Off With Their Heads!

Ethical issues

The last set of issues concerns ethics. In other words, even if you could do it, should you?

There is no doubt that the idea of head transplantation evokes a knee-jerk reaction of uneasiness, disgust, maybe even fear. But beyond being gross, crazy, or stupid, there are pertinent questions to address before pursuing it.

The first one is: would it be ethical from a medical perspective to subject someone to this procedure? We know that virtually all medical procedures carry some risk. But we also know that, when such a procedure is recommended to a patient, the benefit outweighs the risks. For example, heart transplantation is no walk in the park. However, doctors routinely perform it because the alternative for their patient would be rapid death. On the other hand, being paralyzed from the neck down, while incredibly limiting to one’s life, does not pose the same threat as a failing heart does. Even if we are talking about patients with muscular dystrophies, which have lower life expectancy, it’s still not the same kind of urgency. In that case, would it be ethical to subject them to an incredibly risky, most likely deadly procedure?

And what about using it as a form of life extension? When he gets bored with the rest of bombastic claims, Canavero switches it up by suggesting that, one day, his “pioneering” head transplantation approach will be used to achieve immortality. Leaving aside the fact that the brain would continue to age, this brings up another issue: where would the bodies come from?

We know for sure that there aren’t enough brain dead donors. And especially if you’re going for immortality, you want a young, healthy body, which, again, that of a brain dead person wouldn’t be. Could this give rise to some sort of dystopian scenario?

Ethical questions rarely have a single clear-cut answer. Carefully thinking about them means considering all potential implications, weighing benefits and costs, and generally going beyond sci-fi claims such as “Cloning will come into play”.

To sum up

Is a head transplant actually possible? No. But will it be possible in a couple of years? Also no. Head transplantation is not only a creepy, but also an incredibly unfeasible idea, nowhere near becoming reality. The media attention given to Sergio Canavero, and especially the lack of critical debunking of his wild statements is disappointing.

Fortunately, independent of that, there are research questions with a lot of merit, such as: spinal cord reattachment and transplantation, electrical spinal cord stimulation, treatment of muscular degeneration etc. Objectively, each one of these has the potential to be more successful, less gruesome, and benefit more people than making Frankenstein’s monster into reality. And luckily, serious researchers are striving to make progress in these directions every day.

Disclaimer: even though this article makes it sounds like Mr. Canavero stole my cat, I don’t have anything personal against him. I have never met him, but based on his appearance in the media, I do consider him a clown. Should his future endeavours prove me wrong, I shall take it back. Until then, use your heads while you still have them.

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Further reading

Anwar, A. T., & Lee, J. M. (2019). Medical management of brain-dead organ donors. Acute and Critical Care34(1), 14-29.

Avlonitis, V. S., Fisher, A. J., Kirby, J. A., & Dark, J. H. (2003). Pulmonary transplantation: the role of brain death in donor lung injury. Transplantation75(12), 1928-1933.

Canavero, S. (2013). HEAVEN: The head anastomosis venture Project outline for the first human head transplantation with spinal linkage (GEMINI). Surgical Neurology International4(Suppl 1), S335.

Guo, Z., Cui, W., Hu, M., Yu, B., Han, B., Li, Y., … & Li, L. (2020). Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator’s experience. International Journal of Oral and Maxillofacial Surgery49(9), 1162-1168.

Lamba, N., Holsgrove, D., & Broekman, M. L. (2016). The history of head transplantation: a review. Acta neurochirurgica158(12), 2239-2247.

Lu, X., Perera, T. H., Aria, A. B., & Callahan, L. A. S. (2018). Polyethylene glycol in spinal cord injury repair: A critical review. Journal of Experimental Pharmacology10, 37.

Max Planck Institute for Brain Research. Good Scientific Practice (retrieved 2022-06-28):

Rowald, A., Komi, S., Demesmaeker, R., Baaklini, E., Hernandez-Charpak, S. D., Paoles, E., … & Courtine, G. (2022). Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis. Nature Medicine28(2), 260-271.

The Guardian. Surgeon promising first human head transplant makes pitch to US doctors (retrieved 2022-06-28):

Urits, I., Jones, M. R., Orhurhu, V., Sikorsky, A., Seifert, D., Flores, C., … & Viswanath, O. (2019). A comprehensive update of current anesthesia perspectives on therapeutic hypothermia. Advances in Therapy36(9), 2223-2232.

Wagner, F. B., Mignardot, J. B., Goff-Mignardot, L., Camille, G., Demesmaeker, R., Komi, S., … & Courtine, G. (2018). Targeted neurotechnology restores walking in humans with spinal cord injury. Nature563(7729), 65-71.

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