Are Predictive Brain Implants an indispensable feature of autonomy?

Novel predictive and advisory brain implants have been tested with significant success for the first time in a human clinical trial. These implantable brain devices are programmed to predict brain activity patterns before specific outcomes occur and provide information to help patients to respond to the upcoming neuronal events that are forecast. Being guided by predictive and advisory information provided through an invasive brain technology offers enormous potential to benefit individuals by increasing control on upcoming symptoms, enhancing decision- making and quality of life. However, these potential benefits do not come free of ethical concerns. What role, if any, do predictive and advisory functionalities play in either impairing or reinstating a patient’s capacity to exercise her/his autonomy? There currently is a gap in our knowledge concerning the consequences of these functionalities on patients’ postoperative life, in particular how it might impact patients’ decision-making as free and autonomous agent. This paper addresses this gap by exploring whether predictive and advisory brain implants are an indispensable feature of autonomy. In order to address this gap in knowledge, the first part of this manuscript explores ethical concerns regarding who is "in control" when patients are experiencing postoperative feelings of "loss of control". Section two examines what could be morally wrong with having predictive and advisory brain system "in control". The third section reports findings resulting from a study we conducted with patients implanted with these novel brain devices. Our conclusion discusses how these findings are evidence that, rather than being a threat, predictive and advisory brain devices are an indispensable feature of autonomy.