Should a head transplant be allowed to happen?

Should a head transplant be allowed to happen?

Should a head transplant be allowed to happen?

Italian neurosurgeon Sergio Canavero claims he will attempt the first human head transplant in December 2017. (Credit: Luzphoto.)

As proposed new medical procedures enter into what looks like science fiction, are ethical concerns being properly taken into account? The latest controversy is over a surgeon who wants to transplant an entire human head.

An Italian neurosurgeon is saying he plans on transplanting a head onto a donor body, not in some distant future, but by the end of 2017.

When Dr. Sergio Canavero first announced his plans a couple of years ago, most people thought he was either crazy, or it was a publicity stunt. Now Canavero says he will put the head of 30-year-old Russian Valery Spiridonov on a donor body in December. Spiridonov suffers from Werdnig-Hoffman disease, which is a form of spinal muscular atrophy.

The surgeon said the procedure would take humanity closer to “extending life indefinitely.”

Although Canavero insists everything is ready to go, a lot of the details remain murky, and it might still be more fantasy than reality.

Dr. David Albert Jones, the director of the Oxford-based Anscombe Bioethics Centre, says the risks associated with such an attempt are “not justifiable.”

The center is a Catholic academic institute that studies the moral issues surrounding medicine.

“The current scientific and medical consensus is that this experiment has very little chance of success,” Jones told Crux, adding the most likely outcome is either death during the operation or survival in a paralyzed state for a few hours or days.

Similar experiments have been done with small animals, to little success. No animal has ever come out of the procedure without being paralyzed, and they all have died soon after.

Jones said the studies are not even advanced enough to attempt the procedure on primates such as monkeys or chimpanzees, let alone a human subject.

“There is nothing to suggest that the current proposal for a head transplant is realistic,” Jones said, adding even if it were, it would not put mankind on a path to immortality.

“People who have received donor organs live longer than they would have done, but they do not live longer, on average, than the average life expectancy of the general population,” Jones said.

“We will all die.”

Jones did warn that if immortality became the goal of a society, this could be a real concern “because the quest for unachievable goals can detract from the achievable goals of society, the realistic goals of healthcare, education and social solidarity.”

Jones responded to some questions from Crux by email, and told us the scientific and ethical concerns about the proposed procedure.

Crux: Is this even possible with today’s technology?

Jones: The idea of a head transplant (or a ‘neck down’ body-transplant) has been attempted in animals but most animals have either died or have been completely paralyzed and none have lived more than a few days.  Given the very poor outcome with mice at the present time it is very difficult to justify attempting this with primates, let alone with humans.  

A key challenge is reconnecting the spinal cord.  Only if we could finally overcome this problem in patients suffering from spinal cord injury (for example, by the use of gene therapy, stem cells and/or growth factors) would it be realistic to deliberately severe the spinal cord and reconnect the head to a different body.  

Thought must also be given to the consequences if the body were to reject the new head.  Could the head be kept alive apart from the body, and what kind of existence would this be?

Is such a transplant ethically permitted?

The current scientific and medical consensus is that this experiment has very little chance of success. The most likely outcome is either death during the operation or survival in a paralyzed state for a few hours or days.

The risks are such that it is not justifiable even with consent, but there is an added concern in that it seems likely that the patient has been given misinformation about the realistic prospects for success, and in these circumstances it seems doubtful that consent is properly informed.

It should also be noticed that the operation would not only take great financial and human resources but would also require a donor whose heart, lungs, liver, and/or kidneys could have given real benefits to several patients on the organ transplant waiting list.  The opportunity costs would, at the very least, involve extending the suffering of these patients and could involve the death of a patient who might otherwise have been saved.

Many are saying that if such a surgery is successful, it puts humanity on the “path to immortality.” Should such a goal concern us?

There is nothing to suggest that the current proposal for a head transplant is realistic.  If some time in the future the technical problems were overcome, it would not be the “path to immortality” any more than current, very successful, transplant medicine puts people on a path to immortality.  People who have received donor organs live longer than they would have done, but they do not live longer, on average, than the average life expectancy of the general population.  We will all die.

How can the Church do more to help people assess the morality of new biotechnologies and medical (or pseudo-medical) procedures?

The goal of immortality is unachievable.  There is no need to be concerned therefore about the achievement of this goal.  On the other hand if (virtual) immortality became the goal of a society, this could be a real concern because the quest for unachievable goals can detract from the achievable goals of society, the realistic goals of healthcare, education and social solidarity.  

The virtue of temperateness is needed if society is to avoid such vain and destructive desires.  The Church could do more to promote the virtues of temperateness and humility, which are necessary not only in relation to this issue but in the wider context of the care of creation.

How should the governments involved handle such things, both on a national and international level? I mean, it seems odd that this doctor is even being allowed to attempt this procedure, given the objections from many that the technology has not even been tested properly.

Governments should ensure that experimental surgery is subject to the same level of ethical scrutiny as the clinical trials of drugs or of medical devices.  Unfortunately surgery is sometimes given a degree of latitude that leaves patients vulnerable to exploitation.  Experimental procedures should not be permitted by a hospital unless and until it has been subject to scientific peer review and has satisfied a clinical ethics committee.  It is difficult to see how the current proposal could fulfill such criteria.

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