Towards Forever Access for Implanted Brain-Computer Interfaces

The 1st Workshop on Hot Topics in Ethical Computer Systems, April, 2024 Designs for implanted brain-computer interfaces (BCIs) have increased significantly in recent years. Each device promises better clinical outcomes and quality-of-life improvements, yet due to severe and inflexible safety constraints, progress requires tight co-design from materials to circuits and all the way up the stack to applications and algorithms. This trend has become more aggressive over time, forcing clinicians and patients to rely on vendor-specific hardware and software for deployment, maintenance, upgrades, and replacement. This over-reliance is ethically problematic, especially if companies go out-of-business or business objectives diverge from clinical promises. Device heterogeneity additionally burdens clinicians and healthcare facilities, adding complexity and costs for in-clinic visits, monitoring, and continuous access. Reliability, interoperability, portability, and future-proofed design is needed, but this unfortunately comes at a cost. These system features sap resources that would have otherwise been allocated to reduce power/energy and improve performance. Navigating this trade-off in a systematic way is critical to providing patients with forever access to their implants and reducing burdens placed on healthcare providers and caretakers. We study the integration of on-device storage to highlight the sensitivity of this trade-off and establish other points of interest within BCI design that require careful investigation. In the process, we revisit relevant problems in computer architecture and medical devices from the current era of hardware specialization and modern neurotechnology.