Title
Digital Brain Twins: Concept, Feasibility, and Morality of an Emerging Technological Paradigm
Abstract
A digital twin (DT) is a real-time virtual representation of a physical system, developed to improve, predict, and monitor its functioning. While DTs are increasingly used in precision medicine to simulate patient-specific organs and optimize treatment, a particularly transformative application lies in digital brain twins (DBTs). DBTs are virtual models of the human brain capable of simulating neural activity and cognitive processes, offering unprecedented opportunities for diagnosis, prognosis, and personalized therapy in neurology and psychiatry. However, because the brain is uniquely tied to identity, agency, and consciousness, DBTs raise profound ethical challenges that go beyond those posed by general medical DTs. Despite the growing number of initiatives exploring DBTs, systematic attention to their ethical implications remains scarce. To address this gap, I conducted a double-scoping review following Arksey and O’Malley’s framework. The first review examined ethical issues associated with medical DTs, while the second explored the ethical discourse around brain-computer interfaces (BCIs). BCIs, as established neurotechnologies, share conceptual and operational similarities with DBTs, making their ethical literature a valuable reference point. Cross-referencing these two domains allows for anticipating ethical concerns specific to DBTs. Preliminary findings highlight risks of altered identity and personality through patient–DBT interactions, potential complications in end-of-life decision-making for patients with disorders of consciousness, and threats to patient agency. While DBTs hold immense promise for advancing neurological and psychiatric care, their development requires proactive ethical scrutiny to balance clinical benefits with risks. This research contributes to the emerging neuroethical debate by outlining critical issues that must be addressed to ensure the responsible integration of DBTs into medical practice.
About Giuseppe
Giuseppe is a doctoral student at the University of Bonn, affiliated with the Department of Social Ethics in the Faculty of Protestant Theology. Previously, he studied philosophy at the State University of Milan and at Vita-Salute San Raffaele University, and he has been an invited visiting student at the Institute of Biomedical Ethics and History of Medicine at the University of Zurich. His research interests include neuroethics, human–machine interaction, digital ethics, and the philosophy of technology.