The exponential growth of computing technology in power and miniaturization has led to a variety of applications in other fields. In this book, medical and computing technologies have been integrated to create devices that can be implanted into the human body. These take on a variety of forms, from passive devices such as radio frequency identification (RFID) chips to active devices such as heart pacemakers, cochlear implants that restore hearing, retinal implants that restore sight, and deep brain stimulators that control the tremors of Parkinson’s disease.

This book provides an overview of how current mainstream technologies work, and discusses in detail some of the technical, legal, ethical, and moral concerns raised from using such tools. These are important considerations because they will affect the people who use implants, usually, but not always, positively. For example, most of those with pacemakers are able to return to a nearly normal lifestyle, whereas some with deep brain stimulators have reported a sense of alienation from themselves.

As with any technology, there is always the possibility of abuse by an overbearing authority or by an individual who might use the technology to gain an advantage over those without it. A prime example of this would be someone with an implant that stealthily accesses information from the Internet during a negotiation. Would use of the implant be ethical in this situation? Should it be legal? In another case, some people have had RFID implants made to provide ready access to the services of a business. Unless the implant has security measures, the possibility now exists that these people could be identified and possibly tracked by any RFID reader they encounter. The use of a pacemaker that can be queried or controlled from outside the body could lead to unauthorized identification or tracking of its user. In an extreme situation, a user with a device that can be externally controlled could be attacked electronically. A researcher with an RFID implant has already demonstrated infection with a digital virus. In addition to these concerns is consideration of legal liability when an implant fails to work as intended.

As one can imagine, research will continue, with uses of this technology expanding and growing. Given the scenarios above, many questions arise as to what sort of regulations or rules should be applied to implants. Should use be strictly based on personal choice, or subject to government limits, such as to prevent a military organization from requiring soldiers to become “superior humans,” say, with eagle vision? Should liability be handled through the determination of defects in manufacturing, negligence, no fault, or some combination of these? How should medical insurers handle the use of implants, especially new ones desired by people who wish for enhancement rather than having a medical necessity? Are societal issues raised by this possible use? In this vein, what does it mean to be human when the brain is directly connected to information technology or, via a network, another human brain?

The papers in this book are all of European origin, so the examples are based on European laws and regulations. That does not negate the value of this material for readers in the US, because although our legal and constitutional system differs from those in Europe, many of the concepts and ethical considerations are similar. For example, European laws are very sensitive to the collection of data about individuals and how such data may be used. The protection of personal privacy is paramount. More generally, the presence of the state in the doctor-patient relationship will come under increasing scrutiny with the progress of medical science.

All in all, this is a thought-provoking book that comes at its subject matter from multiple directions, as befits the complexity of the topic. Many questions are raised and discussed; answers will necessarily come later after much public discussion. The book is well written with many references. It is worthy of consideration by anyone interested in the development of this area of medical technology.