A Neurological Foundation for Freedom

¶1 Few people have read or watched the film adaptation of The Diving Bell and the Butterfly without proclaiming it a triumph of human will. Jean-Dominique Bauby authored the original memoir after suffering a major stroke that left him paralyzed from head to toe with minor exception, but with his mental capacities intact. He did so through a novel form of dictation. Slowly and repeatedly a transcriber recited a French language frequency-ordered alphabet, to which Bauby communicated his story through the blinks of his one working eye. When the transcriber reached the letter of the word Bauby wished transcribed, Bauby blinked once. He signaled the end of a word with two eye blinks, and used rapid eye blinks to communicate that the transcriber had guessed a letter or word ending incorrectly. Letter by letter, blink by blink, Bauby conveyed his thoughts to the transcriber. 200,000 blinks later, the story was done. His memoir provides in gripping detail the separability of the intention to act and the ability to effectuate intended actions. That Bauby could convey his thoughts through such extraordinary means is at once remarkable and tragic that anyone should suffer such a fate. Through the use of his one working eye, Bauby overcame, at least in a limited way, constraints on his freedom to act—by choosing to act, effectuating actions, and identifying with the actions he achieved. ¶2 Today, Bauby might have instead have used a revolutionary new technique from neuroscience to communicate his memoir. A technology known as brain-machine interface enables a computer to “read” brain activity and to decode it through pattern-recognition algorithms.1 Cyberkinetics Neurotechnology Systems, Inc. has developed a brain-machine interface technology that connects the motor cortex of the brain to a computer, where the subject is able to move a cursor on the computer screen, check email, change the volume, and select or move anything on the screen that would be possible with cursor movements by simply thinking about hand movements.2 So by