Transplanting living human heads onto new bodies raises extraordinary ethical questions. We'd better think about them before someone tries it
HAVE you ever wondered what happens to an amputated limb? People can remain emotionally attached to their detached flesh, but they can't do whatever they want with it. A severed arm can't be formally cremated, for example, because a death certificate is required for that. So hospitals may incinerate a limb like any other waste, then return its ashes to their owner – perhaps to be reunited after their death.
But what if it's not just a single limb at stake, but an entire body? This week, we report surgeon Sergio Canavero's plan to transplant a living head onto a donated body by 2017. He believes it won't be long before someone tries it, and that going public with his plan will help stimulate debate over its practical and ethical implications (see "First human head transplant could happen in two years").
We began imagining such grafts centuries ago. One telling has it that the Hindu god Ganesha was beheaded by his father and revivified thanks to a donated elephant's head. Fast-forward to the 1920s, and H. P. Lovecraft was writing about Herbert West preserving severed heads in a "vat of pulpy reptile-tissue", ready to be attached to fresh bodies. Today, heads or brains in jars are a staple of pop culture, mostly played for horror, sometimes for comedy.
Add to that our special dread of decapitation, which anyone who has been watching the news lately will appreciate, and this is not a promising milieu against which to launch such a radical proposal. Transferring a head to a new body is being touted as a solution to inoperable cancers, quadriplegia and inexorable diseases like amyotrophic lateral sclerosis, the condition that Stephen Hawking has. But even if it works – a big if –would we ever sanction its use?
It certainly isn't going to be a comfortable discussion. Many specialists contacted by New Scientist flatly refused to discuss Canavero's ideas, dismissing them as outlandish or unethical. To be fair to them, this may be because Canavero has yet to describe some aspects of his proposed protocols in the detail they deem necessary for a proper debate. However, every advance in transplantation has seemed outlandish at first, from hearts to hands to faces, but in each case, doubts have given way to appreciation.
On the ethics, they have a point. Any attempt, even if it falls short of Canavero's ambitions, would raise serious questions. For a start, we don't know how a donated body will feel. Organ donation is now a simple matter of restoring internal function, but we use our bodies to interact with the world: they are intertwined with our sense of self (see "The touch that made you").
Then there is the question of who, if anyone, should qualify to have the procedure. The cases of those with terminal illness or drastic physical impairment may be relatively simple to assess. But what about those with identity issues? People with body dysmorphias go to extraordinary lengths to have healthy but unwanted limbs removed: will they take desperate measures to rid themselves of their bodies?
And if it were to be successful, how would body swaps affect our ideas about the end of life? Those planning to freeze their heads in the hope of revival might now be one step closer to their goals. Will we – or more likely, a chosen few – one day be able to simply swap bodies to extend our lives?
On the basis of past experience, you can safely bet on there being an outcry if and when the first operation is attempted. Far better if the debate is held before any particular individuals become its focus.
This article appeared in print under the headline "The ultimate makeover"
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