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Biosecurity is Everyone's Business (Part 2)

(Here is Part 1.)

Part 2. From natural security to neural security

Humans are fragile. For most of history we have lived with the expectation that we will lose the use of organs, and some of us limbs, as we age or suffer injury. But that is now changing. Prostheses are becoming more lifelike and more useful, and replacement organs have been used to save lives and restore function. But how robust are the replacement parts? The imminent prospect of technological restoration of human organs and limbs lost to injury or disease is cause to think carefully about increasing both our biological capabilities and our technological fragilities.

Technology fails us for many reasons. A particular object or application may be poorly designed or poorly constructed. Constituent materials may be faulty, or maintenance may be shoddy. Failure can result from inherent security flaws, which can be exploited directly by those with sufficient technical knowledge and skill. Failure can also be driven by clever and conniving exploits of the overall system that focus on its weakest link, almost always the human user, by inducing them to make a mistake or divulge critical information. Our centuries of experience and documentation of such failures should inform our thinking about the security of emerging technologies, particularly as we begin to fuse biology with electronic systems. The growing scope of biotechnology will therefore require constant reassessment of what vulnerabilities we are introducing through that expansion. Examining the course of other technologies provides some insight into the future of biology.

We carry powerful computers in our pockets, use the internet to gather information and access our finances, and travel the world in aircraft that are often piloted and landed by computers. We are told we can trust this technology with our financial information, our identities and social networks, and, ultimately, our lives. At the same time, technology is constantly shown to be vulnerable and fragile at a non-trivial rate -- resulting in identity theft, financial loss, and sometimes personal injury and death. We embrace technology despite well-understood risks; automobiles, electricity, fossil fuels, automation, and bicycles all kill people every day in predictable numbers. Yet we continue to use technology, integrating it further into multiple arenas in our lives, because we decide that the benefits outweigh risks.

Healthcare is one arena in which risks are multiplying. The IT security community has for some years been aware of network vulnerabilities in medical devices such as pacemakers and implantable defibrillators. The ongoing integration of networked medical devices in health care settings, an integration that is constantly introducing both new capabilities and new vulnerabilities, is now the focus of extensive efforts to improve security. The impending introduction of networked, semi-autonomous prostheses raises obvious similar concerns. Wi-fi enabled pacemakers and implantable defibrillators are just the start, as soon we will see bionic arms, legs, and eyes with network connections that allow performance monitoring and tuning.

Eventually, prostheses will not simply restore "human normal" capabilities, they will also augment human performance. I learned recently that DARPA explicitly chose to limit the strength of its robotic arm, but that can't last: science fiction, super robotic strength is coming. What happens when hackers get ahold of this technology? How will people begin to modify themselves and their robotic appendages? And, of course, the flip side of having enhanced physical capabilities is having enhanced vulnerabilities. By definition, tuning can improve or degrade performance, and this raises an important security question: who holds the password for your shiny new arm? Did someone remember to overwrite the factory default password? Is the new password susceptible to a dictionary attack? The future brings even more concerns.  Control connections to a prosthesis are bi-directional and, as the technology improves, ever better neural interfaces will eventually jack these prostheses directly into the brain. "Tickling" a robotic limb could take on a whole new meaning, providing a means to connect various kinds of external signals to the brain in new ways.

Beyond limbs, we must also consider neural connections that serve to open entirely novel senses. It is not a great leap to envision a wide range of ensuing digital-to-neural input/output devices. These technologies are evolving at a rapid rate, and through them we are on the cusp of opening up human brains to connections with a wide range of electromechanical hardware capabilities and, indeed, all the information on the internet.

Just this week saw publication of a cochlear implant that delivers a gene therapy to auditory neurons, promoting the formation of electrical connections with the implant and thereby dramatically improving the hearing response of test animals. We are used to the idea of digital music files being converted by speakers into sound waves, which enter the brain through the ear. But the cochlear implant is basically an ethernet connection wired to your auditory nerve, which in principal means any signal can be piped into your brain. How long can it be before we see experiments with a cochlear (or other) implant that enables direct conversion of arbitrary digital information into neural signals? At that point, "hearing" might extend into every information format. So, again we must ask, who holds the password to your brain implant

Hacking the Bionic Man

As this technology is deployed in the population it is clear that there can be no final and fixed security solution. Most phone and computer users are now all too aware that new hardware, firmware, and operating systems always introduce new kinds of risks and threats. The same will be true of prostheses. The constant rat race to chase down security holes in new products upgrades will soon extend directly into human brains. As more people are exposed to medical device vulnerabilities, security awareness and improvement must become an integrated part of medical practice. This discussion can be easily extended to potential vulnerabilities that will arise from the inevitable integration into human bodies of not just electromechanical devices, but of ever more sophisticated biological technologies. The exploration of prosthesis security, loosely defined, gives some indication of the scope of the challenge ahead.

The class of things we call prostheses will soon expand beyond electromechanical devices to encompass biological objects such as 3D printed tissues and lab-grown organs. As these cell-based therapies begin to enter human clinical trials, we must assess the security of both the therapies themselves and the means used to create and administer them. If replacement organs and tissues are generated from cells derived from donors, what vulnerabilities do the donors have? How are those donor vulnerabilities passed along to the recipients? Yes, you have an immune system that does wonders most of the time. But are your natural systems up to the task of handling the biosecurity of augmented organs?

What does security even mean in this context? In addition to standard patient work-ups, should we begin to fully sequence the genomes of donor tissues, first to identify potential known health issues, and then to build a database that can be re-queried as new genetic links to disease are discovered? Are there security holes in the 3D printers and other devices used to manipulate cells and tissues? What are the long term security implications of deploying novel therapeutic tissues in large numbers of military and civilian personnel? What are the long-term security implications of using both donor and patient tissue as seeds of induced pluripotent stem cells, or of differentiating any stem cell line for use in therapies? Do we fully understand the complement of microbes and genomes that may be present in donor samples, or lying dormant in donor genomes, or that may be introduced via laboratory procedures and instruments used to process cells for use as therapies? What is the genetic security of a modified cell line or induced pluripotent stem cell? If there is a genetic modification embedded in your replacement heart tissue, where did the new DNA come from, and are you sure you know everything that it encodes? As with information technologies, we should expect that these new biological technologies will sometimes arrive with accidental vulnerabilities; they may also come with intentionally introduced back doors. The economic motivation to create new protheses, as well as to exploit vulnerabilities, will soon introduce market competition as a factor in biosecurity. 

Competition often drives perverse strategic decisions when it comes to security. Firms rush to sell hardware and software that are said to be secure, only to discover that constant updates are required to patch security holes. We are surrounded by products in endless beta. Worse yet, manufacturers have been known to sit on security holes in the naive hope that no one else will notice. Vendors sometimes appear no more literate about the security of hardware and software than are their customers. What will the world look like when eletromechanical and biological prostheses are similarly in constant states of upgrade? Who will you trust to build/print/grow a prosthesis? Are you going to place your faith in the FDA to police all these risks? (Really?) If you decide to instead place your faith in the market, how will you judge the trustworthiness of firms that sell aftermarket security solutions for your bionic leg or replacement liver?

The complexity of the task at hand is nearly overwhelming. Understanding the coming fusion of technologies will require competency in software, hardware, wetware, and security -- where are those skill sets being developed in a compatible, integrated manner? This just leads to more questions: Are there particular countries that will have a competitive advantage in this area? Are there particular countries that will be hotbeds of prosthesis malware creation and distribution?

The conception of security, whether of individuals or nation states, is going to change dramatically as we become ever more economically dependent upon the market for biological technologies. Given the spreading capability to participate and innovate in technology development, which inevitably amplifies the number and effect of vulnerabilities of all kinds, I suspect we need to re-envision at a very high level how security works.

[Coming soon: Part 3.]