Reaching Independence via AI Dependence

By Hannah Srinivasan

 

Imagine being able to do anything you wish one moment, only to have it taken away from you the next. This happened to Noe Sotelo, a healthy and active 62-year-old whose life took a dramatic turn after a fall at a family gathering. Noe Sotelo’s accident left him with almost no movement in his arms and legs, leaving him dependent on others for self-care and basic daily tasks. He underwent extensive surgery, having done a C3-C7 laminectomy and a C2-T1 posterior fixation and fusion, surgery done to alleviate pain and stabilize the spine. Still, the surgeries were unsuccessful, rendering him a quadriplegic. 

Thankfully, due to intensive inpatient rehabilitation at Yuma Rehabilitation Hospital, he was able to defy the odds and return home, ultimately living independently with his son. While Sotelo was able to overcome this hurdle, many quadriplegia patients struggle to gain independence despite rehabilitation therapy due to deep injury. 

Quadriplegia, also commonly known as tetraplegia, is a medical condition characterized by the partial or complete paralysis of both arms, legs, and torso, typically due to traumatic spinal cord injuries at higher cervical levels, diseases such as Amyotrophic Lateral Sclerosis (ALS), as well as congenital disorders. The incidence rate of traumatic spinal cord injuries is approximately 11.5 to 53.4 cases per million inhabitants, sixty percent of which result in partial or complete quadriplegia. 

In addition to rehabilitation, assistive devices, and long-term care, a newer revolutionary therapy has been developed by Neuralink.The company founded by Elon Musk in 2016 has started to develop implantable brain-machine interfaces (BMIs) to create a symbiotic relationship between the human brain and artificial intelligence, providing patients with a degree of independence and interaction that was previously unattainable. Brain-machine interfaces aim to translate brain activity into action via readily available technology like computers, phones, and even prosthetics. Neuralink’s technology involves implanting 1,024 microelectrodes distributed over 64 ultra-thin threads in the brain to minimize invasiveness. These threads are then connected to the main system called the Link. The firing from neurons in the brain due to brain activity and thought patterns are then perceived as signals to the Link. The process of administering the brain-machine interface technology begins with a robot designed by the company surgically inserting the ultra-thin threads into specific brain regions. Once activated, the Link wirelessly transmits data between the brain and external technology, enabling  Neuralink to translate human thought into readable signals, granting individuals with quadriplegia a source of independence. This technology further allows for the possibility of prosthetics controlled by data transmission from the Link restoring sensory and motor functions. 

 

In January 2024, Neuralink reached a milestone by starting human trials, implanting threads into Noland Arbaugh, a patient attempting to regain autonomy post-spinal cord injury paralysis. With the aid of Neuralink technology, he now regained a level of independence, permitting him to have full control of a computer, browse the web, and play computer games. Prior to Neuralink, Arbaugh had to use a mouth-held stick to operate an iPad for a means of communication. In an interview with WIRED, he explained the impact of the surgery on his life: “It’s just made me more independent… It makes me feel less helpless and less of a burden.”   

Nevertheless, while revolutionary advances like those by Neuralink offer a new sense of hope by potentially allowing quadriplegics to reclaim independence via brain-machine interface technology, they also bring up significant ethical concerns around transparency, animal welfare, and patient safety.Within three weeks of insertion, several threads placed in Noland Arbaugh’s brain retracted spontaneously. Arbaugh noted in his interview -that he could acknowledge there was something wrong with the device and that he “didn’t have any knowledge that it was possible.” While Neuralink was able to resolve the issue within two weeks, the comment made by Arbaugh raises concerns that there was a lack of transparency between the company and patient. Five sources who spoke out anonymously due to having signed non-disclosure agreements with Neuralink-indicated to news source Reuters that the problems of threads retracting and dislodging in animal models had been a long-standing issue. The lack of transparency from Neuralink to Arbaugh is a clear violation of the ethical principle of informed consent which requires that  patients are fully informed of all possible consequences before making a medical decision.  

 

Further, while Neuralink has passed all United States Department of Agriculture (USDA) and Food and Drug Administration (FDA) inspections and regulations, the company’s chief executive continues to push hard to accelerate progress, which is significantly dependent on animal testing. Consequently, Neuralink employees claim that the number of animal deaths is considerably higher than it needs to be due to rushing experiments, causing several groups, such as the Physicians Committee for Responsible Medicine, a group advocating for animal welfare, to complain to the USDA and FDA regarding regulation breaches. In addition to animal welfare concerns, Elon Musk’s desire to accelerate Neuralink’s progress causes us to question whether Neuralink’s current experimental data is sufficient to continue human trials. Musk’s well-documented penchant for prioritizing speed over caution is clearly reflected in Neuralink’s operations, repeatedly dismissing criticisms and concerns voiced by employees in the high-pressure work environment. Elon Musk’s increasing influence on the tech and political realm—especially considering his nomination by President-elect Donald Trump to lead the Department of Government Efficiency—has further intensified discussions about potential conflicts of interests and Musk’s ability for looser regulations of Neuralink. As Neuralink continues to make progress, it is necessary for Elon Musk’s regulatory shortcuts to be closely monitored to fully ensure patient safety and ethical accountability. 

 

Despite Neuralink’s ethical concerns, the potential for positive effects of brain-machine interface technology used by Neuralink is undeniable, as is evidenced by Noland Arbaugh’s general satisfaction. Neuralink can help those with quadriplegia regain independence and improve their quality of life, promising potential restoration of motor function via the pairing of Neuralink and prosthetics down the line. With increased guidance and closer experimental management, Neuralink can potentially alter the lives of people with quadriplegia for the better by offering them new means of communication and control over their environment.