Dr. Sergio Canavero plans to attempt the first human head transplant this December

Dr. Sergio Canavero and his Upcoming Procedure: Ethical? Egregious? Enigmatic? Your Call

By Colby Conway on May 8, 2017
In highly controversial fashion, Sergio Canavero, an Italian neurosurgeon, has plans for a late 2017 surgical procedure that he believes will result in one of the largest advances in the medical field to date. However, other doctors in the field are of the opinion that the procedure should not happen. Canavero and Chinese surgeon Xiaping Ren have plans to perform the first human head transplant, reportedly scheduled for December of 2017. This procedure, which seems straight out of a sci-fi horror film, has created such controversy that not only the medical profession, but society as a whole has debated this operation on numerous grounds. The ethical considerations revolving around this procedure play a large role to say the least, while the physical risks of the operation are perilous.

One of the last holdups for the surgery is the lack of a volunteer. Valery Spiridonov, a man in his early-30s who has Werdnig-Hoffmann disease (a genetic disease that deteriorates and kills motor neurons) originally volunteered his head for the surgery. However, recent reports indicate that Spiridonov will not be a patient in this procedure. Whomever the patient in the surgery turns out to be, Canavero will proceed ahead with his blueprints for the procedure.

Head Transplant From a medical standpoint, the surgery is far from simple. There will be two teams in the operating room, with rumors of over 100 surgeons in on the procedure. The body of the brain-dead man, assuming family’s permission, would be prepped for surgical decapitation, while another team of surgeons would fill Spridonov’s—or whoever the patient is—veins full of fluids at 50 degrees Fahrenheit in order to delay the death of brain tissue. The surgeons have one hour to make this happen. They would then make a quick, precise cut on both bodies, just above the collarbone, and be sure to prevent nerve damage and scarring. When it becomes time to attach the head, and making sure that the brain and spinal cord can fuse together properly, Canavero and his team will use polyethylene glycol, or PEG, to combine two of the most intricate parts of the human body. The patient will remain in an induced coma for a few weeks following the surgery, since machines will perform many of the basic life functions, including breathing and pumping blood. For a more detailed description of the surgery, check out this video.

With all that in mind, Canavero claimed that the procedure has a “90 percent plus” chance of success. To put that into perspective, one of the world’s most extensive face transplants carries just a 50 percent chance of survival. Surgeries for carpal tunnel and detached retinas carry a success rate right around 90 percent, a similar mark proclaimed by Canavero for the first human head transplant.

Ashok Kumar Biswas, geriatric public health specialist and editor-in-chief of IGI Global’s International Journal of User-Driven Healthcare (IJUDH), weighed in on the procedure, which he believes to be a “media stunt,” as well as the “illogical” success rate claim by Canavero.

“Unless you perform it, you must not guess about the chances in such a highly risky surgical procedure,” says Biswas. “Performing on a rat, dog or even a rhesus monkey doesn’t give you a success rate on a human.”

A major concern in the surgery is whether the body will accept the new head. In the first hand transplant, the recipient later had the hand removed. Biswas questions whether the patient can accept a new body mentally, let alone physically. Canavero has stated that the patient will have to take immunosuppressants, likely every day, to ensure that the body does not reject the head and start internally attacking it. Would that allow the body to survive from pathogens? Not without a daily dose of immunosuppressants, and even then there is no guarantee.

While the sheer scientific details of the surgery have been questioned, perhaps it’s the ethical quandaries revolving around this procedure that has society scratching its head. Are Canavero’s motives for scientific advancement or the pure lust of becoming a medical pioneer? Brett Lunceford, published author and contributor to multiple IGI publications, including the International Journal of Technoethics (IJT), points out that “pushing the envelope” of what can be done carries great risk.

“If you are the outlier and many others in the profession think that this is bad science and unethical, then you have to be willing to accept the possibility that you are a crackpot rather than a visionary,” says Lunceford.

Aside from the surgeon’s motives, the costs of this surgery have some questioning whether the benefits are worthwhile. Would this money be better suited for spinal cord research? What if there was a way to fix the spinal cord to allow the individual to regain movement, without having to transfer the head to a new body? These are just a few more ethical lines the procedure tiptoes.

“First of all, it proves to be insane when it comes to the cost, which I feel is unnecessary,” says Biswas.

“I realize that most people would consider their life priceless, but the estimates I have seen for this procedure puts it in the tens of millions of dollars,” says Lunceford. “Is this something that would only benefit the very wealthy?”

“Most importantly, where is the benefit of this expensive and insane procedure?” questions Biswas. “We are human with intelligence to improve, I agree! However, we should invest our resources in better reason of survival. The donor body with valuable, useful organs can give lives to many.”

Lunceford agrees with Biswas, explaining, "To use an entire body means that this body will only help one person, where harvesting the liver, kidneys, heart, and other tissues could help many more people, who may need these organs to survive."

To this point in his career, much of Lunceford’s work has come from studying embodiment and identity, which has become monumental in this case. After the surgery, if it proves successful, Spiridonov, or whomever the patient is, will look in the mirror and see a different body than the one with which they were born. What does that mean for an individual’s identity? What does that do to a person’s sense of self?

“So much of our embodied experience is tied to elements of the body that we don’t even think about,” says Lunceford. “Imagine looking in the mirror and not seeing your own face.”

Rocci Luppicini, associate professor at the University of Ottawa and editor-in-chief of IGI Global’s International Journal of Technoethics (IJT) analyzes three different meaning of “the body” and how it relates to an individual’s sense of self.

“The continuity of one concept of self derives much of its meaning from one human body they were born and develop with,” says Luppicini. “If you take that away, you remove some of what constitutes our self-concept and gives meaning to our individual lives.”

Another question about the surgery asks who is the donor and who is the recipient? Who donates and who receives? Additionally, what receives and what donates? Is the body of the brain-dead individual receiving or donating life? Is the head of the individual gaining a new body, and life, or receiving the body of an individual to carry out his life? According to Luppicini, it’s a “complicated” question that has many questions itself.

Head Transplant “What is being exchanged (arm, leg, face, head), at what stage in life (newborn, child, adolescent, adult), for what aim (survival, normalization, augmentation), within what type of community, with what values and ethical/religious norms in place, etc.,” says Luppicini. “Second, we need legal framework in place to safeguard the rights and responsibilities of implicated agents (donor-recipients-family members—community members) affected by such an act. And third, there is a need of a proper technoethical inquiry to examine the technical and non-technical aspects of such a relationship to determine if it is worth it."

As this procedure looms closer, the advocates and adversaries will continue to make their assertions regarding the first human head transplant. Does the head transplant cross an ethical line? Or many? Are the surgeons’ motives for the right reasons? Does the overwhelming amount of media hype distract individuals from bold assertions, some without much backing, made by Canavero?

Luppicini addresses these concerns, saying “What I have seen so far lacks and I would invite proponents of this procedure, like Canavero, to participate in the dialogue, since the agenda focus seems to revolve around misinformation, untested promises, and media hype to get the public interested in this experiment.”

From a utilitarian perspective, does this operation satisfy “the greatest happiness for the greatest number of people?” Lunceford points out that “consequentialists would say that the ethics depend on the outcome of the procedure.” With all of the ethical dilemmas swirling pre-operation, will society and medical professionals be inclined to wait until post-op to come to its conclusions? Is putting a living patient’s life in danger worth it when the first imperative in the medical field is to “do no harm?” Biswas finds it “morally insensible.”

So, does the procedure cross an ethical boundary for three IGI Global editors-in-chief? It sure does.

Lunceford: “For me, the main issues are: Are we ready, and is it worth it to lose these organs in this procedure? I would like to see more research on spinal cord repair before we do this, and the medical professionals who do this kind of research are not convinced that we are ready."

Luppicini: “While I commend [Sergio] Canavero and others with his keen scientific mind for their efforts, I do not think it is ethically worthwhile at this time to misinform the public about the real risks about transplants in general or mislead potential (and often desperate) participants to sign up to be guinea pigs for unknown suffering, prior to approved testing on a primate level."

Biswas: “Altogether, I am completely against this decision, and my moral conscience would never accept such illogical action in the future either. After all, I too am a human, not a robotic science maniac.”
A sincere thanks to Dr. Brett Lunceford, Dr. Rocci Luppicini and Dr. Ashok Kumar Biswas for sharing their thoughts on the ethical considerations regarding the first human head transplant. Please take a moment to view the International Journal of Technoethics and International Journal of User-Driven Healthcare.
Disclaimer: The opinions expressed in this article are the author’s own and do not reflect the views of IGI Global.
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