SYSTEMATIC REVIEW article
Front. Neurosci.
Sec. Neural Technology
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1568800
Ethical, Legal, and Sociocultural Considerations in Neural Device Explantation: A Systematic Review
Provisionally accepted
Manuela Vooijs1
Katherine Bassil2*Anne Van Den Brink2
Odile Van Stuijvenberg2
Nick F Ramsey3
Karin Jongsma2- 1VU Amsterdam, Amsterdam, Netherlands, Netherlands
- 2Bioethics and Health Humanities, Julius Center, University Medical Center Utrecht, Utrecht, Netherlands
- 3Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands, Netherlands
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Implantable neural devices such as brain-computer interfaces and spinal cord stimulators offer therapeutic potential for conditions like paralysis and chronic pain. The novelty of neurodevices has presented unique ethical challenges, with a current focus mostly on development-related challenges like device safety and ethical issues associated with explantation are relatively underexplored. This systematic review aims to elucidate these issues and has searched for ethical, legal, and sociocultural considerations in explantation using the IEEE BRAIN neuroethics framework. Subsequent thematic analysis revealed a focus on medical motives, with 83% of studies reporting medical complications as a consideration in explantation. Other themes included changes in cognition and behavior, emotional well-being, lack of benefit, identity, financial issues, autonomy, post-trial considerations, neurorights, and identity. Our findings highlight the multifaceted nature of neural device explantation and the need for interdisciplinary approaches to address these challenges.
Keywords: neurodevices, Neural implants, Brain-Computer Interfaces, Explantation, Ethics Deleted: During full-text selection, reference lists of included publications were manually reviewed to identify additional relevant studies -referred to as the snowballing method Normal (Web), Space After: 0 pt English (US) Font: Not Italic Formatted: Font: Not Italic
Received: 30 Jan 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Vooijs, Bassil, Van Den Brink, Van Stuijvenberg, Ramsey and Jongsma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Katherine Bassil, Bioethics and Health Humanities, Julius Center, University Medical Center Utrecht, Utrecht, Netherlands
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.