Two years ago, the controversial Italian neurosurgeon Sergio Canavero made a brazen announcement: In December 2017, for the first time in history, he would transplant a human head.
Sergio Canavero. Image: AP
The prospect of a head transplant raises all kinds of questions, both technical and ethical. There may be no bigger question, though, than the one that also seems most obvious: From where, exactly, are they going to get this body and head?
At least that's what Karen Rommelfanger, a neuroethicist at Emory University, is wondering.
"Why have we yet to ask where the bodies are coming from, either the body with the head or the body with the body?" she told Gizmodo. "We're missing very important basic details about this and we're missing the larger picture."
Canavero has long attracted hatred, scepticism and ire for his plans to proceed with a human head transplant. Initially his lab was based in Italy, but he was forced to abandon those plans to move ahead with a surgery on Valery Spiridonov, a Russian man suffering from the muscle-wasting Werdnig-Hoffman's disease. Instead his plans were transplanted to China, where, along with a Chinese scientist named Xiaoping Ren from Harbin Medical University, he plans to proceed with the surgery on an unnamed Chinese national next month.
In 2016, Canavero claimed to have performed the surgery on a monkey but without reattaching the spinal cord and without publishing a paper on the procedure. This month, he claimed to have successfully performed the procedure on a human corpse, including connecting the spine, nerves and blood vessels. The next obvious step, he says, is a transplant on a living person. Scientists are sceptical that he can pull it off.
But whether he can, said Rommelfanger, is a little besides the point. Asking where the bodies will come from is important because it raises questions about both consent and death and the way those things play out differently in different cultural standards.
In America, the Uniform Determination of Death Act holds that someone is dead when their brain irreversibly ceases to function. In Australia, state legislation defines death as "irreversible cessation of all function of the person's brain" or "irreversible cessation of circulation of blood in the person's body". China has no such brain death standard.
In research, it's generally recognised that ethical research on living people requires acquiring "informed consent".
But, said Rommelfanger, it's unclear both whether the Chinese research will rely on heads and bodies that have consented and whether those heads and bodies would by Western standards be considered legally dead. If they were both not legally dead and did not consent, that could amount to an experiment that crosses many Western ethical boundaries.
"This is going to be done to someone," she said. "But the question is whether people will even be given the opportunity to consent or will they just sort of be volun-told," she said, referencing the problems with unethical organ harvesting in China.
Even more complicated: How do you address consent if someone is dead, but a procedure will make them essentially un-dead?
Rommelfanger expressed concern that this will only be the first of many risky, ethically fraught experiments it opens its door to, in a quest for international acclaim. Already, China has pushed the ethical boundaries in the realm of human embryo editing.
She is also concerned that the technology isn't being developed for the Chinese people - or really for any therapeutic use at all.
"Why is this technology even being developed?" she said. "We live in a culture that thinks of the human body as something like a car that just needs a tune-up or fix. This is a technology being developed for the ultra-rich, Silicon Valley types that want to download their brains and live forever."