Neuralink company image

Bioethics Forum Essay

The Neuralink Patient Behind the Musk

The sole virtue of Elon Musk’s report on X, formerly known as Twitter, of the first in-human brain implant by his company, Neuralink, is its brevity: “The first human received an implant from @Neuralink yesterday and is recovering well. Initial results show promising neuron spike detection.”

But, in this case, that virtue is very limited. Brevity is not so admirable in novel human research.

Opening up the brain of a living human being to insert a device, particularly someone with serious medical problems, deserves more than a two-sentence report on what is, in effect, a proprietary social media platform not distinguished for its reliability where facts are concerned. This human research subject, their family, all potential future research subjects and patients, the medical community, and all of us deserve more.

Assuming that some brain-computer interface device was indeed implanted in some patient with severe paralysis by some surgeons somewhere, it would be reasonable to expect some formal reporting about the details of an unprecedented experiment involving a vulnerable person. But unlike drug studies in which there are phases that must be registered in a public database, the Food and Drug Administration does not require reporting of early feasibility studies of devices. From a legal standpoint Musk’s company is in the clear, a fact that surely did not escape the tactical notice of his company’s lawyers.

Nevertheless, when they engaged in this medical intervention his company and the surgeons, neuroscientists, and nurses incurred certain moral responsibilities. A technical regulatory veil does not shield them from the ethical obligations of transparency to avoid the risk of giving false hope to countless thousands of people with serious neurological disabilities.

Many may not appreciate that “neuron spike detection” is only an acceptable preliminary endpoint for a carefully controlled experiment whose safety is far from established and could engender complications that would leave the human subject in a worse, if not life-threatening, condition. We are not even told what plans there are to remove the device if things go wrong or the subject simply wants to stop. Nor do we know the findings of animal research that justified beginning a first-in-human experiment at this time, especially since it is not lifesaving research. The company has denied that it mistreated primates in response to allegations of animal cruelty. Which scientists—who were not on the Neuralink payroll—decided that the research was ready to try in humans?

This episode reaches beyond one incident. Science by press release, while increasingly common, is not science. When the person paying for a human experiment with a huge financial stake in the outcome is the sole source of information, basic ethical standards have not been met.

Arthur Caplan, PhD, is the founding head of the Division of Medical Ethics at NYU Grossman School of Medicine. He is a Hastings Center fellow and a member of The Hastings Center’s advisory council. @ArthurCaplan

Jonathan D. Moreno is the David and Lyn Silfen University Professor of Ethics at the University of Pennsylvania and a Hastings Center fellow. @jonathanmoreno.bsky.social

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  1. Elon Musk’s Neuralink experiment is problematic for all the reasons you concisely cite. The broader picture of his research aims just here is no less disconcerting. A confessed admirer of the 1999 movie “The Matrix “ (see Issacson’s biography, 2023), Musk is ultimately looking forward to a time when various knowledge software modules can be uploaded to a subject’s brain and central nervous system. Hence, Musk’s bioethical ly questionable work with patients suffering from paralysis is but a baby step to his ambition of streamlining and revolutionizing how humans learn. If so: (1) Who will control this technology? (2) What will count as knowledge (versus, say, propaganda)? (3) What is the proper role of bioethics in checking or adjudicating any of this free market, potentially profiteering and obviously dangerous technology?

    1. Indeed. The enhancement questions you raise can too easily be missed while therapeutic potential is being sorted out.

  2. It’s quite something to live in a world where “Twitter” must be cited as the primary source of information for potentially breakthrough science projects—or utter shams. Professionals trained in science communication should be the ones delivering research news to the public. Most people reading Musk’s tweets will never look in an academic journal and will never understand what vetted, quality research looks like.

  3. This article doesn’t fully appreciate how technologies like Neuralink can revolutionize treatments for people with serious conditions like quadriplegia. And while more formal and regular updates are a step in the right direction, one should be mindful not to over simplify the complex balance between pushing for quick innovation and the need to follow strict ethical guidelines. It’s like navigating without recognising the progress you’ve made along the way.

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