Cognitive Prosthethics

By Maxime Derian

Computerized machines can be found in many forms and all around us – in our pockets, and even sometimes in our body. For many of us, they are now essential elements of everyday life.

When it comes to smartphones, connected objects, medical digital devices and e-health, these digital tools have proliferated in our environment, continually transforming our modes of social organization. They act as prostheses and orthotics that “enhance our cognitive capacities and influence our inherent behaviors.

Are digital tools that perpetually envelop the body and the spirit able to overwhelm the social order? Could our cognitive prosthetics lead to permanent, radical change to our society, which could become similar to a hive? This book explores this reflection, which is at the center of social research on digital tools.

• Presents a complete review of the field of computerized human prosthetics
• Drawn from research conducted over 6 years and from 2 post doctoral surveys conducted at renowned institutions in France and Japan (Sorbonne University, CNRS, Tokyo Institute of technology)
• Provides an interdisciplinary approach, combining anthropology, sociology, psychology and philosophy

• Language: English
• Publisher: Elsevier Science
• Release date: Nov 22, 2018
• ISBN: 9780081027578

Maxime Derian

Maxime Derian is a researcher at Panthéon-Sorbonne University – Paris 1 (CETCOPRA), France, and a member of the Observatoire des mondes numériques en sciences humaines (OMNSH), France. He is an anthropologist of techniques, specializing in the domain of social uses and digital tools, especially concerning e-health. His research focuses on the hybridization of the human body with computerized machines.

Book preview

Cognitive Prosthetics

Maxime Derian

Health Industrialization Set

coordinated by

Bruno Salgues

Table of Contents

Cover image

Title page

Dedication

Copyright

Preface

Introduction

1: Typology of Prostheses and Interface Modes between Humans and Digital Systems

Abstract

1.1 Interfacing humans and machines

1.2 Bionic prostheses as repairs to the body

1.3 Cognitive prostheses as an augmentation of the body

2: Design and Distribution of Detachable Digital Prostheses

Abstract

2.1 Constructing self-animated objects such as digital prostheses

2.2 Constructing simulated environments: virtual reality and augmented reality

3: Cyber-utopianism

Abstract

3.1 The emergence of a new vision of the relation between the living and the tool

3.2 The invention of an unusual technical apparatus: the infosphere

4: Living with Digital Prostheses

Abstract

4.1 The birth of a society that is constantly connected to a digital network

4.2 Social isolation in a digital communication society

4.3 Enhanced human or shrunken human?

5: The Addictive Nature of Cognitive Prostheses

Abstract

5.1 Cognitive prostheses and Internet addiction

5.2 Cognitive prostheses and electromagnetic radiation

6: Cognitive Prosthetics and Social Engineering

Abstract

6.1 To program or to be programmed

6.2 Hive mind

6.3 Uberization and monopolistic concentration fostered by the infosphere

6.4 The advent of techno-clergy and pseudo-divinities?

7: Potential Pedagogical Impact of Massive and Excessive Use of Cognitive Prosthetics

Abstract

7.1 Impact on cognitive development and children’s education

7.2 Infantile otakism and academic problems

7.3 Language and attention development disorders induced by excessive use of cognitive prosthetics

7.4 Treating attention disorders

8: Body and Technology through the Concepts of the Cyborg and the Enhanced Human

Abstract

8.1 The cyborg and the transhuman: enhanced human or standardized human

8.2 Limits inherent to the marriage between Metal and Flesh

9: The Economic and Environmental Impact and the Sustainability of Computer-based Prosthetics

Abstract

9.1 The hyper-efficiency of machines and the ecological question

9.2 The survival of Metal compared to the survival of the Flesh

9.3 Depletion of resources and raw materials

Conclusion

C.1 On the anthropological level

C.2 On the economic and environmental level

C.3 On the cultural level

C.4 On the psychological level

C.5 On the political level

C.6 On the philosophical level

References

Index

Dedication

To my father: Raymond (†)

To my sister: Cécile (†)

To my mother: Denise

To my sister and her husband: Florence and Laurent

To my brother: Xavier

To my brother and his wife: Charles and Gisèle

To my wife: Mona-Lisa

To my daughter: Victoire

I love you

Copyright

First published 2018 in Great Britain and the United States by ISTE Press Ltd and Elsevier Ltd

Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms and licenses issued by the CLA. Enquiries concerning reproduction outside these terms should be sent to the publishers at the undermentioned address:

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Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

For information on all our publications visit our website at http://store.elsevier.com/

© ISTE Press Ltd 2018

The rights of Maxime Derian to be identified as the author of this work have been asserted by him in accordance with the Copyright, Designs and Patents Act 1988.

British Library Cataloguing-in-Publication Data

A CIP record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

ISBN 978-1-78548-295-3

Printed and bound in the UK and US

Preface

Maxime Derian July 2018

This book constitutes a sociological, anthropological and philosophical consideration of the cultural consequences of the current advent of ubiquitous information technology.

Indeed, information technology is following a trend of ever-increasing pervasiveness ¹ in our environment and in our lives.

Digital devices are literally proliferating. For most of us, today they are essential elements in our day-to-day lives.

Different types of automated objects are produced, transported, sold, used and thrown away, in never-endingly increasing quantities. We view manufactured objects, despite their very high level of technology and their relatively recent nature, as almost completely commonplace. We encounter them in our surroundings in various guises, in our pockets and sometimes even inside our body. This situation presents unusual and fundamental anthropological questions.

In this research, we hypothesize that some of these digital devices, those which accompany our body on a day-to-day basis, tend to become, globally and for a growing number of individuals, true prostheses for their body or orthoses for their mind.

Here, we are going to attempt to define the outlines of the anthropology of digital prostheses of the human body.

Whether they are implants or detachable ² , digital tools appear to be able to modify, subtly or drastically, their wearer’s physiology or thoughts. The presence of these machines gives rise to new social behaviors. This is the process that we are going to explore in this volume.

Indeed, this book is dedicated to digital orthoses of the human body and it proposes a consideration of the development of cognitive digital tools in our daily lives. By orthoses we refer to the fact that digital tools are above all else objects that influence our behavior, our cognitive activity and our postural attitudes.

To a certain extent, these are also a form of mobile prostheses, such as exosomatic organs, added to our body thanks to technoscience and industry.

Currently, it cannot be denied that smartphones, tablets and computers are in the process of turning our social and professional environments, and our daily lives, upside down, because they provide constant access to the web and social networks.

Are these digital tools that envelop us to an incessantly greater extent in a position to overturn our social order to such a point that they would make the very form of society, as we know it now, literally disappear, in favor of an entirely new human interdependence? This is a theme that I approach by means of my concept of a Hive as a social order, and of the Hived as a new manner of describing certain human populations.

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¹ This is the technical trend known as pervasive information technology or ubiquitous information technology.

² A removable tool is defined here as a material object that we are at liberty to equip ourselves with or to get rid of.

Introduction

We consider that a detachable digital prosthesis/orthosis is a digital tool in contact with the human body capable of interacting with its environment (by generating movements and electrical impulses, and producing images and sounds) and whose control and use interface is accessible to the user.

A prosthesis, by definition, is something that replaces a deficient organ. Referring to a leg prosthesis to designate the artificial leg worn by an amputee or agenesic person (born with the absence of a member or of a part of the human body) seems entirely appropriate.

Thus, bionic prostheses of limbs (hand, arm, leg, foot, etc.) are a particular type of digital prosthesis. However, this category of prosthesis is still very rarely seen, only in exceptional cases. The demand for it is limited, since currently, and very fortunately, proportionately few people are affected by amputation or agenesis in comparison to the overall population.

The therapeutic and reconstructive vocation of these particular types of detachable digital tools leads them to be fully regulated as medical devices. Their uses are therefore contained within a strict framework.

However, is it an abuse of language to use the term prosthesis when we are talking about a communication tool such as the smartphone? In my view, it depends on the connection that has developed between the user and their tool.

First, we need to admit that the body is incapable of connecting to the Internet, or to a telephone network in order to transmit data, by itself. The human body is equipped with five senses and the capacity to formulate words and to make gestures; however, it is not in a position to naturally detect wireless networks. It is therefore essential for it to resort to a digital device in order to exchange data with the Internet. Thus, this tool does not replace a deficient organ, but rather an organ that was until now non-existent.

However, the need to access the Internet and various online services has a tendency to become a social imperative (whether it is a case of ease or professional efficiency when scheduling a meeting, or to pay one’s taxes to comply with a legal injunction).

If this access is so highly valued by a significant part of society, then the detachable communication tool becomes essential. It can then, to a certain extent, be assimilated to a form of prosthesis imposed by contemporary life.

Second, detachable digital prostheses can also be cognitive prostheses/orthoses. Computers, smartphones, game consoles, augmented reality glasses and tablet computers are appliances external to the human body, intended to interact with it essentially through sight, hearing and touch, and which overall have no therapeutic function.

This category of prostheses, that we can designate cognitive prostheses, is on the other hand extremely widespread. Thanks to these tools, we create, access and diffuse texts, videos, animations and sound recordings with unusual ease. Even before mobile use of digital tools, it proved to be the case that their calculation power and ease of use generated phenomenal quantities of exchanges of information, increased professional and artistic productivity, and significant economic consequences.

When a prosthesis is difficult to move, due to its weight, its energy supply or a particular wiring (dialysis apparatus, artificial lungs, office computer), its use requires the user to be relatively sedentary.

However, with the significant progress in terms of autonomy and miniaturization, a large number of digital removable prostheses can now be easily transported and repeatedly accompany the human body.

It is relatively legitimate to talk about these devices as orthoses when we want to bring the prescriptive and influential aspect induced by prolonged use to the forefront. Implanted therapeutic prostheses aim to be discreet and silent. Cognitive prostheses, on the contrary, are highly stimulating, providing us with information in real time, and ceaselessly propose new data to consult and to evaluate. Web 2.0 encourages us to make immediate contributions using functions such as like, by making comments, etc.

These notifications, in a certain way, affect our daily rhythms, implant ideas in our minds that would otherwise not be there and are often also driving forces for marketing, politics, cultural industries and the like. These are the means of conveying (sometimes incessantly and in an untimely manner) industrial stimulations created by the world of consumption of material and immaterial goods, just like the most traditional stimulations coming from our inner circle, from our family, our friends or our work colleagues.

Initially, the orthosis is an object that assists and supports a deficient organ. Traditionally, an orthosis is a cane, or crutches, or a plaster that holds the body in place or reinforces weakened parts of it.

Orthopedics in the classic sense designates the desire to straighten out part of the body, and the orthosis is the tool used to do this. This can be for posture or for dental implants in the jaw (with orthodontics). Michel Foucault, in Discipline and Punish, evokes the concept of social orthopedia to talk about the capacity of human institutions to influence the behavior of members of society by resorting to compulsory prescriptions and punishment mechanisms, in particular by influencing life rhythm and movements. Foucault uses the idea of prison to support his thoughts.

Without going that far, it is possible all the same to consider that our digital assistants play a significant role in influencing our daily rhythm, our time management and our relations with others. With exactly this in mind, instead of talking about prostheses of the body to describe smartphones or their equivalent, it is however entirely appropriate to name them orthosis, since they support our behavior on a day-to-day basis. They ring to connect us with those who wish to speak to us, they flash to indicate that a message has been received, their content helps us to find our way around cities, they can allow us to buy goods, recommended beforehand by a clever advertising algorithm akin to alchemy, etc.

This is far from anecdotal. Portable cognitive tools have just recently been democratized and had already polluted our contemporary environment. They are currently used daily by a large proportion of human populations on Earth.

As is the case the world over, smartphones were sold by the millions in France in the year 2017 ¹ . The number of smartphones around the world could reach the considerable number of 3.3 billion by the end of 2018. Various connected objects are proposed on the market and they have various degrees of success. Smartphones are an unprecedented commercial success. Digital watches like the Apple Watch have benefitted from a passing fad, which quite quickly faded out. Google Glass has not yet been adopted en masse, perhaps due to the aesthetic restrictions of wearing such devices on the face and evidence of many problems related to personal privacy.

However, if we consider the accumulation of all types of connected devices, then we realize that they are already present in our lives en masse.

According to the estimates of Erich Spitz, advisor for the group Thalès, there were more than 1,000 billion digital objects on the planet in 2010, including the different types of RFID ² tags, workshop machine-tools, various digital tools and computers ³ .

More than 6 billion mobile telephones were already in operation around the globe in 2012 ⁴ . We consider, therefore, that 80–90% of the human population has a mobile telephone ⁵ . This colossal spread of digital objects is a wave that, in the same way as a stream or high seas, currently seems irrepressible and almost uncontrollable.

In an urban context, we are surrounded by machines and robots. Even in the countryside, we are constantly immersed in flows of electromagnetic waves generated by the use of radio transmitters, for television and radio broadcasting, for mobile phones, for smartphones, for Wi-Fi networks, satellites, radar systems and a large number of other communication devices.

With repetitive use, a kind of behavioral, psychological and social dependency sets in, which leads little by little to the prosthesis being seen as an essential object, a new form of extension of the human body. It becomes natural to live amongst machines.

There is even a tendency for some of these tools to be considered as elements of the body itself. They become objects from which the user can technically be separated, but this separation is carried out almost solely in the case where it is substituted by another model. In other words, we only part with a mobile telephone in order to immediately use another one.

In the end, this resembles the behavior of certain amputees or agenesics who use limb prostheses, who, like Aimee Mullins, are only separated from a prosthesis on the condition that another model is used immediately to avoid a feeling of being naked.

With detachable digital prostheses, the Flesh starts to cognitively depend on Metal, when the latter is incorporated into the scheme of the body by force of habit and dependency ⁶ . Users of cognitive prostheses, although entirely whole, can paradoxically feel incomplete when the smartphone is not nearby. The increase in body operations quickly becomes just as natural for us as using running water or electricity.

Detachable digital cognitive prostheses, whether they are replacing a motor or a cognitive operation, are part of a very intimate relationship with their users. They are technical objects responsible for a particular attachment from the point of view of their user.

The relationship established with these machines is similar to the one existing with a toothbrush or corrective glasses. They are only lent to a third party on exceptional occasions.

Although limb prostheses and cognitive prostheses are part of the same family of technical objects, these two types of detachable digital prostheses do not come under an identical framework nor the same social representations.

Cognitive prostheses are excellent tools to learn, invent, sell and defend oneself, but they are not trivial objects. They constitute a phenomenal economic market.

However, they are not toys, although they have great potential as much for fun as for entertainment.

As much as they are legitimately included in social and individual practices for adults today, they can pose problems for the very youngest, in particular before the age of 4. This subject is developed to a great extent in Chapter 7 of this book, Economic, Environmental Impact and Sustainability of Computer-based Prosthetics.

A digital cognitive prosthesis seen as a comfort blanket or a nanny is a risk factor for a child’s development. These are potentially weapons of massive destruction.

My observations at the time of my PhD viva, in March 2013, came in particular in the wake of considerations expressed by Nicholas Carr about the Internet, as well as those by academics such as Sherry Turkle, Frederick Zimmerman, Michel Demurget, Serge Tisseron or even Bernard Stiegler on the effects on children of watching television.

Sadly, today in 2018, we are seeing an epidemic of autism spectrum problems in young children ⁷ .

I consider that if, from an early age, the brain has been configured as a function of digital stimulations, then the mind will never have known operation without machines. Cognitive behavior will then be structured by taking the use of digital tools into account, and these tools will occupy a position of importance in the daily mental activity of the individual.

Cognitive prostheses can be a true drug sans substance, which phagocytizes all troublesome moments. The compensation for this overuse situation is that the imagination is called on much less. Infobesity inhibits certain creative mechanisms directly linked to the act of imagining, talking and thinking, and diminishes the frequency of verbal exchanges and essential emotions in the first stage of life.

In fact, the deciding factor carrying the most weight seems to be the age at which users become accustomed to these devices. If the brain is already sufficiently adult, the plasticity caused by Internet addiction is, it seems, more easily reversible. It is possible for the mind to return to a mode of operation that had previously been known over a long period of time.

An adult individual can legitimately choose, with full knowledge of the facts, to develop their hyper attention (required in certain video games) to the detriment of their concentration capacity or to choose to remain hyper-concentrated for hours on a screen, writing, working or programming. Managing their attention and their schedule is their responsibility.

On the other hand, it will be much more difficult and problematic to carry out a change of cognitive activity when mental activity has never previously been capable of deep attention over long periods of time, because a high level of attention has not been sufficiently developed at an early age.

Over-intensive use of cognitive prostheses, even more so than the diffused content, represents a difficult question. Disturbance of sleep patterns is caused by the difficulty, for a child who is under no obligation to do so, of stopping play and interaction with the cognitive prosthesis by themselves.

Adolescents are mentally already sufficiently structured to use these tools without great danger. Nevertheless, they remain fragile when faced with the question of lack of sleep. This can damage their recovery from daily fatigue in the same way as, in addition, the physiology of their brain, which only reaches its adult configuration around the approximate age of 15 years. Yet, peer pressure plays a crucial role at this age. Spending the night on Facebook or a similar site contributes to excessive fatigue of the body and the mind to a point where, on the contrary, it is necessary to balance rest with the highly energetic rhythm inherent to adolescence.

This attention paid to children’s exposure to these human augmentation tools must of course also have a bearing on the content proposed for the youngest in society.

Imposing programs with shocking content on children of a young age causes them anxiety. What is provided must obviously be adapted to youngsters. This is why providing a cognitive prosthesis connected to the Internet is not desirable in a first instance. A child’s perspective is not the same as our perspective as adults. Images that are trivial in our eyes can be seen as aggressive or disturbing for young children.

Inappropriate use of cognitive prostheses is a motivation for transmission of rules of good practice to be implemented. Social support and regulation of uses of detachable cognitive prostheses become essential to preserve development of attention amongst children. Prostheses, even detachable ones, need to be combined with an elaborate mode of use, based on social and human supervision.

The worst scenario is perhaps considering the machine in the role of a babysitter. Is it simply desirable that children identify themselves with it and seek to resemble it instead of integrating into the social and affective game involving other humans and possibly domestic animals present in the surroundings? The average time children spend looking at screens is several hours per day. Cognitive prostheses have a very powerful attraction for the youngest children, captivating an enormous amount of their attention.

Added to this are concerns raised about excessive sedentary tendencies generated by the compulsive use of the cognitive prosthesis, moreover often associated with unsuitable nutrition and possible muscular and ocular problems. All these factors can unfortunately fundamentally disrupt the fulfillment of developing human beings.

It is not a case of saying that our children should never be left to use screens, obviously, but rather of not delegating the responsibility for their socio-affective education to them.

Cognitive prostheses are significantly powerful tools in terms of social engineering. We probably only have a tiny glimpse of the disruption that is likely to change modes of social organization for a large proportion of the global population. I fear that this deep change will only contribute again to further transforming citizens into consumers. The culture of immediacy, the claim to rights associated with a refusal to admit having obligations, the weight of social networks that often reinforces crowd psychology and a Pavlovian form of outrage sometimes give the impression that, instead of moving further towards democracy, we are going in the direction of a society where free will can no longer be expressed in the same way.

Lastly, it is also very important to think about the longevity of the global information system, which maintains all these new exosomatic human organs in operation (to re-use the concept of Alfred James Lotka adopted by Nicholas Georgescu-Roegen). Cognitive prostheses or orthoses are not naturally produced by our organisms, and their spread is intrinsically linked to the industrial economy and to energy and raw material resources.

If the conditions for the exploitation of resources and energy supply to the industry are not met, digitized tools will no longer be available. Our daily lives would then again drastically change.

The Flesh is however also fragile and it is easy to go from life to death. Repairing it is not an easy task. The existence of this Flesh, which serves as a support for successive decades, is the milestone by which we measure our human existence and feel our relationship with the world.

The Hive is the concept that I propose in order to think about the radical transformations that affect our society due to the massive diffusion of digital cognitive prostheses. The queen bees of this metaphorical Hive would be large multinational companies in the Information and Digital fields.

Since Jaron Lanier uses the expression hive mind to describe the appearance, in recent years, of a type of human thinking distributed in digital networks and influenced by our cognitive prostheses and our uses of the Web 2.0, I have progressively envisaged taking this expression literally, pondering the idea that this hive metaphor did not seem applicable only to the mind, but potentially also to a global anthropological reconfiguration [LAN 10].

Are we the generation that will see the advent of a new mode of social existence, a new population, made up of people permanently connected to digital networks? This population, whose operation would be based on the backbone of a thought distributed by means of various digital relay methods, which swaddle individuals, by analogy with pheromones and coded behavior in insect swarms, could be depicted as the Hived, managed by the Cloud, and no longer, as has been the case until now, as a society founded on the social contract, or even a community, of which the clan is of highest importance.

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¹ Available at: http://www.economiematin.fr/news-smartphones-utilisation-monde-reseau-operateurs-mobiles.

² Certain digital systems are very discreet, like RFID chips. They are used as anti-theft devices in shops or as swipe cards for access to certain areas. Although they are equipped with a microprocessor, they are not human protheses since they do not have a user control interface, but are instead a function added to a material object. The associated social representation is assimilated to a tag or to a key, and not to a computer. However, when the RFID chip is implanted in a human body, it becomes a prosthesis allowing a digital network to identify the body in question.

³ Intervention at the Collège de France 2006, on Friday 13 October 2006.

⁴ Mobile Phone Access Reaches Three Quarters of Planet’s Population, World Bank Press Release, Washington, available at the link: http://www.worldbank.org/en/news/2012/07/17/mobile-phone-access-reaches-three-quarters-planets-population, 17 July 2012, consulted on 18 November 2012. The term mobile phone is used here to both describe all smartphones and all classic mobile telephones.

⁵ Certainly not all these telematic terminals include functions that we find on the latest smartphones, but nevertheless all these devices are external digital devices, which have a screen, a keyboard, a microphone, a loudspeaker and a digital microprocessor.

⁶ The Flesh is a concept that refers here to the material nature of our human bodies, this instrument of muscles, blood, epidermis, the red cloud whose soul is a lightning bolt [YOU 00]. The chemistry of our bodies is based on carbon, on the basis of organic materials. Our body is structured by a genome coming from sexual reproduction. We, humans, are multicellular living organisms, of a genre which is part of the animal kingdom, of the class of mammals, of the order of primates and of the family of hominids. Our species, named Homo sapiens, is the only current representative of the human genre. The very strength of the Flesh that constitutes us remains profoundly enigmatic. Autonomously, we exist in an environment, we breathe, we nourish ourselves, we reproduce, we think, etc. However, the Flesh is fragile and it is easy to go from life to death. Repairing it is not an easy task and, at the same time, it has its own surprising capacities of self-repair. Here, Metal is seen as a synecdoche to designate the family constituted from all our digital machines. Computers are activated by means of electrical energy. They are controlled by a logico-mathematical chip. They are essentially made up of cables and electronic components, which associate different metals with polymers, ceramics and silicon. Metal is constituted entirely from non-living and inorganic material. However, Metal is a mechanism that sometimes causes a true illusion of life, since Metal, in the same way as the Flesh, is capable of having a relative capacity for autonomous movement. Computers, smartphones, touch-sensitive tablets, portable games consoles, virtual reality or augmented reality devices, communicative objects, digital glasses and active medical implants, RFID implants or even robotic bionic limbs are an illustration of the many different forms that can be adopted by digitized devices designed to interact with the human body. Such technical objects, created by humans, are referred to in this book in their entirety under the general designation of Metal. However, Metal requires maintenance pertaining to trade and industry to continue to operate.

⁷ Available at: http://www.20minutes.fr/sante/2072979-20170522-video-ecrans-troubles-autistiques-chez-enfants-vrais-risques.

1

Typology of Prostheses and Interface Modes between Humans and Digital Systems

Abstract

Not all digitized systems are necessarily prostheses or orthoses for the human body.

Keywords

Augmentation; Bionic prostheses; Cognition; Cognitive prostheses; Digital systems; Myoelectric; Orthoses; Typology

Not all digitized systems are necessarily prostheses or orthoses ¹ for the human body.

For the interaction between a tool and a human being to be of a prosthetic or orthotic nature, some kind of physical or psychological hybridization needs to be put in place between Metal and the Flesh. Human–Machine interfaces (HMIs) are the precise physical locations where Metal and the Flesh join forces. This site of exchange and hybridization can be either within the body, on the skin or outside the body.

Endoprostheses have implanted interfaces. With this type of device, the interaction between Metal and the Flesh is very often not of a consistent kind. In a way, the HMI can be considered as homeostatic.

The HMI of robotic bionic limbs is sometimes implanted, but most of the time it is external to the body. Currently, the most widespread technological trend involves electromyographical detection (EMG), also known as myoelectric.

In 2008, the time I spent at the Koike Lab taught me that myoelectric interfaces were sufficiently satisfactory in terms of data acquisition and reliability in order to make robotic systems work. The considerable advantage of EMG sensors is that they do not need to be implanted. The other solution, also effective in direct control of a robotic system by thoughts, is the BCI (Brain–Computer Interface) system, which involves very high iatrogenic risks since it requires, in order to be optimal, implantation of electrodes directly into the brain. Until now, experiments have required trepanation of the skull of the patient in order to install the electronic connection socket, which implies enormous risks in terms of infection and greatly reduces the life expectancy of the user. The Neuralink project, which began in March 2017, proposes to try to place a stentprobe in the brain by taking the electronic interface through the jugular vein, then deploying it in the brain in a manner that is probably irreversible, a little like an umbrella. This allows the size of the orifice essential for installation of the necessary connector to be slightly reduced.

Cognitive prostheses (in other words, devices that supplement our personal memory, communication and calculation capacities, such as mobile phones, laptop computers, tablets and smartglasses) systematically have, until now, external interfaces.

Cochlear implants have an obvious direct cognitive impact, but, since they aim to restore hearing without adding additional information, I believe it is pertinent to assimilate them instead to endoprostheses. Effectively, their HMI is also globally homeostatic.

A minimum ergonomic level is always required for us to be in a position to interact with our external digitized tools.

Forms of interaction between humans and digital tools that are not implanted but embedded arise from history of use and technological innovation. The story involves ergonomy and choices made by the industrial sector. Ergonomy includes "all that is related to human effort ² with the understanding being that the notion of effort is applied in the widest sense of human activity" [GAI 97].

Mobile phones, which are currently amongst the most widespread detachable digital prostheses, in a certain way extend our senses of hearing and sight as well as our capacity to communicate.

If the mobile phone is considered to be a prosthesis, it is legitimate to ask the question of exactly which organ it is replacing. Ernst Kapp, at the end of the 19th Century, told us that:

In the internal organization of the body, ‘organs’ denote the physical structures that deal with nutrition and maintenance, but also the senses, these thresholds across which perception of what is happening transfers from the outside to the inside, as well as the external organization of the body, the body extremities. [KAP 07]

Smartphones are prostheses for perception, recall and cognition. They are attempts to augment the human brain. A cognitive prosthesis is a sort of detachable new organ.

For a large number of people, a personal computer is the storage medium for a significant amount of important data, household bills and other irreplaceable data (photographs, video recordings) or professional work (CAD, artists’ works, university publications, etc.). Mobile phones contain the phone numbers of close friends and family, a call register, a number of sent and received text messages, family photos, audio and video recordings and so on. The telephone directory is a critical databank for an individual. With respect to pre-existing tools (libraries, address books, video tapes, storage boxes, GPS, movie cameras, image cameras, hi-fi systems, barcode readers, etc.), tools such as smartphones have the defining characteristic of bringing together all these functions, and many more, into a small volume, which can be easily carried on the person.

1.1 Interfacing humans and machines

Prosthetic digital technology clearly subscribes to the paradigmatic framework of ubiquitous information technology. RFID tags, smartphones and future augmented reality glasses are the contemporary expression of this technological trend, which was conceptualized in the 1990s:

The arcane aura that surrounds personal computers is not just a ‘user interface’ problem. My colleagues and I at [Xerox] PARC think that the idea of a ‘personal’ computer itself is misplaced, and that the vision of laptop machines, dynabooks and ‘knowledge navigators’ is only a transitional step towards achieving the real potential of information technology. Such machines cannot truly make computing an integral, visible part of the way people live their lives. Therefore, we are trying to conceive a new way of thinking about computers in the world, one that takes into account the natural human environment and allows the computers themselves to vanish into the background. [WEI 91]

The key to ubiquitous or pervasive ³ information technology lies in the effort to miniaturize and increase electrical autonomy. It is precisely these technological improvements that enable the prosthesis to become portable.

Since the initial Xerox Dynabook ⁴ was the size of a washing machine in the 1970s, its use was restricted in a manner comparable to a desktop PC. Having become easily portable, digital tools can potentially be used 24/7. Touch-sensitive and portable objects such as iPads constitute popularization, 40 years later, of the underlying concept of Dynabook.

It seems that the current rise in information technology, of a ubiquitous nature, has the consequence of modifying our relationship with the world and with others.

But clearly, it is not innovations related to homeostatic and implanted HMIs and endoprostheses that are in the process of overthrowing our society. It is much more the pervasive presence of HMIs created by detachable digitized machines that are in the process of modifying our social world:

The increase in the number of researchers working on ubiquitous information technology is going to allow the most discouraging technological challenges to be overcome. This leaves only challenges of a psychological, social and commercial dimension. The most disruptive revolutions are not those proclaimed by pundits, but those that surreptitiously insinuate themselves in areas where they are least expected. Time will tell if ubiquitous information technology, or something else, will be the next thing to quietly transform our lives. [WEI 93]

Mark Weiser is the founding father of the ubiquitous information technology concept. He died in 1999, a decade before his prediction came true. Indeed, the current widespread existence of information technology tools seems to be little by little transforming our lives. This transformation is social in nature, imaginary. Some talk of a revolution.

Undeniably, the mass surge of computers truly causes subtle modifications in certain cognitive and behavioral aptitudes. A dialectical movement is effectively established: the user acts on the prosthesis and the prosthesis reacts in return to the user.

Computers were initially used, around the time of World War II (only a few decades ago) to make exceptional calculations (such as calculating carpet bombing during a campaign of attrition warfare, calculating the physics of thermonuclear bombs, and sending missiles and rockets into space).

Nowadays, computers are at the very heart of our everyday lives.

The ideology that accompanies information technology sometimes has a tendency to replace spirituality, religions and famous ancient tales. Anthropologically, it is not too far from the truth to consider that we are seeing an increase in a modernized form of animism, whose numerical tools are techno-talismans. HMIs of cognitive prostheses are like magic mirrors, like doorways through which we address the spirits of programs.

Resorting to cognitive prostheses sometimes instigates increased dependency on external devices in order to be able to think in a normal way. An enhanced human, and enhanced cognition, is an expression that cannot avoid the question of a relative decrease in user independence.

Numerous cases of disconnect anxiety ⁵ related to separation from mobile phones or from the ability to make phone calls illustrate this state of dependency on a removable article. Fear of not being reachable and not being able to make calls is a source of stress and worry for a significant number of mobile phone users.

For those who have the greatest addiction to their device, we see a kind of memory externalization and, in return, such strong psychological internalization of the device that it is