Will We Be Cyborgs? Robots and the Future of Disability

Robots are in the news a lot these days, especially robots for people with disabilities. In Japan, a recently-opened café hired people with disabilities to operate robotic servers that take orders and bring food. The futuristic dining experience brings in customers while also providing valuable jobs to people who would otherwise be unemployed.

When I heard about this café, I was reminded of the movie “Surrogates,” in which humans live their lives through robotic bodies that were originally developed for people with disabilities. The film presents a dystopian view of such a world, depicting most people eschewing their physical bodies for a “safe” robotic existence. (Spoiler alert!) The villain was angered when able-bodied people started using the technology and sought to destroy it to force people to connect in the “real world” again. The film ends with this goal achieved, many lives saved and the people with disabilities who needed the technology forgotten and isolated again.

Could Robots Bring Us Closer Together?

If the plethora of “robots gone bad” movies is any indication, humans tend to fear that relying on robots or connecting to robots separates us further from each other. On one level I share those concerns, but what about the people who are currently excluded from various aspects of society because they aren’t able to physically interact in the same way as others? The cafe robots open new opportunities for physically disabled people to do a job most of us would otherwise be unable to perform. They also allow their operators to care for others, which has both practical and emotional significance for people who have needed more physical care than they could give in return. Robots could enable not just independence, but interdependence. Under the control of a person with a disability, a robot might not only help them dress but cook their spouse’s favorite meal and set the table for a romantic evening.

Unfortunately, the concept of a person with a disability controlling their robot and its actions is largely absent from most of the “care bots” currently being developed. Instead, they are designed to operate independently and offer activities such as social interaction, as well as health checks and reminders. It’s great that these technologies (as well as devices many of us already have in our homes like Siri and Alexa) can help with medication reminders and be used to call for help if someone falls or becomes ill. However, there is a line between empowerment and control, and it’s already been crossed in some disturbing ways. For example, there’s an FDA-approved pill that sends a digital alert to the patient’s doctor after it has been taken, and many sleep apnea devices monitor how long they’ve been used. People who don’t meet certain requirements face a loss of insurance coverage, even if there was a perfectly reasonable explanation for not using the technology. In the United States, a new law mandating electronic visit verification has been used in some states to GPS track people with disabilities and our caregivers, sending up alerts if the caregiver checks in at a “non-approved” location.

A subplot in the TV show “Humans,” which depicts a world with humanoid robots known as synths, takes this kind of surveillance to its terrifying but logical conclusion. An elderly man is told he must trade in his aging but beloved synthetic caregiver for a new model, as both are paid for by Britain’s National Health Service. When he asks the new model to cook his favorite meal, the robot refuses, stating that the fat and salt content exceed his doctor’s recommendations. In various creepy scenes, the robot controls his actions and restricts his life on the grounds of it being for his own good. To me, this storyline was more terrifying than any “Terminator” movie, because I already see the signs it could become reality for millions of seniors and people with disabilities.

Sex Robots Aren’t the Answer

Many robot development projects seem to focus on companionship, the idea that people with disabilities are lonely. They try to develop robots who act like people, instead of looking at the reasons why non-disabled humans aren’t including disabled humans. Concerns about loneliness and disability also inevitably come up when people start talking about sex robots. There are articles that express concern sex robots will further isolate humans from each other and give them unrealistic expectations for a human partner, but they’re far too quick to throw these worries out the window when it comes to people with disabilities. They’ll say things like “sex robots are mostly bad, but we need them for people with disabilities.” This implies people with disabilities can’t have a “normal” relationship, which is both inaccurate and offensive. No human would want us, so we should just settle for a robot?

To be clear, there’s a real need for more accessible sex toys and for technology to enable people with disabilities to enjoy sex regardless of physical limitations. However, many of the barriers people with disabilities face when it comes to healthy sexuality and relationships are not physical. They are social and cultural. While no individual is entitled to a relationship with another individual, people with disabilities as a group have the right to be seen as appealing potential partners, and to be judged on our personal merits, not our disabilities. The solution to loneliness among people with disabilities is to fight the stereotypes that lead to people not wanting to hire us, befriend us and date us, not create an artificial human that would do all those things but without any real emotion. That’s why I believe the real danger of AI isn’t Skynet-style world domination, but that society will make judgments about who is worthy of real human interaction and who isn’t.

Will We Be Cyborgs?

I believe it’s essential for people with disabilities to get involved with the development of new robotic technology, so it can be built “by us, for us” and empower us to be full participants in society. I’ve long been fascinated by Hugh Herr, a mountain climber turned MIT professor doing pioneering work in robotics and cybernetics. Herr lost both of his lower legs due to frostbite after a climbing accident but was determined to return to the sport he loved. After years of not caring much about school, he enrolled in college and began designing his own prosthetic legs, which he found actually gave him an advantage as he could change his feet to adapt to various terrains. Today, he develops advanced bionic limbs and is doing pioneering research in cybernetics.

Herr and his team recently created a cyborg. That word may bring up terrifying visions of alien hordes coming to “assimilate” humanity, but in our reality, he gave an amputee his leg back. The new technology maps a prosthetic leg’s movement to the nerves in what remains of the amputee’s leg, so his new foot moves just like his old one did — without him having to think about it. This is mind-blowing stuff. The team is also developing exoskeletons which could enable people with muscle weakness to walk and enhance the strength of able-bodied people. I wonder if such technology could eventually “unscramble” the incorrect neural signals of people like me who have brain damage from cerebral palsy or a stroke, enabling us to walk with an exoskeleton.

An End to Disability?

Some might be put off by Herr’s goal of an “end to disability,” and I also have concerns with that wording. Disability is part of being human, and people with disabilities will probably always exist, even if or when science finds a cure for certain diseases. Disability isn’t inherently bad, and the way society treats us often limits us more than our conditions.

But the “end” Herr proposes is vastly different from technologies like genetic engineering that would eradicate disability through erasure. Bionic technology validates the humanity of people with disabilities, views us as deserving of inclusion in society, and can transform us while retaining our uniqueness. It preserves our agency and gives us the opportunity to not only exist on a physically equal playing field, but a more advanced one. Bionic bodies will be able to move in ways those who are purely organic cannot. In the future, we may see dances that can only be performed with prosthetic limbs, bionic sports teams and vehicles controlled by nerve impulses. Mechanical parts would be integrated into our self-concept, a process Herr calls “neurological embodiment.”

Would neurological embodiment cause us to lose our humanity? Herr doesn’t seem to think so, and I don’t either. As a wheelchair user, I experience neurological embodiment every day. Although I can’t control my wheelchair with nerve impulses, on a psychological level it feels like part of my body, an extension of my self. I’ve heard many other wheelchair users say the same thing.

My neurological embodiment was further enhanced when I became a cyborg myself — though I never thought of it that way until I watched Herr’s TED Talk. Several months ago I got a standing wheelchair, which helps me not only stand, but bend to reach items, elevate to sit at a bar table, and so much more. It’s an amazing piece of technology, like a cross between a Transformer and an exoskeleton on wheels. I knew it would help with practical matters, but I never expected how much it would change the way I relate to other people, and the way people see me. When I talk to people at eye level or get out on the dance floor, it feels more real, more natural. Nothing comes between us physically or psychologically, and I no longer feel like an outsider. It seems like people don’t notice my wheelchair as much, and when they do, their comments are positive. They see me as a person enabled by a cool piece of tech, not an object of pity.

Our Bodies, Our Choice

Sometimes my wheelchair moves in a way that feels natural, but other times I’m acutely aware of its limitations. Interestingly, many of those limitations are not inherent to the system but programmed by the manufacturer for my supposed safety. For example, the wheelchair will only operate at a very slow speed while standing, so I can’t roll along next to someone who is walking without them having to slow down. I can’t spin around on the dance floor quickly unless I go back to a fully seated and lowered position. It’s both liberating and frustrating at the same time.

Unfortunately, many companies that develop products for people with disabilities do not presume competence. They treat us as if we are not capable of making smart decisions about our mobility devices, and design for the lowest common denominator. They put safety over freedom, which may seem wise but can put unreasonable restrictions on our bodily autonomy. Non-disabled people have the right to take risks with their bodies — why don’t we? I shouldn’t be limited from spinning on the dance floor or “walking” beside a friend indoors just because going down a steep ramp while standing would be dangerous. People with disabilities should be taught how to use technology safely, just like people without disabilities are taught to use their bodies safely.

New Future, Same Challenges

I imagine the future of cybernetics as a spectrum, ranging from people who use technology for physical and cosmetic enhancements, to those who have replacement or repaired body parts, to those whose bodies are entirely mapped to a piece of technology and their “Surrogate”-style robot walks through the world as they remain in bed. Such mapping would also surely translate to the digital world, where virtual reality bodies defy all physical limitations. As an avid user of the virtual reality platform Second Life, I’ve experienced a taste of this and can attest that friendships formed through digital bodies continue into the real world. I see all of this as opening more opportunities for people with disabilities, especially those who are currently homebound due to severe muscle weakness, chronic fatigue, and/or complete paralysis.

Unfortunately, the greatest barrier to adoption of whatever new technologies come along is already readily apparent — money, and the broken American health care system. Currently, amputees struggle to get funding for more than the most basic prostheses, and people who need power wheelchairs and other advanced mobility technology are often denied insurance coverage. Many promising products never make it to market or fail because insurance doesn’t cover them. Remember the iBot? It went under after almost no one could get funding to buy one, and although Toyota has now acquired the technology, they only seem interested in using it for marketing purposes. My guess is they discovered how grueling the FDA’s medical device approval process is and that no insurance would pay, and decided to stick to cars.

I have three forms of health insurance, but it still took a year of fighting and extra funding from the state Vocational Rehabilitation program to get my standing wheelchair. And what about when things go wrong? A crucial part of my wheelchair just broke for the second time in less than a year, and of course, insurance doesn’t want to cover the cost. As technology becomes more integrated with our bodies, its failure will increasingly mean the loss of someone’s mobility and possibly even their life.

We don’t need machines to love us. We need them to empower us to live freely in the world so we can love and be loved by other human beings. We need a health care system that recognizes the value of technology and gives us the funding and support we need to thrive. That’s a future I hope to see.