Tesi etd-08262025-095627
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Tipo di tesi
Corso di Dottorato (D.M.226/2021)
Autore
CASSINADRI, GUIDO
URN
etd-08262025-095627
Titolo
Bridging the Gap between Neurorights and the Extended Mind Thesis:
Expanding the Mind and Rights of Patients in Post-trial Access to iBCI Treatment.
Settore scientifico disciplinare
M-FIL/03
Corso di studi
Ph.D. in Health Science, Technology and Management - Ph.D. in Health Science, Technology and Management
Commissione
relatore MORGANTE, GAETANA
Membro Prof. BUBLITZ, CHRISTOPH
Membro Dott.ssa FORSBERG, LISA
Membro Prof. ANDREA LAVAZZA
Presidente Prof. IENCA, MARCELLO
Membro Prof. BUBLITZ, CHRISTOPH
Membro Dott.ssa FORSBERG, LISA
Membro Prof. ANDREA LAVAZZA
Presidente Prof. IENCA, MARCELLO
Parole chiave
- Extended Mind Thesis
- Extended Cognition Thesis
- Neurorights
- Right to Mental Integrity
- Brain-Computer Interfaces
- Non-Voluntary Explantation
Data inizio appello
15/01/2026;
Disponibilità
parziale
Riassunto analitico
In this thesis, I construct a theoretical framework for the right to mental integrity (RMI), applying it to the urgent issue of post-trial abandonment and the non-voluntary explantation of implantable brain-computer interfaces (iBCIs). The central argument is that the strenght and scope of neurorights, fundamental entitlements protecting the human brain and mind, are profoundly shaped by our underlying assumptions about the nature of the mind itself. The extended mind and cognition thesis (EXT) posits that cognitive processes, under specific conditions, are realized by the join interaction between brain, body and technological devices. This work explores how EXT shapes and defines the definition, strenght, and scope of neurorights. In this work I compare neurorights violations in light of contrasting mental ontologies: EXT and an organism-bound view of cognition (EMB). The thesis is structured into a theoretical and a practical part. The theoretical section including chapters 1, 2, 3, and 4, lays the groundwork by first introducing and defending the extended mind and thesis (EXT), the framework of neurorights and the right to mental integrity (RMI).
Chapter 1 is the introduction and provides an overview of the argumentative path of the entire thesis. Chapter 2 provides a historical reconstruction of EXT. This chapter contrasts EXT with the cognitive artifacts approach, highlighting that while both address the cognitive role of external tools, EXT offers a more radical ontological claim by considering some artifacts as constitutive parts of the mind.
Chapter 3 develops the core of the thesis: a multidimensional and multilayered framework for the right to mental integrity (RMI). This framework defines a violation of the RMI as a nonconsensual, reasoning-bypassing interference that causes mental harm. Mental harm is further categorized into phenomenological (pain, suffering) and functional (instillation of a dysfunction) types, which can be either organism-bound or extended. This nuanced definition enables a fine-grained analysis that disentangles the RMI from other neurorights like the right to cognitive liberty (RCL), mental privacy (RMP), and psychological continuity (RPC). The chapter then demonstrates how adopting EXT expands the scope of the RMI, creating a layered protection that prioritizes the organism-bound agent while also safeguarding the mind-extending device.
In Chapter 4, this framework is defended against the view proposed by Buller (2025), who argues that neurotechnology fails to extend cognition and mental integrity. The practical application of this theoretical framework is illustrated in the subsequent chapters, focusing on the real-world problem of non-voluntary Brain-Computer Interface (BCI) explantation.
Chapter 5 analyzes the case of Rita Leggett, an Australian patient who suffered severe psychological trauma following the non-voluntary removal of her implanted BCI, which she had come to see as a part of herself. The chapter compares how traditional and internalist (brain-bound) views of the mind versus EXT interpret this event and its ethical consequences. It concludes that while both perspectives can identify a violation of the patient's rights, EXT better captures the full extent of her experience, trauma and harm, including the disruption of her extended self and agency, thereby supporting stricter post-trial obligations for device manufacturers and researchers.
Finally, Chapter 6 broadens the analysis of non-medically required and non-voluntary BCI explantation to the legal and policy spheres. It critiques the current legal status quo, which often relies on a narrow contractualist interpretation of consent, leaving patients vulnerable to abandonment and explantation when clinical trials end or companies go bankrupt. The chapter argues that such a framework is ethically inadequate as it violate fundamental ethical guidelines in medical ethics and it fails to protect patients’ autonomy as well as their fundamental rights to bodily and mental integrity. To rectify this, a suite of actionable legal and practical solutions is proposed. These include the implementation of mandatory insurance schemes for trial sponsors, establishing interoperability mandates for BCI components, creating continuity funds, and requiring intellectual property and data pledges from companies to ensure that device maintenance can be transferred to third parties in cases of corporate failure. To avoid that overregulation stifles innovation and to balance the rights and interests of different stakeholders, we propose balanced partnerships between for-profit/non-profit organizations.
Chapter 7) considers and replies to potential counterarguments, acknowledging the limitations of this work and opening towards new research developments.
In essence, this thesis makes a contribution by developing a sophisticated framework for the right to mental integrity, and demonstrating its utility in addressing one of the most pressing ethical challenges in contemporary neurotechnology. By comparing the ethical implications of an organism bound and an extended view of cognition, it offers a compelling case for rethinking the boundaries of the self and the corresponding scope and strengths of third-parties duties and responsibilities toward patients with implantable Brain-Computer Interfaces.
Chapter 1 is the introduction and provides an overview of the argumentative path of the entire thesis. Chapter 2 provides a historical reconstruction of EXT. This chapter contrasts EXT with the cognitive artifacts approach, highlighting that while both address the cognitive role of external tools, EXT offers a more radical ontological claim by considering some artifacts as constitutive parts of the mind.
Chapter 3 develops the core of the thesis: a multidimensional and multilayered framework for the right to mental integrity (RMI). This framework defines a violation of the RMI as a nonconsensual, reasoning-bypassing interference that causes mental harm. Mental harm is further categorized into phenomenological (pain, suffering) and functional (instillation of a dysfunction) types, which can be either organism-bound or extended. This nuanced definition enables a fine-grained analysis that disentangles the RMI from other neurorights like the right to cognitive liberty (RCL), mental privacy (RMP), and psychological continuity (RPC). The chapter then demonstrates how adopting EXT expands the scope of the RMI, creating a layered protection that prioritizes the organism-bound agent while also safeguarding the mind-extending device.
In Chapter 4, this framework is defended against the view proposed by Buller (2025), who argues that neurotechnology fails to extend cognition and mental integrity. The practical application of this theoretical framework is illustrated in the subsequent chapters, focusing on the real-world problem of non-voluntary Brain-Computer Interface (BCI) explantation.
Chapter 5 analyzes the case of Rita Leggett, an Australian patient who suffered severe psychological trauma following the non-voluntary removal of her implanted BCI, which she had come to see as a part of herself. The chapter compares how traditional and internalist (brain-bound) views of the mind versus EXT interpret this event and its ethical consequences. It concludes that while both perspectives can identify a violation of the patient's rights, EXT better captures the full extent of her experience, trauma and harm, including the disruption of her extended self and agency, thereby supporting stricter post-trial obligations for device manufacturers and researchers.
Finally, Chapter 6 broadens the analysis of non-medically required and non-voluntary BCI explantation to the legal and policy spheres. It critiques the current legal status quo, which often relies on a narrow contractualist interpretation of consent, leaving patients vulnerable to abandonment and explantation when clinical trials end or companies go bankrupt. The chapter argues that such a framework is ethically inadequate as it violate fundamental ethical guidelines in medical ethics and it fails to protect patients’ autonomy as well as their fundamental rights to bodily and mental integrity. To rectify this, a suite of actionable legal and practical solutions is proposed. These include the implementation of mandatory insurance schemes for trial sponsors, establishing interoperability mandates for BCI components, creating continuity funds, and requiring intellectual property and data pledges from companies to ensure that device maintenance can be transferred to third parties in cases of corporate failure. To avoid that overregulation stifles innovation and to balance the rights and interests of different stakeholders, we propose balanced partnerships between for-profit/non-profit organizations.
Chapter 7) considers and replies to potential counterarguments, acknowledging the limitations of this work and opening towards new research developments.
In essence, this thesis makes a contribution by developing a sophisticated framework for the right to mental integrity, and demonstrating its utility in addressing one of the most pressing ethical challenges in contemporary neurotechnology. By comparing the ethical implications of an organism bound and an extended view of cognition, it offers a compelling case for rethinking the boundaries of the self and the corresponding scope and strengths of third-parties duties and responsibilities toward patients with implantable Brain-Computer Interfaces.
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