Socio-Ethical Implications of Implantable Technologies in the Military Sector

Abstract:

The military sector has been investing in nanotechnology solutions since their inception. Internal assessment committees in defense programmatically determine to what degree complex technologies will be diffused into the Armed Forces. The broad term nanotechnology is used in this Special Issue of IEEE Technology and Society Magazine to encompass a variety of innovations, from special paint markers that can determine unique identity, to RFID implants in humans. With the purported demand for these new materials, we have seen the development of a fabrication process that has catapulted a suite of advanced technologies in the military marketplace. These technologies were once the stuff of science fiction. Now we have everything from exoskeletons, to wearable headsets with accelerated night vision, to armaments that have increased in durability in rugged conditions along with the ability for central command without human intervention. Is this the emergence of the so-called supersoldier, a type of Iron Man?

Nanotechnology in the Military Sector

The military sector has been investing in nanotechnology solutions since their inception. Internal assessment committees in defense programmatically determine to what degree complex technologies will be diffused into the Armed Forces. The broad term nanotechnology is used in this Special Issue of IEEE Technology and Society Magazine to encompass a variety of innovations, from special paint markers that can determine unique Identity, to RFID implants in humans. With the purported demand for these new materials, we have seen the development of a fabrication process that has catapulted a suite of advanced technologies in the military marketplace. These technologies were once the stuff of science fiction. Now we have everything from exoskeletons, to wearable headsets with accelerated night vision, to armaments that have increased in durability in rugged conditions along with the ability for central command without human intervention. Is this the emergence of the so-called super-soldier, a type of Iron Man?

Social Implications: Key Questions

This special issue is predominantly based on proceedings coming from the 9th Workshop on the Social Implications of National Security, co-convened by the authors of this guest editorial. The workshop focused specifically on human-centric implantable technologies in the military sector. Key questions the workshop sought to address with respect to implants included:

  • What are the social implications of new proposed security technologies?
  • What are the rights of soldiers who are contracted to the defense forces in relation to the adoption of the new technologies?
  • Does local military law override rights provided under the rule of law in a given jurisdiction, and 1 what are the legal implications?
  • What might be some of the side effects experienced by personnel in using nanotechnology devices that have not yet been tested under conditions of war and conflict?
  • How pervasive are nanotechnologies and microelectronics (e.g., implantable technologies) in society at large?


Recommended Reading

More broadly the workshop sought to examine socio-ethical implications with respect to citizenry, the social contract formed with the individual soldier, and other stakeholders such as industry suppliers to government, government agencies, and the Armed Forces [1].

  • F. Allhoff, P. Lin, D. Moore, What is Nanotechnology and why does it matter? From Science to Ethics, West Sussex, Wiley-Blackwell, 2010.
  • S.J. Florczyk and S. Saha, “Ethical issues in nanotechnology,” J. Long-Term Effects of Medical Implants, vol. 17, no. 3, pp. 107-113,2007.
  • A. Krishnan, Military Neuroscience and the Coming of Neurowarfare, London, Routledge, 2017.
  • K. Michael, “Socio-ethical Implications of the Bionic Era”, Academy of Science in Australia, https://www.youtube.com/watch?v=QOOgep8ery8, Shine Dome, Canberra, 25/05/17.
  • R.A. Miranda, W.D. Casebeer, A.M. Hein, J.W. Judy, E.P. Krotkov, T.L. Laabs, J.E. Manzo, K.G. Pankratz, G.A. Pratt, J.C. Sanchez, D.J. Weber, T.L. Wheeler, G.S.F. Ling, “DARPA-funded efforts in the development of novel brain-computer interface technologies,” Journal of Neuroscience Methods, vol. 244, http://www.sciencedirect.com/science/article/pii/S0165027014002702, 2015.
  • M. Murphy, “The US Military Is Developing Brain Implants to Boost Memory and Heal PTSD,” Defense One, 2015; http://www.defenseone.com/technology/2015/11/us-military-developing-brain-implants-boost-memory-and-heal-ptsd/123784/, 17/11/15.
  • M. Orcutt, “DARPA's New Neural Implant Has a Sneaky Way of Getting Inside Heads,” M.I.T. Tech. Rev., 2016; https://www.technologyreview.com/s/600761/darpas-new-neural-implant-has-a-sneaky-way-of-getting-inside-heads/, 09/02/16.
  • D. Ratner, M. Ratner, New Weapons for New Wars: Nanotechnology and Homeland Security, New Jersey, Prentice Hall, 2004.
  • P.S. Saha and S. Saha, “Clinical trials of medical devices and implants: Ethical concerns,” IEEE Eng. Med. & Biol. Mag., vol. 7, pp. 86–87, 1988.
  • S. Saha and P. Saha, “Biomedical ethics and the biomedical engineer: A review,” Critical Reviews in Biomedical Eng., vol. 25, no. 2, pp. 163–201, 1988.
  • P. Tucker, “The Military Is Building Brain Chips to Treat PTSD,” The Atlantic, 2014; http://www.theatlantic.com/technology/archive/2014/05/the-military-is-building-brain-chips-to-treat-ptsd/371855/, 29/05/2014.

DARPA's RAM Project

In 2012, the U.S. military's Defense Advanced Research Projects Agency (DARPA) confirmed plans to create nanosensors to monitor the health of soldiers on battlefields [2]. In 2014, ExtremeTech [3] reported on a 2013 DARPA project titled the “Restoring Active Memory (RAM) Project.” Ultimately the aim of RAM was:

“to develop a prototype implantable neural device that enables recovery of memory in a human clinical population. Additionally, the program encompasses the development of quantitative models of complex, hierarchical memories and exploration of neurobiological and behavioral distinctions between memory function using the implantable device versus natural learning and training” [4].

Several months later, the U.S. Department of Defense (DOD) published on their web site an article on how DARPA was developing wireless implantable brain prostheses for service members and veterans who had suffered traumatic brain injury (TBI) memory loss [5]. Quoting here from the article:

“Called neuroprotheses, the implant would help declarative memory, which consciously recalls basic knowledge such as events, times and places…”
“these neuroprosthetics will be designed to bridge the gaps in the injured brain to help restore that memory function… Our vision is to develop neuroprosthetics for memory recovery in patients living with brain injury and dysfunction.”
“The neuroprosthetics developed and tested over the next four years would be as a wireless, fully implantable neural-interface medical device for human clinical use.”

The U.S. DOD also noted that traumatic brain injury has affected about 270 000 U.S. service members since 2000, and another 1.7 million civilians. The DOD said that they would begin to focus their attention on service members first [6]. Essentially the program is meant to help military personnel with psychiatric disorders, using electronic devices implanted in the brain. Treated disorders range from depression, to anxiety, and post-traumatic stress disorder [7]. The bulk of the15 million) and the University of Pennsylvania ($22.5 million), in collaboration with the Minneapolis-based biomedical device company Medtronic [8].

More Information

Visual proceedings of the 9th Workshop on the Social Implications of National Security, including powerpoint presentations, are available [9]. The workshop was held during the 2016 IEEE Norbert Wiener Conference, at the University of Melbourne, Australia. Several DARPA-funded neurologists from the Vascular Bionics Laboratory at the University of Melbourne were invited to present at the workshop, including a team led by Thomas Oxley, M.D. [10]. (Oxley did not personally appear as he was in the U.S. on a training course related to intensive neurosurgical training.)

The military implantable technologies field at large is fraught with bioethical implications. Many of these issues were raised at the Workshop, and remain unanswered. If there is going to be a significant investment in advancing new technologies for soldiers suffering from depression or post-traumatic stress disorder (PTSD) in the military, there needs to be commensurate funding invested to address unforeseen challenges. In fact, it is still unclear whether U.S. service members must accept participation in experimental brain research if asked, or if they can decline in place of other nonintrusive medical help.

References

1. K. Michael, "Mental Health Implantables and Side Effects", IEEE Technology and Society Magazine, vol. 34, no. 2, pp. 5-17.

2. B. Unruh, "U.S. Military Developing Spychips for Soldiers", WND, [online] Available: http://www.wnd.com/2012/05/u-s-military-developing-spychlps-for-soldiers/.

3. S. Anthony, "US military begins work on brain implants that can restore lost memories experiences", ExtremeTech, [online] Available: http://www.extremetech.com/extreme/176337-us-military-begins-work-on-brain-implants-that-can-restore-Iost-memories-experience.

4. "Restoring Active Memory (RAM)", [online] Available: https://www.fbo.gov/index?s=opportunity&mode=form&id=925a0e2faf1c2e3c3782e1788fcc660d&tab=core&_cview=0.

5. T. M. Cronk, DARPA Developing Implants to Help with TBI Memory Loss, US Department of Defense.

6. T. M. Cronk, DARPA Developing Implants to Help with TBI Memory Loss, US Department of Defense.

7. John Hamilton, "Military Plans To Test Brain Implants To Fight Mental Disorders", Npr.org, [online] Available: http://www.npr.org/sections/health-shots/2014/05/27/316129491/military-plans-to-test-brain-implants-to-fight-mental-disorders.

8. Tanya Lewis, "US Military Developing Brain Implants to Restore Memory", LiveScience, [online] Available: http://www.livescience.com/46710-military-memory-brain-implants.html.

9. K. Michael, M.G. Michael, J.C. Galliot, R. Nicholls, "The Socio-Ethical Implications of Implantable Technologies in the Military Sector", The Ninth Workshop on the Social Implications of National Security (SINS16).

 10. "Minimally Invasive “Stentrode” Shows Potential as Neural Interface for Brain: Implantable device repurposes stent technology to enable direct recording from neurons", Darpa.mil, [online] Available: http://www.darpa.mil/news-events/2016-02-08.

 

Citation: Katina Michael, M.G. Michael, Jai C. Galliot, Rob Nicholls, "Socio-Ethical Implications of Implantable Technologies in the Military Sector", 15 March 2017, Vol. 36, No. 1, pp. 7-9, 10.1109/MTS.2017.2670219.

IEEE Keywords: Special issues and sections, Military communication, Military technology, Implantable biomedical devices, Nanotechnology

INSPEC: ethical aspects, nanofabrication, night vision, radiofrequency identification, social sciences, implantable technologies socio-ethical implication, military sector, nanotechnology, internal assessment committee, RFID implant, fabrication process, military marketplace, night vision,durability, super-soldier

Mental Health, Implantables, and Side Effects

Then I was 8 years of age my older sister who was 8 years my senior was diagnosed with paranoid schizophrenia. As a result, my family spent quite a few years visiting hospitals and mental health facilities on a daily basis. It is painful to reflect on that period, as our whole world was rocked by this illness. My once vibrant, skilful, dynamic, energetic, extremely kind, and top-of-her-class sister was plagued by a disease process of schizophrenia that would have her attempting to take her own life on several occasions, battle with hearing voices, go into a state of catatonia for long periods of time, and suffer severe bouts of anxiety and depression.

The onset of my sister's schizophrenia was spontaneous, during what should have been the most carefree years of her life. We will never know what triggered her illness but for whatever reason that this “thing” landed in our household, we learned to come to terms with its impact. I grew up with an understanding that, in life, there are some things we can fix, and some things we cannot. There are some things we can explain, and some things we cannot. Sometimes medical science has the answers, and sometimes it does not. It does not mean I give up on the potential for a cure or therapy for various forms of mental illness, but I am more wary than most about silver bullet solutions.

In the 30 years my sister has lived with schizophrenia there have been numerous incremental innovations that have been beneficial to some sufferers. First, there have been advancements in pharmacology and in the composition of antidepressants so that they are more effective. But pharmaceutical treatments have not helped everyone, especially those sufferers who do not take their medication on a regular basis. Many persons living with depression who come on and off antidepressants without seeking medical advice are at an increased risk of suicide.

Cognitive behavior therapy (CBT), an empirically-based psychotherapy, has also aided increasing numbers of patients to better cope with their condition. Yet CBT is not given the same media attention as the new range of dynamic neural stimulators, commonly dubbed “brain implants,” now on the market [1].

For sufferers who are diagnosed with major depressive disorder (MDD), and for whom antidepressants and CBT simply do not work, doctors have turned to the prospect of somatic therapies. These include: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS). If an individual does not respond to ECT (and only fifty per cent do), they are said to have treatment-resistant depression (TRD) [2].

In plain language, ECT is when electricity is applied to the scalp generally over a treatment period of between 2-4 weeks, several sessions per week. rMTS treatment goes for 4-6 weeks, of 5 sessions per week and uses a fluctuating magnetic field from electromagnetic coil placed outside the skull sending an electrical current to the brain.

VNS and DBS are more intrusive procedures targeting specific parts of the brain [3]. In VNS, an electrode is wrapped around the left vagus nerve in the neck and stimulation occurs about every 5 minutes for about 30 seconds. The battery packs sit under the skin of the chest in both VNS and DBS, but in the DBS procedure, one or more leads are implanted in the brain, targeted through burr holes in the skull, and locked into place [2].

VNS and DBS were unavailable techniques when my sister first became ill, but I do recollect vividly the results of ECT upon her. Post the treatments, we lost her well and truly into a dark space one cannot reach she was placed on higher dosages of antidepressants for the weeks to follow, and it was apparent to us she was not only in mental anguish but clearly in physical difficulties as well. Doctors claimed clinically that she “did not respond to the treatment,” but never acknowledged that the ECT process might have caused her any short-term distress whatsoever. In fact, we were told: “There is no change in her condition. She continues to be as she was before the treatment.” That was debatable in my eyes. Even though I was just a kid, I observed it took a good three months to get my sister back to where she was before the ECT treatment. But she was only one participant among many in clinical trials, and in no way do I generalize her outcomes to be the outcomes of all ECT patients.

VNS and DBS are again very different techniques, and while VNS is used as an adjunct therapy for major depression, DBS is mainly reserved for treating Parkinson's disease and has had only limited approval for combatting intractable obsessive compulsive disorder (OCD). However, what I gained from those childhood experiences is that human life is precious and experimentation can have some very adverse side effects without any direct benefits to the individual sufferer. Doctors need to be held accountable, caregivers and patients with MDD must be told clearly about the risks, and VNS patients must be monitored closely into the longer-term. I am alarmed at the lack of qualitative research being conducted across the spectrum of implantable devices in the health sector. And that is an area I intend to personally address in my own research in years to come.

To this day, I believe my sister was in no condition to consent to the treatment she received. At the time she intermittently thought I was Brooke Shields and that my siblings were other television personalities. She was delusional and completely unaware of herself. Prior to the trial my sister participated in, my parents had no real idea what ECT was, save for what they had heard anecdotally. As my sister's “guardians,” my parents did not understand how ECT would be administered and were not given the option to accompany her during the actual treatment. They were simply told that my sister would wear something on her head and have an electrical current travel all around it to hopefully “zap” her back to normal. They were not informed of what the risks might be to their beloved daughter, although they were clear it was all “experimental.” It was also emphasized, that this “electro-shock treatment” was the only other alternate route of exploration to help my sister get better. I remember their expectations being raised so high, only to be dashed after each treatment [4]. My parents had to rely on an interpreter as my father did not speak English and my mother only broken English. When one was not available my brother and sisters and I would do the translation.

In the end, when all other routes failed, my family turned to God for help. Alongside an excellent medical and health team (psychiatrist, social worker, general practitioner), and a loving home environment, it was faith that gave my family the will to go on facing everyday issues, as my sister slowly regained parts of herself to become functional again, such as her mobility and speech. As the saying goes “prayer works,” and while it might not make rational sense to believe in miracles, I remember witnessing these on at least a few occasions.

A few months ago, the cover of the February 2015 issue of IEEE Spectrum was graced with the title: “Hot-wiring the nervous system: implanted in the brain, smart-systems are defeating neurological disorders” (pp. 28) [5]. As someone who has spent the greater part of their academic career studying surveillance, risk, privacy and security, trust, and control, I have long reckoned that if we can “defeat” neurological disorders using implantable devices, then we can also “construct” and “trigger” them willingly, as well. But the point of my editorial is not to discuss the future of dynamic neural stimulators; we can debate that in another issue of T&S Magazine. Rather my point is to try to generate discussion about some of the fundamental issues surrounding the socio-ethical implications of penetrating the brain with new technologies, especially those that are remotely triggerable [6].

While the early studies for VNS with respect to MDD look promising, we need to acknowledge we are still at the very beginning of our investigations. I am personally more circumspect about published figures that simply categorize subjects post implantation using minimal labels like “non-responders,” “responders” and “achieved remission” [7]. Longitudinal data will give us a clearer picture of what is really happening. DBS, on the other hand, has been used to treat well over 75 000 persons, mostly suffering from movement disorders [2], but it is increasingly being piloted to treat OCD [8]. This is a call to the research community, to publish more widely about some of the complications, side effects, and resultant social life changes that implantees (of all kinds) are faced with post-surgery.

I am not referring here to issues related to surgical implantation (e.g., symptomatic haemorrhage after electrode placement), or even device failure or hardware-related complications (of which I have great concerns that there will be severe hacking problems in the future). Rather, I am referring to the resultant effect of “artificially constructed” dynamic stimulation on the human brain and its impact on an individual. In short, these are the unintended consequences, that range in scope from psychotic symptoms post stimulation (e.g., for epilepsy, or for patients presenting with auditory hallucinations for the first time), to modifications in sleep patterns, uncontrolled and accidental stimulation of other parts of body function [9], hypersexuality, hypomania [10], changes to heart and pulse rates, and much more.

Many implantees resort to social media to share their pre-and post-operative experiences. And while this is “off the record” self-reporting, clearly some of these discussions warrant further probing and inquiry. My hope is that the copious note-taking that occurs during pilots and clinical trials, specifically with respect to side effects, will be more accessible in the form of peer reviewed publication for doctors, engineers, government officials, standards organizations, regulatory approval bodies, and of course, the general public, so that we can learn more about the short-term and long-term effects of neural stimulation devices.

One patient, as a result of a particular procedure in a DBS pilot study described a sensation of feeling hot, flushed, fearful, and “panicky.” “He could feel palpitations in his chest, and when asked indicated he had an impending sense of doom. The feelings were coincident and continuous with the stimulator ‘on’ setting and they rapidly dissipated when switched ‘off'” [11]. Surely, this kind of evidence can be used to inform stakeholders towards what works and what does not, and the kinds of risks a patient may be exposed to if they opt-in, even if we know the same state will not be experienced by every patient given the complexity of the brain and body. In the more mature heart pacemaker industry, it is device manufacturers who tend to wish to hoard the actual physiological data being recorded by their devices [12], [13]; the brain implant industry will likely follow suit.

To conclude this editorial, at the very least, I would like to echo the sentiments of Fins et al., that deep brain stimulation is a “novel surgical procedure” that is “emerging,” and should presently be considered a last resort for people with neuropsychiatric disorders [14]. There needs to be some tempering of the hype surrounding the industry and we need to ensure that rigor is reintroduced back into trials to minimize patient risk. Exemptions like that granted by the U.S. Food and Drug Administration (FDA) on the grounds of a “humanitarian device” allow implant device manufacturers to run trials that are not meaningful because the size of the trial is inappropriate, lacking commensurate statistical power [14]. The outcomes from such trials cannot and should not be generalized.

I would go one step further, calling not only for adherence to more careful research requirements during clinical trials, but also urging the medical community in general to really think about the direction we are moving. If medical policies like these [15] exist, clearly stating that “there is insufficient evidence to support a conclusion concerning the health outcomes or benefits associated with [vagus nerve stimulation] … for depression” then we must introduce major reforms to the way that consent for the procedure is gained.

Between 1935 and 1960, thanks to a rush of media (and even academic coverage), lobotomies were praised for the possibilities they gave patients and their relatives [16]. Although I am not putting lobotomies on the same level as VNS and DBS, I am concerned about placing embedded devices at the site of the most delicate organ in the human body. If we can “switch on” certain functions through the brain, we can also “switch them off.”

It is clear to anyone studying emerging technologies, that the future trajectory is composed of brain implants for medical and non-medical purposes. Soon, it won't be just people fighting MDD, or OCD, epilepsy [17], [18], Parkinson's disease [19] or Tourette's Syndrome who will be asking for brain implants, but everyday people who might wish to rid themselves of memory disorders, aggression, obesity, or even headaches. There is also the potential for a whole range of amplified brain technologies that make you feel better – diagnostic devices that pick up abnormalities in physiological patterns “just-in-time,” and under-the-skin secure identification [20]. And while the current costs for brain implants to fight mental illness are not cheap, at some $25 000 USD each (including the end-to-end surgical procedure), the prices will ultimately fall [1]. Companies like Medtronics are talking about implanting everyone with a tiny cardiac monitor [21]; it won't take long for the same to be said about a 24×7 brain monitor, and other types of daily “swallowable” implants [22].

Fears related to embedded surveillance devices of any type may be informed by cultural, ethical, social, political, religious concerns that must be considered during the patient care process [23]. Fully-fledge uberveillance, whether it is “surveillance for care” or “surveillance for control” might well be big business in the future [24], but for now academicians and funding bodies should be less interested in hype and more interested in hope.

References

1. S. Upson, "A difficult time for depression devices", IEEE Spectrum, pp. 14, May 2008.

2. W. K. Goodman, R. L. Alterman, "Deep brain stimulation for intractable psychiatric disorders", Annu. Rev. Med., vol. 63, pp. 511-524, 2012.

3. P. Kotagal, "Neurostimulation: Vagus nerve stimulation and beyond", Seminars in Pediatric Neurology, vol. 18, pp. 186-194, 2011.

4. V. Johansson, "Beyond blind optimism and unfounded fears: Deep brain stimulation for treatment resistant depression", Neuroethics, vol. 6, pp. 457-471, 2013.

5. T. Denison, "Building a bionic nervous system: Smart neural stimulators sense and respond to the body's fluctuations", IEEE Spectrum, pp. 28-35, Feb. 2015.

6. W. Glannon, "Stimulating brains altering minds", J. Medical Ethics, vol. 35, pp. 289-292, 2009.

7. T. Schlaepfer, J. Fins, "Deep brain stimulation and the neuroethics of responsible publishing: when one is not enough", JAMA, vol. 303, pp. 775-776, 2010.

8. B. Aouizerate, "Deep brain stimulation for OCD and major depression", Amer. J. Psychiatry, vol. 162, pp. 2192, 2005.

9. P. Moore, "Enhancing Me: The Hope and the Hype of Human Enhancement" in , Wiley, 2008.

10. C. Ch, "Hypomania with hypersexuality following bilateral anterior limb stimulation in obsessive-compulsive disorder", J. Neurosurg., vol. 112, pp. 1299-1300, 2010.

11. S. Na, "Panic and fear induced by deep brain stimulation", J. Neurol. Neurosurg Psychiatry, vol. 77, pp. 410-12, 2006.

12. J. Carvalko, "The Techno-Human Shell: A Jump in the Evolutionary Gap" in , Sunbury, 2013.

13. J. Carvalko, "Who should own in-the-body medical data in the age of ehealth?" in IEEE Technology & Society Mag., Summer, pp. 36-37, 2014.

14. J. Fins, "Misuse of the FDA's humanitarian device exemption in deep brain stimulation for obsessive-compulsive disorder", Health Aff. (Millwood), vol. 30, pp. 302-311, 2011.

15. C. Blue, "Medical Policy: Implantable Eletrical Nerve Stimulators (Vagus Autonomic Nerve and Peripheral Nerve Stimulators)", 2014, [online] Available: https://www.capbluecross.com/wps/wcm/connect/73f7fba6-65df-4f7f-a35c-acc4d805a066/Implantable_Electrical_Nerve_Stimulators_3-25-14.pdf?MOD=AJPERES.

16. G. J. Diefenbach, "Portrayal of lobotomy in the popular press: 1935–1960", J. History of the Neurosciences, vol. 8, pp. 60-70, 1999.

17. C. M. DeGiorgio, "Pilot study of trigeminal nerve stimulation (TNS) for epilepsy: A proof-of-concept trial", Epilepsia, vol. 47, pp. 1213-1215, 2006.

18. A. Schulze-Bonhage, V. Coenen, "Treatment of epilepsy: peripheral and central stimulation techniques", Nervenartz, vol. 84, pp. 517-528, 2013.

19. E. Strickland, "How brain pacemakers treat parkinson's disease", IEEE Spectrum, Apr. 2015, [online] Available: http://spectrum.ieee.org/tech-talk/biomedical/devices/new-clues-how-does-a-brain-pacemaker-control-parkinsons-symptoms.

20. K. Michael, Microchipping People, 2012.

21. E. Strickland, "Medtronic wants to implant sensors in everyone", IEEE Spectrum, Jun. 2014, [online] Available: http://spectrum.ieee.org/tech-talk/biomedical/devices/medtronic-wants-to-implant-sensors-in-everyone.

22. "Google director Regina E. Dugan pushing RFID microchips", 2014, [online] Available: https://www.youtube.com/watch?v=RvYnWBdmcQk.

23. K. Michael, M. G. Michael, The Social Cultural Religious and Ethical Implications of Automatic Identification, 2004.

24. M. G. Michael, K. Michael, "Towards a state of Uberveillance", IEEE Technology & Society Mag., vol. 29, pp. 9-16, 2010.

Citation: Katina Michael, "Mental Health, Implantables, and Side Effects", IEEE Technology and Society Magazine, Volume: 34, Issue: 2, June 2015, pp. 5 - 17, 19 June 2015, DOI: 10.1109/MTS.2015.2434471