The sum of our parts RCSIsmj staff writer Katie Nolan
The scientific and medical field have been buzzing with anticipation since Italian neuroscientist Sergio Canavero revealed plans for the first human head transplant in 2013. 1 As the proposed date for this pioneering work looms closer, December 2017, experts and critics have been weighing in heavily on the pitfalls and likely outcomes of a surgery that has only previously been imagined in horror stories and fiction novels. 2
The possibility of transplanting a human head onto a newer, functional donor body holds far more risks and uncertainties than benefits. While it could hold the answer to treating many life-limiting diseases, such as Werdnig Hoffman disease as in the case of the original proposed volunteer Valery Spiridonov , the overall outcomes and repercussions stretch far beyond the initial surgery. 3 While there are devastating motor and movement disorders that could be altogether â€œcuredâ€ by swapping one body for another if the surgery is successful there are many ethical and emotional dilemmas to address also.
Putting aside the vast numbers of doctors and surgeons who have said that in their expert opinion the technology is not ready for a successful surgery, and considering that Spiridonov, the original candidate, has been replaced with an anonymous â€œvolunteerâ€ from China, the country hosting the pioneering surgery, the implications for the future of human reproduction and genetic inheritance has been called into question. 4 5, 6
Presuming a complete head transplant is successful and the donor body becomes the property of the recipient, the recipient will also â€œinheritâ€ the donorâ€™s reproductive organs. The donor in theory is not simply donating their body but also their prospective children. This in itself has major implications for any children conceived by the recipient and for the wider medical practise itself. In cases of life-limiting inherited diseases, will the recipient have access to this private medical history and should any children conceived post transplant have access to their biological parentâ€™s history? Who has legal control of any children conceived, the recipient or the more closely biologically related family of the donor? Would it be ethical for a young recipient to receive an infertile body or for an older recipient to receive a younger donor body capable of reproduction? What would the emotional implications be for a successful recipient if the donor was unknowingly infertile and the recipient, already experiencing huge emotional trauma through the loss of their own body, rejected the new body or viewed it as defective? 7 8
A body is not, in itself, a vessel that we carry around. This experiment in medicine will make us reconsider how we define a person. We are greater than the sum of our parts and while the dream of curing the incurable is the ultimate goal of modern medicine, we must not overlook the remarkable complexity that makes up human beings. A successful head transplant will have far reaching implications for both the recipient, the donorâ€™s family and may create unrecognised ethical dilemmas for the larger medical community.
- Canavero S. HEAVEN: The head anastomosis venture Project outline for the first human head transplantation with spinal linkage (GEMINI). Surg Neurol Int. 2013;4(Suppl 1):S335-42.
- Mika A. Experts skeptical of plans for first human head transplant The Scientist: The Scientist; 2017 [Available from: http://www.the-scientist.com/?articles.view/articleNo/49323/title/Experts-Skeptical-of-Plans-for-First-Human-Head-Transplant/.
- Jane J. Russian Valery Spiridonov, first human head transplant volunteer The Science Times: The Science Times; 2017 [Available from: http://www.sciencetimes.com/articles/11302/20170329/russian-valery-spiridonov-first-human-head-transplant-volunteer.htm.
- Osborne H. Head Transplants: Sergio Canavero says first patient will be chinese national not Valery Spiridonov Newsweek: Newsweek; 2017 [Available from: http://www.newsweek.com/head-transplant-sergio-canavero-valery-spiridonov-china-2017-591772.
- Cuoco JA. Reproductive implications of human head transplantation. Surg Neurol Int. 2016;7:48.
- Lltis AS. The first human body transplant-ethical and legal considerations Harvard Law: Harvard Law; 2017 [Available from: http://blogs.harvard.edu/billofhealth/2017/05/30/the-first-human-body-transplant-ethical-and-legal-considerations/.
- Cuoco JA, and Davy, J.R. Operation Frankenstein: Ethical reflections of human head transplantation. Insights in Neurosurgery [Internet]. 2016; 1(2). Available from: http://neurosurgery.imedpub.com/operation-frankenstein-ethical-reflections-ofhuman-head-transplantation.php?aid=9421.
- Cartolovni A, Spagnolo AG. Ethical considerations regarding head transplantation. Surg Neurol Int. 2015;6:103.