Changing the world often begins with the identification of neglected topics. Many of these problems involve an underserved market segment or a source of economic loss that existing technology fails to address. We do not know the quantity of investment devoted to the research, development, and mass production of the internal combustion engine or human flight. But assuredly, relative to the economic value unlocked, at least at first, these topics were neglected. In others, the value lies in mitigating an existential risk that is beyond the scope of most research and policy-making.

For instance, it’s probably not within the scope of your professional aspirations to mitigate the risk of a meteoroid destroying the earth or a nuclear holocaust or some pandemic in which the pathogen had the transmissibility of mealses and the fatality rate of Ebola. However, if the probability of any of those examples is 0.2% in the next decade, lowering the probability by 0.1%, in expected value terms, saves on the order of millions of lives. Deploying some rough assumptions regarding the number of quality-adjusted-life-years (QALY) saved¹ and the value of a QALY², we’d be talking about an economic impact on the order of a trillion dollars.³

I’m not certain the level of global investment addressing these risks or others of their ilk, but I’d be willing to wager a tidy sum that the value is orders of magnitude lower than one trillion dollars.

And then, in rare cases, there are neglected problems that offer both the mitigation of catastrophic risk and the stunning economic upside. Brain-computer interfaces are one such technology.

Brain computer interfaces (BCI) are devices that facilitate a direct link between the brain and the broader world. For the entirety of human history, minus the most recent decades, reflexes, thoughts, intentions, and ideas could only be communicated to the physical world with our bodies. One must move, speak, or even click a mouse to convey intent. BCI bypasses the motor system. And this changes the nature of what it is to be human.

Academic research continues as it has for several decades, but recent breakthroughs in terms of both hardware and software have opened the floodgates to researchers, technologists, and companies. This then raises the question of which applications offer the maximum commercial potential, which might be widely adopted, and which present existential risks.

Unsurprisingly, a technology that offers literal connections to the human brain presents risks of misuse. Neuroethicists have already expressed concern about the commercialization of such technology. Facebook/Meta has shown interest via its acquisition of CTRL, a tool that reads muscle activity via the wrist. They would presumably extract even greater value in decoding the intentions in the brain rather than the body (hence their own investments in BCI). When the primary business model of a for-profit, publicly-traded company is fundamentally to acquire detailed user data, then sell said data to advertising partners, user agency is often decreased. Now, the dopamine hits are delivered in attempts to nudge consumers en masse to purchase goods they never knew they needed or wanted, and/or manipulate them into pseudo-addict patterns of usage.⁴ Imagine if, upon receiving intimate thoughts, you received an ad capitalizing upon those desires?

Tech giants aren’t the only risk factors. Totalitarian regimes salivate at the surveillance capabilities of BCI. Orwellian notions of prosecuting “thought-crime” would no longer plot lines of dystopian novels. For this reason, the effective altruism forum lists BCI as an existential risk factor. Beyond the traditional risks (identity theft, hacking, blackmail, etc.), they offer probabilistic logic to suggest that once BCI technology is widely adopted, it is almost certain that some regime will deploy it in pursuit of establishing and maintaining authoritarian control. From there, the risk of indefinite usage, rewiring of dissidents’ consciousnesses to ensure loyalty, and other horrors is, at a minimum, likely enough to be terrifying.

So we reframe the question: If BCI can be deployed at the expense of human agency, “how can BCI increase human agency?” One example available with BCI technology is neuroprosthetics. Replacing lost agency by restoring lost function (e.g. limbs) is both enormously valuable to the recipient, and places the bar where current technology can surpass it. Building a BCI that performs at-or-above the performance of the human body and its millions of years of evolution is extremely difficult. An unimpaired individual would likely find most BCI applications frustrating to learn, slower, and ultimately less accurate than interfaces for their hands and eyes. For those with severe impairments however, this can be life-altering. Paralysis represents a $40B cost to Americans on an annual basis.⁵

The impact upon an individual’s life when agency is restored cannot be fully grasped or quantified. The ethical imperative of continuing the pace of technological growth to ease suffering and improve quality of life requires no quantitative argument. But even in cold, financial terms, the scale is apparent.

In the US alone, 5,000 individuals per year develop ALS. Life expectancy is 2-5 years. The current standard of care places a cost per QALY at ~22K GBP. Even if BCI cannot cure the disease, the improvement in QALY during its progression is potentially on the order of $1B per year in the US. Given the ~800,000 individuals in the US who suffer strokes annually, we can conclude that roughly 30,000 survive brain stem strokes.⁶ If half of those injuries were fits for BCI remedies, given an assumption of ~4 years of survival after the first stroke, we’d again be talking about billions of economic value annually.

Whether bilateral cochlear implants for deaf children or deep brain stimulation (DBS) for Parkinson’s disease or thoughts-to-text for aphasics, the opportunity to improve lives is staggering in ethical or economic terms.

And all of this is the tip of a larger iceberg in which able-bodied individuals turn thought into action with a computer that responds to intention rather than pointing, clicking, and typing. That economic value could easily approach trillions per year.

So how does this remain a neglected problem? How can a technology with the potential for autocratic, dystopian misery and the restoration of agency to the ill and injured still not garner the attention it deserves? Because our skeuomorphic⁷ technologies are easily imagined, but paradigm shifts are not. Meta is hiring the relevant neurological talent in droves. They can see the opportunity. Totalitarian regimes build their own surveillance apparatuses. They can see the potential. Shouldn’t we all recognize the opportunity and risks ahead?

¹

^{The average person on the planet has tens of years to live.}

²

^{The value of the average person’s QALY is on the order of tens of thousands of USD.}

³

^{~10E10 humans on earth * 10E-3 (decrease in probability of cataclysmic event) * ~30 QALY/person * $30K/QALY = ~$1 trillion}

⁴

^{More eyes on screens for longer periods, more ads to view, lather, rinse, repeat.}

⁵

^{Of course, the other nations of the world would raise this value well north of $100B.}

⁶

^{795,000 people * 75% first time strokes * 87% ischemic * 10% brain stem * 60% survival ~ 30,000.}

⁷

^{Applications that reflect the nature of the human motor system (e.g. a robotic “arm” or a computer’s cursor).}

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