their interest (7.5% found the topic interesting and were disappointed by the course).

Therefore, students had a positive opinion of the course, and it seems to have had an impact on their training in neurorights and related issues.

The course structure allowed the students to learn first the main aspects of the current discussions on neurorights. Then, this topic was secondary to highlighting the possibilities of intracranial recordings, brain–computer interfaces, AI applied to neural data, and brain manipulation through invasive and noninvasive techniques. Neurorights were put back into the foreground by asking the speakers beforehand to pose one ethical issue related to the topic: privacy, autonomy, bias, and integrity and identity, respectively. By doing so, we stimulated discussions in a realistic environment and pinpointed the ethical concerns that could be considered first in this field. The most important were the following:

1. Protecting the privacy of brain data is a priority, although two factors mitigate the risks in certain circumstances: (a) brain devices do not need to be connected to the network; and (b) decoding of brain data is much more advanced for motor signals and premotor intentions than for complex mental content. Be that as it may, discussions on whether brain data is exceptional or not (see Hallinan et al. Citation2023) in terms of privacy when compared to other types of biological data (e.g. genetic and genomic data) should be encouraged.

2. Bias in algorithms used in neurotechnology represents a significant risk to the well-being of patients and users (e.g. Muñoz and Marinaro Citation2024). Moreover, it can impact the reliability of neuroscientific results. This bias must be thoroughly analyzed, and necessary legal measures must be adopted.

3. Informed consent mechanisms for interventions with invasive neuroscientific techniques must be reviewed to include not only information on the physical risks derived from the intervention but also the risks to the patient’s identity (see, e.g. Witt et al. Citation2013), integrity, and autonomy.

Ultimately, interdisciplinary training on the concept, scope, and limitations of neurorights must continue to be promoted in the coming years. While the approaches from philosophy and law are essential, so must be the approach from neuroscience—a realistic neuroscience that avoids neurohype (see Wexler Citation2019; Gilbert and Russo Citation2024). Integrating these three disciplinary axles will help detect conceptual difficulties that may appear when defining neurorights, discussing the ethical challenges that their implementation may entail, and identifying possible legal gaps or redundancies that this implementation could generate in national and international normative systems.