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Concerns center on the safety and long-term effects on users. These include obtaining [[informed consent]] from individuals with communication difficulties, the impact on patients' and families' quality of life, health-related side effects, misuse of therapeutic applications, safety risks, and the non-reversible nature of some BCI-induced changes. Additionally, questions arise about access to maintenance, repair, and spare parts, particularly in the event of a company's bankruptcy.<ref>{{Cite web |title=Paralyzed Again |url=https://www.technologyreview.com/2015/04/09/168424/paralyzed-again/ |access-date=2023-12-08 |website=MIT Technology Review |language=en}}</ref>
The legal and social aspects of BCIs complicate mainstream adoption. Concerns include issues of accountability and responsibility, such as claims that BCI influence overrides free will and control over actions, inaccurate translation of cognitive intentions, personality changes resulting from deep-brain stimulation, and the blurring of the line between human and machine.<ref>{{Cite web |title=Gale - Product Login |url=https://galeapps.gale.com/apps/auth?userGroupName=nysl_ca_arg&sid=googleScholar&da=true&origURL=https%3A%2F%2Fgo.gale.com%2Fps%2Fi.do%3Fid%3DGALE%257CA594456959%26sid%3DgoogleScholar%26v%3D2.1%26it%3Dr%26linkaccess%3Dabs%26issn%3D00280836%26p%3DAONE%26sw%3Dw%26userGroupName%3Dnysl_ca_arg%26aty%3Dip&prodId=AONE |access-date=2023-12-08 |website=galeapps.gale.com}}</ref><ref>{{Cite journal|last1=Sample|first1=Matthew|last2=Sattler|first2=Sebastian|last3=Blain-Moraes|first3=Stefanie|last4=Rodríguez-Arias|first4=David|last5=Racine|first5=Eric |date=2020|title=Do Publics Share Experts’ Concerns about Brain–Computer Interfaces? A Trinational Survey on the Ethics of Neural Technology |url= https://doi.org/10.1177/0162243919879220|journal=Science, Technology, & Human Values|volume=45|issue=6|pages=1242–1270|doi=10.1177/0162243919879220}}</ref> Other concerns involve the use of BCIs in advanced interrogation techniques, unauthorized access ("brain hacking"),<ref>{{Cite journal |last1=Ienca |first1=Marcello |last2=Haselager |first2=Pim |date=June 2016 |title=Hacking the brain: brain-computer interfacing technology and the ethics of neurosecurity |url=https://dx.doi.org/10.1007/s10676-016-9398-9 |journal=Ethics & Information Technology |volume=18 |issue=2 |pages=117–129 |doi=10.1007/s10676-016-9398-9 |s2cid=5132634|hdl=2066/157644 |hdl-access=free }}</ref> social stratification through selective enhancement, privacy issues related to mind-reading, tracking and "tagging" systems, and the potential for mind, movement, stigmatization, and emotion control.<ref>{{Cite journal |last1=Steinert |first1=Steffen |last2=Friedrich |first2=Orsolya |date=2020-02-01 |title=Wired Emotions: Ethical Issues of Affective Brain–Computer Interfaces |url=https://doi.org/10.1007/s11948-019-00087-2 |journal=Science and Engineering Ethics |language=en |volume=26 |issue=1 |pages=351–367 |doi=10.1007/s11948-019-00087-2 |issn=1471-5546 |pmc=6978299 |pmid=30868377}}</ref><ref>{{Cite journal|last1=Sample|first1=Matthew|last2=Sattler|first2=Sebastian|last3=Blain-Moraes|first3=Stefanie|last4=Rodríguez-Arias|first4=David|last5=Racine|first5=Eric |date=2020|title=Do Publics Share Experts’ Concerns about Brain–Computer Interfaces? A Trinational Survey on the Ethics of Neural Technology |url= https://doi.org/10.1177/0162243919879220|journal=Science, Technology, & Human Values|volume=45|issue=6|pages=1242–1270|doi=10.1177/0162243919879220}}</ref><ref>{{Cite journal|last1=Sample|first1=Matthew|last2=Sattler|first2=Sebastian|last3=Boehlen |first3=Wren| last4=Racine|first4=Eric |date=2023|title=Brain-computer interfaces, disability, and the stigma of refusal: A factorial vignette study|url=https://doi.org/10.1177/09636625221141663|journal=Public Understanding of Science|volume=32|issue=4|pages=522–542|doi=10.1177/09636625221141663}}</ref> Researchers have also theorized that BCIs could exacerbate existing social inequalities.
In their current form, most BCIs are more akin to corrective therapies that engage few of such ethical issues. Bioethics is well-equipped to address the challenges posed by BCI technologies, with Clausen suggesting in 2009 that "BCIs pose ethical challenges, but these are conceptually similar to those that bioethicists have addressed for other realms of therapy."<ref>{{Cite journal |last=Clausen |first=Jens |date=2009-02-01 |title=Man, machine and in between |url=https://ui.adsabs.harvard.edu/abs/2009Natur.457.1080C |journal=Nature |volume=457 |issue=7233 |pages=1080–1081 |bibcode=2009Natur.457.1080C |doi=10.1038/4571080a |issn=0028-0836 |pmid=19242454 |s2cid=205043226}}</ref> Haselager and colleagues highlighted the importance of managing expectations and value.<ref>{{Cite journal |last1=Haselager |first1=Pim |last2=Vlek |first2=Rutger |last3=Hill |first3=Jeremy |last4=Nijboer |first4=Femke |date=2009-11-01 |title=A note on ethical aspects of BCI |url=https://www.sciencedirect.com/science/article/pii/S0893608009001531 |journal=Neural Networks |series=Brain-Machine Interface |volume=22 |issue=9 |pages=1352–1357 |doi=10.1016/j.neunet.2009.06.046 |issn=0893-6080 |pmid=19616405 |hdl-access=free |hdl=2066/77533}}</ref> Standard protocols can ensure ethically sound informed-consent procedures for locked-in patients.
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