The Ethics of Human Head Transplants Explored: Part One

Doctor inspecting a patient on an operating table
"Surgery circa 1922" by Balcer~commonswiki is public domain in the US (via Wikimedia Commons)

They are not just plot points in bad horror films anymore. Real surgeons and medical doctors are currently exploring the feasibility of human head transplants. In fact, surgeons Sergio Canavero and Xiaoping Ren claimed in November 2017 that such a transplant was “imminent.” The surgery did not happen, but these two surgeons still claim they intend to perform a human head transplant.

Theoretically, in a human head transplant procedure, a special blade made from diamonds would be used to sever the spinal cord of the donor and recipient as cleanly as possible. The detached human head would be kept alive for a period of time at a very cold temperature and hooked up to pumps for oxygen and blood flow. The spinal cords from the donor and recipient would then be fused together using polyethylene glycol. Vertebrae, blood vessels, muscles, and organs would then be stitched together as well. The person would then be placed into a month-long coma, while blood and nerve networks are re-built, in hopes that the body does not reject the new head (or vice versa).

This whole proposal may sound absurd to you; multiple surgeons and doctors have also questioned on scientific grounds Canavero’s and Ren’s proposals for the procedure. Dean Burnett, neurosurgeon and columnist for The Guardian, writes, “The human body is not modular. You can’t swap bits around like you would Lego blocks, take a brick from castle and put it onto a pirate ship and have it work fine.” Burnett argues that one’s brain develops along with one’s body; as such, a relatively unique interface develops between the two. Simply put, no one knows what would happen between a brain and a body that do not share this interface that was built up through years of growth. The results may be traumatic and tragic.

What’s more, the experimental testing and preparation for a human head/body transplant by Canavero and Ren is quite weak. Canavero and Ren have conducted experiments transplanting rat heads onto rat bodies. Disappointingly, one of these studies involved 60 rats, but only 14 survived for any period longer than 36 hours. They have also claimed to have successfully re-fused the severed spinal cords of a dog and a monkey, but scant evidence has been published to back up these claims. Burnett notes that, in the monkey head transplant, the monkey never regained consciousness after the procedure and only survived for twenty hours after the procedure.

Numerous ethical questions, obviously, emerge from the prospects of human head transplants. As Paul Root Wolpe on Vox suggests, would attempting the surgery on humans at this stage be tantamount to murder? The attempted surgery would likely result in death for the human patient (or at best life in a persistent vegetative state), should it fail. Given the paucity of experimental evidence backing up the safety and efficacy of the surgery, one has little rational justification for believing the surgery, at this stage of development, would even succeed. Defenders of the doctors might reply that the proposed head transplant is offered as a last chance procedure for someone suffering from a degenerative terminal neurological disorder. The intent of the surgery is not to end the life of the person, but rather to save it. As long as the doctors do not manipulate the patient to consent to this radical procedure when other safer options still exist, a human head transplant would be as ethical as any other Hail Mary last chance medical procedure.

Terminal patients may have other life-affirming and important choices to make that would be forsaken should they choose to gamble with such a radical procedure, such as saying goodbye to loved ones, making psychological peace with death and oneself, and having control over ending one’s life in a personally dignifying manner. The doctors advocating for trying this surgery on a degenerative terminal patient might not have the patient’s best interests at heart. In addition, it is not clear if the decision to volunteer for this procedure (at its current stage of development) could be considered rational. While respect for a patient’s decisions is generally important, some obviously harmful and irrational decisions do not accord such respect. A patient who believed that an obviously harmful action would cure him a disease, say ingesting large amounts of a strong poison, should probably be stopped from carrying out this action. Having your head cut off in hopes of a successful head transplant may be considered analogous.

Another important moral question concerns fairness and the allocation of organs. There is a severe shortage in viable transplantable organs in the United States. According to the United Network for Organ Sharing (UNOS), twenty people on average die each day while waiting for an organ transplant. What’s more, one organ donor can save up to eight lives. If a person were to donate their whole body for transplant, rather than their individual organs, that would theoretically deprive seven needy people of viable organs. Another allocation issue concerns cost: the head transplant procedure’s cost was estimated at $100 million USD. It may seem unfair to spend that much money on the vanishingly small likelihood of saving one person, considering what this amount could do for many more people.

Presume, now, that the above moral and scientific questions are overcome, and head transplants become a real (if not regular) part of the medical community’s transplant procedures. We are still left with an intriguing metaphysical question, one that would have serious ramifications for morally and legally fraught issues. What person would emerge from the procedure? The assumption is that the person to whom the head originally belonged is the “recipient” of the transplant, and the person from whom the body came “the donor.” But, is this correct? Is there any basis for conceiving of it the other way around? More intriguingly, it may be that the resulting person after the procedure is a third person metaphysically distinct from either the donor or the recipient. These issues will be discussed in a follow-up post.

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Daniel Beck is a recent PhD graduate from Michigan State University’s Department of Philosophy. He has presented on topics in bioethics, environmental philosophy, moral philosophy, and political philosophy at both national and international professional conferences, and his scholarly work on bioethics methodology has been published in a peer reviewed academic journal.