Body –to-head transplant; a "caputal" crime? Examining the corpus of ethical and legal issues

Abstract

Neurosurgeon Sergio Canavero proposed the HEAVEN procedure – i.e. head anastomosis venture – several years ago, and has recently received approval from the relevant regulatory bodies to perform this body-head transplant (BHT) in China. The BHT procedure involves attaching the donor body (D) to the head of the recipient (R), and discarding the body of R and head of D. Canavero’s proposed procedure will be incredibly difficult from a medical standpoint. Aside from medical doubt, the BHT has been met with great resistance from many, if not most bio- and neuroethicists.Given both the known challenges and unknown outcomes of HEAVEN, several important neuroethical and legal questions have emerged should Canavero be successful, including: (1) What are the implications for transplantology in the U.S., inclusive of issues of expense, distributive justice, organizational procedures, and the cost(s) of novel insight(s)? (2) How do bioethical and neuroethical principles, and legal regulations of human subject research apply? (3) What are the legal consequences for Canavero (or any other surgeon) performing a BHT? (4) What are the tentative implications for the metaphysical and legal identity of R should they survive post-BHT? These questions are analyzed, issues are identified, and several solutions are proposed in an attempt to re-configure HEAVEN into a safe, clinically effective, and thus (more) realistically viable procedure.Notably, the permissibility of conducting the BHT in China fosters additional, important questions, focal to (1) whether Western ethics and professional norms be used to guide the BHT – or any neuroscientific research and its use - in non-Western countries, such as China; (2) if the models of responsible conduct of research are identical, similar, or applicable to the intent and conduct of research in China; and (3) what economic and political implications (for China and other countries) are fostered if/when such avant garde techniques are successful.These questions are discussed as a further impetus to develop a globally applicable neuroethical framework that would enable both local articulation and cosmopolitan inquiry and oversight of those methods and approaches deemed problematic, if and when rendered in more international settings.

A Scoping Review of Professionalism in Neurosurgery

“…Articles on ethics and conflicts of interest (COI) ranged from general discussions of ethics in neurosurgery to very specific ethical questions. 152-178 Furr et al and Suskin and Giordano reviewed the topic of human head transplantation. 173,175 Four authors discussed informed consent.…”

“…152-178 Furr et al and Suskin and Giordano reviewed the topic of human head transplantation. 173,175 Four authors discussed informed consent. 153,160,166,177 Both Cohen-Gadol et al and Kistka et al explored the problem of misrepresentation of publications in applicants to neurosurgery residency.…”

Theoretical possibilities of head transplant

“…Often, ideas of Canavero [1] or related procedural developments by Canavero and Ren [3] are considered to be medically impossible tasks and unethical. One may find many articles on medical impossibilities as well as ethical issues related to head transplantation in human [4,5,6], but only a few groups are supporting possibilities of head transplantation in human [7,8]. In short, Canavero's HEAVEN (The head anastomosis venture project) with spinal linkage (project GEMINI) [1] is a matter of discussion from various sides, in spite of Ren and Canavero's hope [7].…”

Development proposals of Human Research Protection Program

“…The "golden rice," "head transplant," "gene-edited baby," and "anti-cancer of malaria" events exposed the sometimes insufficient protections of human participants in China. [1][2][3][4] With quick development of human research and large number of international clinical trials for drug and medical device in China, though laws and regulations related to human participant protection are constantly improving, participants protection in the procedure of ethics review and supervision needs to keep up with the pace of development. Therefore, China is a typical representative of developing countries that need to urgently establish the Human Research Protection Program, which will also be an experience for other developing countries.…”