Roula Khalaf, Editor of the Financial Times, shares her favorite stories in this insightful weekly newsletter, shining a light on transformative experiences and technological advancements.

One such story recounts the dramatic changes faced by Sarah de Lagarde, who, after losing the use of two limbs in a tragic accident, returned to her role as the global head of corporate affairs at Janus Henderson Investors. De Lagarde emphasizes that the support from her employers during her reintegration into office life was as critical as the advanced technology she now depends on.

In 2022, De Lagarde became one of approximately 60 million individuals worldwide living with amputation as a result of traumatic incidents. Her life was forever altered when she fell onto the tracks of the London Underground's Northern Line, where two trains tragically ran over her, resulting in the loss of her right arm and severe injuries to her leg.

Before her accident, De Lagarde held an idealistic view of prosthetics and the lives of amputees. However, her personal experience has revealed a different and often harsh reality. Living with bionic limbs has been fraught with challenges, including high costs and participation in numerous clinical trials. Instead of becoming 'superhuman,' she found that the current state of prosthetic technology is far from perfect. As she insightfully notes, 'the image can be quite misleading, and were not done perfecting technologies or medical prosthetics.'

Research indicates that the market for bionic limbs remains relatively small, primarily due to a lack of collaboration with users and inadequate representation of disabled individuals in the development process. A 2022 report from the University of Utah highlighted that many current prostheses are cumbersome, leading many users to abandon them altogether.

De Lagarde is keen to explore new prosthetic adaptations and provide feedback on their functionality. For instance, when her first bionic arm proved to be excessively hot, heavy, and lacking in battery life, she took the initiative to suggest potential improvements. She is now adapting to a gel-lined sock attachment designed for her Ottobock-crafted hand, which utilizes a pinlock system, enabling it to slide on and off more smoothly while also enhancing muscle movement detection.

Despite her proactive approach, the financial and mental burden of maintaining her prosthetics is significant. She faces the constant need for replacements every six months, along with regular physiotherapy and weekly fittings, which all contribute to ongoing stress.

According to a UN study, people with disabilities constitute the world's largest and fastest-growing minority group. The World Health Organization reported last year that more than 2.5 billion individuals across the globe require at least one assistive product, a number expected to rise by an additional billion by the year 2050. In the United States alone, approximately 5.6 million individuals live with limb loss or limb differences, as cited by the Amputee Coalition, a prominent non-profit organization.

Artificial Intelligence (AI)-driven assistive technologies are at the forefront of evolving prosthetic limbs and transcription applications, promising a transformative impact on the working lives of disabled employees worldwide. However, the steep costs associated with these innovations often deter potential users and companies from adopting them. For example, Coapt Engineering, which specializes in pattern-based control technology for upper limb prosthetics, estimates that a bionic hand can reach prices as high as $45,000.

At the University of Utah, Jacob George, the director of the NeuroRobotics Lab, is dedicated to developing a motorized limb covered with a silicone 'skin' that can be controlled by the user's thoughts. This innovative prosthetic, named the 'Luke' arm in homage to the iconic robotic hand used by Luke Skywalker in the film The Empire Strikes Back, is designed to restore a sense of touch to its users as well.

Despite its potential, the products available on the market remain limited. For instance, there are only eight Luke arms currently in use, and only 30 Hannes hands, produced by the Italian Institute of Technology, are available. Notably, the Luke arm is distinguished as one of the few prosthetics that can be controlled via neural signals instead of muscle signals, with AI serving to enhance this process by decoding movement patterns from the residual limb. While George acknowledges that the AI may not be flawless, he reassures that 'its still the human in the drivers seat.'

As the market for these advanced devices expands, costs may eventually decrease. The Texas-based startup Alt-Bionics anticipates that its clinical trial-stage Genesis prosthetic hand will be priced around $5,000, while established body-powered solutions, like the Becker hand, typically cost less than $1,000.

However, there is some skepticism surrounding high-tech prosthetics. Britt H. Young, a lecturer at the University of California, Berkeley, who was born without most of her left forearm, has expressed disillusionment with the advanced versions of AI bionic limbs after years of experimentation with various prosthetics. She points out that each new device necessitates significant relearning for the user and often overshadows simpler, more affordable prosthetic options that can be effective. This situation, she argues, places the burden of adaptation squarely on the shoulders of disabled individuals.

Young made the decision to stop using prosthetic arms during her graduate studies and has grown cautious of AI technology. Her sentiment reflects a broader concern that disabled persons are largely marginalized within the tech industry, often omitted from the design processes which tend to favor profitability over inclusivity.

The issue of bias in the design and use of assistive technology has been underscored by the latest findings from the Research Institute for Disabled Consumers. Its chief executive, Gordon McCullough, advocates for the inclusion of disabled individuals early in the development process, stating, 'involve disabled people at the start, not the end.'

De Lagarde is a strong proponent for assistive care to be recognized as a fundamental human right and advocates for the ethical use of AI technology in the realm of prosthetics. She envisions a future where advancements in technology can harmoniously coexist, enhancing the lives of those with disabilities. 'Its not a luxury to want an arm that functions,' she states emphatically. 'These costs need to be democratized. Even if its a challenge, I think technology will be able to lower the costs.'