Relational Personhood: The missing link for evaluating the clinical impact of Brain-Computer Interfaces

Brain-Computer Interfaces (BCI) use brain signals to control a computer and represent a highly promising assistive technology to enable people with severe motor and speech impairment to interact with the world. Successful demonstrations of fast and accurate BCI-generated expressions, as well as testimonials by BCI research participants, highlight the enormous impact BCI technology can have in their daily lives. With the advent of companies seeking to bring BCIs to market, a key remaining challenge for regulatory approval, reimbursement and clinical implementation of BCIs is the definition of clinical outcome measures that accurately reflect, and can be used to quantify, this impact. Here, we argue that ‘Relational Personhood’ needs to be integrated in the clinical outcome assessment (COA) of BCIs. This concept captures a fundamental, existential dimension of what BCI technology can contribute to the lives of people with motor and speech impairments and their caregivers, which is not sufficiently covered by currently available clinical outcome measures.