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I really like the proposal from John Scalzi's 'Lock In' series where companies that produce neural implants have to establish a trust or insurance contract with
by drodgers 4y ago
I really like the proposal from John Scalzi's 'Lock In' series where companies that produce neural implants have to establish a trust or insurance contract with enough assets to pay for the maintenance of any implants for the lifetime of the recipients, regardless of what happens to the company.
Governments could provide generous subsidies, tax breaks etc. to such funds to reduce the barrier for entry for companies.
Without some solution like this, it's hard to imagine any non-essential neural implants really taking off: who would ever buy a neural lace from a startup — or even an established company like Google who might just lose interest — if there was no guarentee of patches and maintenance?
- menzoic 4y ago> who would ever buy a neural lace from a startup — or even an established company like Google who might just lose interest I'm sure they would if it helped relieve severe chronic pain. A limited period of relief is still better than zero relief.
- plastiquebeech 4y agoWe need to be very careful with brain implants designed to relieve pain, lest we repeat the mistakes which brought us the opioid crisis. I've seen videos at BCI conferences of deep brain stimulation implants which provide the patient with a "happy button" to relieve chronic pain/anxiety/depression/etc. They seem to work very well in a clinical setting, but the patient reactions make it clear that there will be an enormous potential for recreational use (and abuse).
- skissane 4y agoThe “opioid crisis” is a crisis because (1) it is easy to accidentally kill yourself with opioids; (2) drug criminalisation makes recreational drug use a lot less safe than it could be were it legal and regulated I doubt overuse of a “happy button” brain implant is going to kill you; and I doubt it is going to end up in a similar legal situation to recreational drugs. So, whatever the negative impacts of overuse of such a button might be, I expect they’ll be a lot less severe than the opioid crisis
- 9wzYQbTYsAIc 4y agoAlso, with a brain implant, it would be possible to rate limit the “happy button” similar to time-locked IV buttons or medicine bottles.
- stavros 4y agoWhy?
- 9wzYQbTYsAIc 4y agoI believe that this document discusses some of the details of patient administered IV opiods in a hospital setting: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-15 https://www.cms.gov/Medicare/Provider-Enrollment-and-Certifi...
- stavros 4y agoRight, but why limit a button that removes pain via direct brain stimulation?
- 9wzYQbTYsAIc 4y agoTo mitigate what was mentioned by the parent commenter: “whatever the negative impacts of overuse of such a button might be”
- ClumsyPilot 4y agolets deliver digital rights management inside your body. Maybe also if you pay a premium subscribtion the happy button can be pressed more often!
- concordDance 4y agoAs long as patients can decide between the DRM version and the equal cost non-DRM version this may be OK.
- xen2xen1 4y agoThe character Garak on DS9 had a brain implant that was designed for resistance to torture. One day he just turned it on, and getting off it was like drug withdrawal. About the same for Louis Wu on Ringworld. "Wireheads" would die of starvation when their implant was turned on. Implants like this have been widely covered in fiction, and among the scariest drugs possible.
- slibhb 4y agoTwo kinds of people will buy them: enthusiasts and people suffering from chronic conditions with nowhere else to turn. Similarly, you can buy unapproved, unresearched medication on the internet. You take on the risk. Personally I like the idea that people can take their lives in their own hands. As long as it's clear that they're opting out of the guiderails put into place for those of us who are more cautious.
- tracker1 4y agoI'm fine with that, assuming the devices, specifications, communication protocols etc are available... even if I (anyone) wouldn't be able to do it themselves, leaving it as an option for someone to take up is far better than left in the cold with an uncontrolled implant in one's body.
- bee_rider 4y agoLetting people take their lives into their own hands is fine for now, while neural implants are largely useless for enhancement. If there came a day when a neural implant provided, say, a massive competitive advantage when working, we’d probably want to regulate. But I mean widespread neural enhancements are probably as far away as… maybe not post scarcity society, but at least “I can get by on basic income” society. So I’m not too worried.
- Mtinie 4y agoIf it means those of us who compete daily with our brains have an opportunity for an advantage—or at least parity—I’m all for it. I don’t expect it will happen within my lifetime but it would be nice for those who follow.
- Jochim 4y agoI'm interested in whether you feel the same way about drug use in competitive sports? My assumption from your position on cognitive enhancement is that you'd support a separate category where your allowed to dope as much as you'd like? Do we have any duty as a society to dis-incentivise people from pushing that too far?
- icelancer 4y ago>> Without some solution like this, it's hard to imagine any non-essential neural implants really taking off: who would ever buy a neural lace from a startup — or even an established company like Google who might just lose interest — if there was no guarentee of patches and maintenance? Speaking as someone who lived with chronic, daily, horrific pain for years before a surgery miraculously solved most of my problems - if that surgery had not worked or wasn't available, I would have eventually signed up. Thousands or more people live with debilitating pain that drives them to suicidal ideation, drug abuse, and worse. We already live in the future you describe and people turn to far worse things than neural implants to cope.
- drodgers 4y agoAgreed. I meant 'essential' in a weak sense to include all high stakes medical cases, not just literally life and death. The key thing is that we won't be able to get much benefit from neural implants as an enhancement technology without solving this problem; there's a ton of potential value which will be left on the table because people are reasonably afraid of these risks.
- manholio 4y ago> I would have eventually signed up. You could have signed up only if excessive regulatory burden wouldn't have killed or prevented the startup from existing. I find the whole "medical startups should support their patients post bankruptcy" train of thought very disingenuous: as long as we as a society make no public concerted effort to cure these people and leave them to the mercy of the markets, then surely some relief from their problems, even if temporary, is better than none, especially if it provides valuable experience that other more successful companies can use in the future for many more patients. In view of these future possible patients, it would be downright imoral to burden such startups, which already take enormous risks, with unreasonable costs such as ensuring their devices function into perpetuity. Yes, they should be regulated to not make the problem worse after they inevitably fail - primum non nocere. But most of the other ideas proposed in the article have a toxic effect on the business viability of medical startups, possibly preventing them altogether.
- egberts1 4y agoNon-essential Cochlear Implant took off because there was a strong demand to restore a human capability, hearing.
- noobermin 4y agoOr even better, if the company fails to fulfill their obligation, their patent and proprietary information is automatically obtained by the government. If they subsidize, there should be strings.
- BurningFrog 4y agoI see how that would help the government, but not how it would help the patients.
- heavyset_go 4y agoOpening the proprietary information allows patients to take control of their health, and gives more options for doctors to help them, and for groups who might take up the helm of maintaining or removing implants from existing patients. It also allows iteration upon the design, so that it may be improved even if the original company was unable to improve it themselves.
- tick_tock_tick 4y agoThey said the government now owns the patent your responding like they said the patent is now voided and the technology is open to anyone.
- heavyset_go 4y agoDo you think the government is going to sit atop of a giant pile of patents like a fire-breathing dragon protecting its hoard? That's what private companies currently do, and by relinquishing them to the government, the public has some say in what happens to them.
- tracker1 4y agoMore likely they auction it off to the highest bidder.
- refurb 4y agoThe answer is - there will be no FDA approved neural implants from start-ups. The government would never approve it. If you want to use it before approval, well, that's on you then.
- kennyloginz 4y agoThere already is, one example is the VNS implant.
- refurb 4y agoThe VNS Therapy received FDA approval in 1997.... https://www.frontiersin.org/articles/10.3389/fmedt.2021.696543/full https://www.frontiersin.org/articles/10.3389/fmedt.2021.6965...
- riwsky 4y agoA close analogue is medical records; when HIPAA says patients should be able to access data for 10 years, that means “even if you go out of business”. Companies need to set up escrow that’d cover the cost of later retrieval.
- heavyset_go 4y ago> Without some solution like this, it's hard to imagine any non-essential neural implants really taking off: who would ever buy a neural lace from a startup — or even an established company like Google who might just lose interest — if there was no guarentee of patches and maintenance? Desperate people who are willing to try anything to improve their lives. Unscrupulous actors have been taking advantage of such people for millennia. You can see it happen today with the proliferation of quack doctors and remedies. If your quality of life is so low, or you're facing death, taking a chance with experimental treatment might make sense in the moment.
- deleted 4y ago[deleted]
- avalys 4y agoOf course your proposal is not free, it would greatly increase the cost of these devices…
- antifa 4y agoSure the price will go up a little, but nowhere near the raw economic damage society at large will pay for people needing to get things like overheating implants removed.
- s1artibartfast 4y agoThis is not at all clear.
- makeitdouble 4y agoThe basic promise of the proposal seems to be that the technology is more of a convenience than a basic need, and/or people who really need it will have the cost dealt with by another entity. This seems reasonable to me, and can be revised once we have a very good grasp of what actually happens with the technology after a few decades at least.
- NautilusWave 4y agoThis sounds right. People in desperate situations shouldn't feel forced to make high risk bets that could put them in a worse situation down the road. Especially in the US where financial security and health are so closely tied to each other.
- AbrahamParangi 4y agoDepriving people of desperate bets is arguably worse than letting them take it. Sure it might not work but you’re not the one who has to live with the consequences either way.
- antifa 4y ago> but you’re not the one who has to live with the consequences either way There's a 99% all of us will have to live with the consequences of it if we don't die young.
- s1artibartfast 4y agoDo you have to live with the consequences? If someone gets a pain-killing implant or eye camera that goes off support after 5 years, how are you materially impacted for the worse?
- toss1 4y agoAt the very least, ALL technology information, including all designs, source code, notes, studies, support logs, etc. is placed in escrow with the appropriate govt agency. If the company (or its successors) is unwilling/unable to provide continuous and effective support for the implants & associated tech, it is all open-sourced / becomes public domain. This provides at least the tech basis for minimal right to repair/remove to other physicians.
- tracker1 4y agoThis is probably the singularly best option available... And should extend to any parties buying related IP from said company, that the culpability falls on them.
- ly3xqhl8g9 4y ago"Governments could provide generous subsidies to reduce the barrier for entry for companies" Yes, because that went so well in the oil/coal/agriculture/chemistry/electric vehicles industries, creating world-endangering practices and authoritarian moguls. What could go wrong when the mogul can shut down your brain. It is funny to say the least that even here, a forum of a venture capital company, people expect "the government", the people, to give free money to companies. Has any VC ever given 1 dollar without expecting not only ROI, but ownership? Why doesn't the government own 99.99% of ExxonMobil, Nestlé, John Deere, DuPont, Tesla—they have been pumping venture capital for years, over a hundred in some cases? Right, capitalism, or with other words, socialism for the rich and powerful: all gain, no pain; privatize profits, socialize losses. This public-private model never worked, perhaps it was never intended to. It's origin is the East India Company, founded December 31, 1600, who, for all intents and purposes, owned the world for a brief moment. Brief mostly due to lack of digitalization and communication latency (London-Bengal around 80 days). The last 400 years have been a stretch of this model, pushing again and again the location of the sweatshops: from the dimly lit, fumes-filled street in the city, to the ghetto, to overseas, as Thomas Smythe [1], governor of East India Company, originally intended. It is particularly funny we cannot even truly imagine a dystopic future where a company gets to own the world, where ownage is the same as helding hostage, for the next 10,000 years since every company is inherently suicidal, another word for something which grows every quarter: cancer. Here is another solution: have a $1 trillion fund, gather some governments or ask nicely the Norwegian oil fund, fund the research and possible product development for the next 10 to 20 years, and have 100% of the technology be open, owned by all, with 100% of the profits going back to the governments/people. Companies Need Not Apply. You say this has never happened, it is unnatural? Sure it did, you see it right here in action, in this very language that we are using: could you imagine how it would be to have a company license the word "the", to have to pay a subscription for using certain "bundles" of words. Programmatic brain input/output is even more fundamental than language. [1] "In 1620, Smythe was formally charged with enriching himself at the expense of the company", a true pioneer https://en.wikipedia.org/wiki/Thomas_Smythe#:~:text=In%201620%2C%20Smythe%20was%20formally%20charged%20with%20enriching%20himself%20at%20the%20expense%20of%20the%20company https://en.wikipedia.org/wiki/Thomas_Smythe#:~:text=In%20162....
- deleted 4y ago[deleted]
- rl3 4y ago>… who would ever buy a neural lace from a startup — or even an established company like Google who might just lose interest — if there was no guarentee of patches and maintenance? Of course there’d be a guarantee: 5 years of security updates for your neural implant until you need new hardware. Golly, that almost sounds completely fucking crazy until you realize it’s already their current policy for smartphones-which arguably already serve a similar role. That’s up from thee years previously. I think it was even two at one point. I should have been a neurosurgeon.
- Archelaos 4y agoI support this idea, but with an additional element: such private insurances should generally be backed by state funds in case that the insurance company goes bankrupt.