Two Regimes, One Body: How Design Decisions Set the Boundary of Legitimate Implantation

Implanted devices can create dependencies that outlast the clinical encounter, research trial, purchase, or employment relationship through which they are acquired. Clinical ethics has developed accounts of consent, maintenance, device abandonment, and explantation, whereas scholarship on non-clinical implantation has often addressed acceptance and bodily integrity. These literatures do not establish that non-clinical recipients lack legal protection, but they leave unresolved which continuing responsibilities should accompany implantation across settings. This article develops a conceptual and normative comparison across consent, maintenance, legibility, exit, and redress. It argues that three properties shaped by design and supply decisions matter across the clinical boundary: whether recipients can understand device behaviour, whether continued function depends on one supplier, and what recipients must bear to stop using a device. Control over foreseeable and avoidable bodily dependence grounds prima facie responsibilities to provide usable information, plan continuity of support, and preserve clinically appropriate exit options. These responsibilities are shared according to actors' control and capacity, constrained by safety and feasibility, and cannot be discharged by initial consent alone. The argument does not establish the prevalence of governance failures or equate passive identification chips with active neural implants. Its strongest prospective application concerns complex implanted consumer neurotechnology. Implantation is ethically defensible only if the continuing relationship it creates is considered alongside the decision to implant.