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The foundational role of autonomy for brain-computer interfaces.

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Title: The foundational role of autonomy for brain-computer interfaces.
Authors: Richter F; School of Transformation and Sustainability, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany. florian.richter@ku.de.
Source: Philosophy, ethics, and humanities in medicine : PEHM [Philos Ethics Humanit Med] 2026 Sep 21; Vol. 21 (1). Date of Electronic Publication: 2026 Sep 21.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BioMed Central Country of Publication: England NLM ID: 101258058 Publication Model: Electronic Cited Medium: Internet ISSN: 1747-5341 (Electronic) Linking ISSN: 17475341 NLM ISO Abbreviation: Philos Ethics Humanit Med Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BioMed Central, 2006-
MeSH Terms: Brain-Computer Interfaces*/ethics , Personal Autonomy*, Humans ; Sense of Agency
Abstract: Invasive brain-computer interfaces (BCIs) pose a challenge for describing human-system interactions because they involve a depth of engagement that is difficult to disentangle. This is particularly problematic when clear authorship of decisions is needed. This presupposes that such devices might also decide autonomously in certain situations. Although the use and implementation of such devices are highly disputed in practical ethics, they seem to offer at least therapeutic benefits for persons with, e.g., Parkinson's disease. That is why it is indispensable to develop a conceptual framework that allows a description of the system's interactions with the human agent. The effects of brain-computer interfaces on patients are assessed empirically in studies and hypothesized on a more speculative level via thought experiments. A model to operationalize dimensions of agency, such as responsibility and privacy, has been proposed. Nevertheless, this model is inchoate if it is not related to autonomy, because it is widely assumed that autonomy is not only a characteristic of the human agent but also of the technological system (at least to a certain degree). Consequently, a more complete model is needed that classifies autonomy at different levels (operational, strategic, and moral). Technological systems can only operate on the first two levels because their behavior is based on dispositions within the scope of alethic modality, whilst human agency is based on deontic structures that are expressed via normative attitudes and statuses that cannot be reduced to alethic modality. This crucial difference can be used to develop methods for evaluating the ethical side of BCIs.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Competing interests: The authors declare no competing interests.
References: Neuroethics. 2021;14(3):365-386. (PMID: 33942016)
AJOB Neurosci. 2023 Jan-Mar;14(1):1-12. (PMID: 34387539)
Neuron. 2018 Oct 10;100(1):19-36. (PMID: 30308169)
Mayo Clin Proc. 2012 Mar;87(3):268-79. (PMID: 22325364)
Neurosci Biobehav Rev. 2020 Apr;111:199-228. (PMID: 32001274)
Front Neurosci. 2018 Mar 21;12:175. (PMID: 29618967)
Brain Topogr. 2014 Jan;27(1):33-45. (PMID: 23733209)
Camb Q Healthc Ethics. 2016 Oct;25(4):623-33. (PMID: 27634714)
J Neurosci. 2018 Dec 12;38(50):10586-10588. (PMID: 30541767)
Brain Stimul. 2016 May-Jun;9(3):323-335. (PMID: 26947241)
Neuroethics. 2013;6:513-526. (PMID: 24273621)
Nature. 2008 Mar 20;452(7185):352-5. (PMID: 18322462)
Neurology. 2006 Jun 27;66(12):1811-6. (PMID: 16801642)
J Med Ethics. 2013 Dec;39(12):757-60. (PMID: 23355227)
Prog Neuropsychopharmacol Biol Psychiatry. 2023 Dec 20;127:110809. (PMID: 37331685)
Nat Rev Neurol. 2019 Apr;15(4):234-242. (PMID: 30778210)
AJOB Neurosci. 2021 Apr-Sep;12(2-3):172-186. (PMID: 33764258)
J Neural Eng. 2018 Aug;15(4):046006. (PMID: 29741160)
Nature. 2017 Nov 8;551(7679):159-163. (PMID: 29120438)
PLoS One. 2016 Mar 16;11(3):e0150667. (PMID: 26982717)
AJOB Neurosci. 2015 Oct 2;6(4):4-11. (PMID: 26740906)
Neuropsychiatr Dis Treat. 2015 Jun 26;11:1549-60. (PMID: 26170668)
J Med Ethics. 2009 May;35(5):289-92. (PMID: 19407032)
Mov Disord Clin Pract. 2020 Sep 21;7(7):788-796. (PMID: 33033736)
Contributed Indexing: Keywords: Autonomous systems; Brain-computer interfaces; Human agency
Entry Date(s): Date Created: 20260923 Date Completed: 20260923 Latest Revision: 20260924
Update Code: 20260924
PubMed Central ID: PMC13595606
DOI: 10.1186/s13010-026-00231-4
PMID: 42773469
Database: MEDLINE
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  Data: <searchLink fieldCode="AU" term="%22Richter+F%22">Richter F</searchLink>; School of Transformation and Sustainability, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany. florian.richter@ku.de.
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  Data: Invasive brain-computer interfaces (BCIs) pose a challenge for describing human-system interactions because they involve a depth of engagement that is difficult to disentangle. This is particularly problematic when clear authorship of decisions is needed. This presupposes that such devices might also decide autonomously in certain situations. Although the use and implementation of such devices are highly disputed in practical ethics, they seem to offer at least therapeutic benefits for persons with, e.g., Parkinson's disease. That is why it is indispensable to develop a conceptual framework that allows a description of the system's interactions with the human agent. The effects of brain-computer interfaces on patients are assessed empirically in studies and hypothesized on a more speculative level via thought experiments. A model to operationalize dimensions of agency, such as responsibility and privacy, has been proposed. Nevertheless, this model is inchoate if it is not related to autonomy, because it is widely assumed that autonomy is not only a characteristic of the human agent but also of the technological system (at least to a certain degree). Consequently, a more complete model is needed that classifies autonomy at different levels (operational, strategic, and moral). Technological systems can only operate on the first two levels because their behavior is based on dispositions within the scope of alethic modality, whilst human agency is based on deontic structures that are expressed via normative attitudes and statuses that cannot be reduced to alethic modality. This crucial difference can be used to develop methods for evaluating the ethical side of BCIs.<br /> (© 2026. The Author(s).)
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  Data: Neuroethics. 2021;14(3):365-386. (PMID: <searchLink fieldCode="PM" term="%2233942016%22">33942016)</searchLink><br />AJOB Neurosci. 2023 Jan-Mar;14(1):1-12. (PMID: <searchLink fieldCode="PM" term="%2234387539%22">34387539)</searchLink><br />Neuron. 2018 Oct 10;100(1):19-36. (PMID: <searchLink fieldCode="PM" term="%2230308169%22">30308169)</searchLink><br />Mayo Clin Proc. 2012 Mar;87(3):268-79. (PMID: <searchLink fieldCode="PM" term="%2222325364%22">22325364)</searchLink><br />Neurosci Biobehav Rev. 2020 Apr;111:199-228. (PMID: <searchLink fieldCode="PM" term="%2232001274%22">32001274)</searchLink><br />Front Neurosci. 2018 Mar 21;12:175. (PMID: <searchLink fieldCode="PM" term="%2229618967%22">29618967)</searchLink><br />Brain Topogr. 2014 Jan;27(1):33-45. (PMID: <searchLink fieldCode="PM" term="%2223733209%22">23733209)</searchLink><br />Camb Q Healthc Ethics. 2016 Oct;25(4):623-33. (PMID: <searchLink fieldCode="PM" term="%2227634714%22">27634714)</searchLink><br />J Neurosci. 2018 Dec 12;38(50):10586-10588. (PMID: <searchLink fieldCode="PM" term="%2230541767%22">30541767)</searchLink><br />Brain Stimul. 2016 May-Jun;9(3):323-335. (PMID: <searchLink fieldCode="PM" term="%2226947241%22">26947241)</searchLink><br />Neuroethics. 2013;6:513-526. (PMID: <searchLink fieldCode="PM" term="%2224273621%22">24273621)</searchLink><br />Nature. 2008 Mar 20;452(7185):352-5. (PMID: <searchLink fieldCode="PM" term="%2218322462%22">18322462)</searchLink><br />Neurology. 2006 Jun 27;66(12):1811-6. (PMID: <searchLink fieldCode="PM" term="%2216801642%22">16801642)</searchLink><br />J Med Ethics. 2013 Dec;39(12):757-60. (PMID: <searchLink fieldCode="PM" term="%2223355227%22">23355227)</searchLink><br />Prog Neuropsychopharmacol Biol Psychiatry. 2023 Dec 20;127:110809. (PMID: <searchLink fieldCode="PM" term="%2237331685%22">37331685)</searchLink><br />Nat Rev Neurol. 2019 Apr;15(4):234-242. (PMID: <searchLink fieldCode="PM" term="%2230778210%22">30778210)</searchLink><br />AJOB Neurosci. 2021 Apr-Sep;12(2-3):172-186. (PMID: <searchLink fieldCode="PM" term="%2233764258%22">33764258)</searchLink><br />J Neural Eng. 2018 Aug;15(4):046006. (PMID: <searchLink fieldCode="PM" term="%2229741160%22">29741160)</searchLink><br />Nature. 2017 Nov 8;551(7679):159-163. (PMID: <searchLink fieldCode="PM" term="%2229120438%22">29120438)</searchLink><br />PLoS One. 2016 Mar 16;11(3):e0150667. (PMID: <searchLink fieldCode="PM" term="%2226982717%22">26982717)</searchLink><br />AJOB Neurosci. 2015 Oct 2;6(4):4-11. (PMID: <searchLink fieldCode="PM" term="%2226740906%22">26740906)</searchLink><br />Neuropsychiatr Dis Treat. 2015 Jun 26;11:1549-60. (PMID: <searchLink fieldCode="PM" term="%2226170668%22">26170668)</searchLink><br />J Med Ethics. 2009 May;35(5):289-92. (PMID: <searchLink fieldCode="PM" term="%2219407032%22">19407032)</searchLink><br />Mov Disord Clin Pract. 2020 Sep 21;7(7):788-796. (PMID: <searchLink fieldCode="PM" term="%2233033736%22">33033736)</searchLink>
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