Scientific history has proven that often the greatest medical breakthroughs go against society’s conventional criterion at that time. Today, society is faced with a pivotal, yet controversial, development in medicine: the body-to-head transplantation (BTH). Some believe that transplanting a head and a brain could perhaps be the final frontier in organ transplantation (1); while others are still skeptic, as BTH is no ordinary surgery and tackles complex medical procedures as well as many ethical dilemmas. Not only is the surgery extremely dangerous with no exit strategy, but it also goes against many of society’s conventional moral standards. However, if executed, the benefits the procedure could provide to terminally ill patients are incalculable.
The goal of body-to-head transplantation (BHT) is to sustain the life of individuals who suffer from a terminal disease, but whose head and brain are healthy. Ideally, BHT could provide a life-saving treatment for several conditions where none currently exist (1). The surgical considerations include identifying a brain-dead body donor, with all healthy organs, and removing the head from the recipient and transplanting it into the donor body (1). The surgery itself would require complex surgical skills, highly specialized and trained surgeons, and the most cutting-edge medical technology. Both the head of the recipient and the body of the donor would have to be cooled down in order for the brain cells to survive minutes without oxygen. Then, the neck and arteries would be cut and the spinal cord fused. Dr. Sergio Canavero, an Italian neurosurgeon that has been attempting to work towards BHT, believes that it is a scientifically sound endeavor that has been carefully conceived (2).
Ethics around this procedure primarily center around the physical implications for the patient. Even if the procedure is successful, the patient will be susceptible to risks and a recovery process so long that, for some, it outweighs the benefits. The patient will require extensive post-transplant support, and they will be maintained in the intensive care unit under strict isolation with ventilator and full circulatory support (1). Assuming that the spinal cord connection succeeds, the patient will need to take a large amount of immunosuppressive drugs, which still may not solve the immune rejection problem (3). Considering the high mortality rate that this surgery could entail, it ultimately leads to the question of whether the procedure should be legally allowed, regardless of the patient volunteering, or if legislation should not to permit this type of surgery.
The possibility of replacing an incurably ill body with a healthy one tests not only medicine’s limits, but also the social and psychological boundaries of physical life (1). The procedure presumes that transplanting a head with a brain would automatically transplant the whole person with its mind, personality and consciousness. Some scholars, like Čartolovni and Spagnolo, consider that BTH patients will experience an extreme mind and body disharmony that could lead to either insanity or death. They argue that the body represents the corporeality of existence, and individuals will fail to adjust to a new and dramatically different physical presence. However, experience with previous organ transplants have not proven these results. In internal medicine and transplantation journals, organ transplantation is generally viewed and described in positive terms (4). The point is put forward, nonetheless, because it is not the same to have somebody’s entire body transplanted on your own than to have just a liver, kidney, or heart that is not yours transplanted to your body. The novelty of the procedure makes it extremely hard to predict what kinds of psychological results to expect from the recipient.
Canavero himself addresses an ethical issue that could emerge from BTH: the donor’s gonads and the transmission of genetic inheritance to the donor’s offspring. In fact, since gonads are considered human identity organs, they are forbidden for transplantation by some legislations (3). The gonads will continue to produce the donor’s offspring. And since the donor is deceased, it is impossible to acquire their consent if not done prior to their death. Transplanting gonads means not only transplanting the organs themselves, but also the donor’s genetic material to be passed on to the recipient’s offspring (1). All sorts of ethical concerns arise from BTH, considering that it is transplanting an entire person’s body, including their reproductive organs.
BTH is also considered an inefficient expenditure of resources, if seen from an economic viewpoint. Only one body could save one life per BTH, while the same donor body could save and enhance up to 15 lives with multiple organ transplants (1). Considering the large number of patients waiting to receive organ transplants, BTH would be considered not only a waste of economic resources, but also of poorly addressing the population’s general medical needs by wasting valuable organs on a procedure from which the patient will not likely survive or recover.
All of the above mentioned psychological, physical, ethical, and economic concerns about body-to-head transplants have been raised since Canavero published his research on the “Gemini” spinal cord fusion protocol (5). Since then, scientists and scholars from around the world have questioned not only the validity of this procedure, but also if it should be done. BHT, however, is an extremely new and novel procedure, meaning that there is no clear-cut answer to the underlying questions behind the surgery (5). The fact remains that no surgeon has been able to successfully complete the procedure on live patients yet, but the future of BHT is extremely uncertain considering Canavero’s most recent research, and the methods being proposed by different scientists as well. Regardless of whether or not the surgery is feasible, an extensive analysis of the ethics behind BHT should be evaluated before moving forward with the proposed procedure.
Andrea Rivera is a first year in Stoughton
Works Cited
[1] Furr, A., Hardy, M. A., Barret, J. P., & Barker, J. H. (2017). Surgical, Ethical, and Psychosocial Considerations in Human Head Transplantation. International Journal of Surgery (London, England), 41, 190–195. http://doi.org/10.1016/j.ijsu.2017.01.077.
[2] Ren, X., & Canavero, S. (2017). From Hysteria to Hope: The Rise of Head Transplantation. International Journal of Surgery,41. doi:10.1016/j.ijsu.2017.02.003.
[3] Čartolovni, A., & Spagnolo, A. G. (2015). Ethical Considerations Regarding Head
Transplantation. Surgical Neurology International, 6, 103. http://doi.org/10.4103/2152-7806.158785.
[4] Durand, C., Duplantie, A., Chabot, Y., Doucet, H., & Fortin, M.-C. (2013). How is Organ Transplantation Depicted in Internal Medicine and Transplantation Journals. BMC Medical Ethics, 14, 39. http://doi.org/10.1186/1472-6939-14-39.
[5] Canavero, S. (2015). The “Gemini” Spinal Cord Fusion Protocol: Reloaded. Surgical Neurology International, 6, 18. http://doi.org/10.4103/2152-7806.150674.
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