Plans to attempt what has been called a head transplant, a body transplant, and a head-to-body transplant in human beings raise numerous ethical, social, and legal questions, including the circumstances, if any, under which it would be ethically permissible to attempt whole-body transplantation (WBT) in human beings, the possible effect of WBT on family relationships, and how families should shape WBT decisions. Our assessment of many of these questions depends partially on how we respond to sometimes centuries-old philosophical thought experiments (...) about personal identity. As with so much in bioethics, it is impossible to escape, or at least inadvisable to try to bypass, the relevant foundational philosophical concerns. (shrink)

A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor’s entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background of full-body (...) transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct. Certainly, this examination can only be preliminary, indicating what should be a wide and vigorous discussion among practitioners and ethicists. It concludes with practical suggestions for how the medical and bioethics community may proceed with ethical assessment. (shrink)

The personal identity relation is of great interest to philosophers, who often consider fictional scenarios to test what features seem to make persons persist through time. But often real examples of neuroscientific interest also provide important tests of personal identity. One such example is the case of Phineas Gage – or at least the story often told about Phineas Gage. Many cite Gage’s story as example of severed personal identity; Phineas underwent such a tremendous change that Gage “survived as a (...) different man.” I discuss a recent empirical finding about judgments about this hypothetical. It is not just the magnitude of the change that affects identity judgment; it is also the negative direction of the change. I present an experiment suggesting that direction of change also affects neuroethical judgments. I conclude we should consider carefully the way in which improvements and deteriorations affect attributions of personal identity. This is particularly important since a number of the most crucial neuroethical decisions involve varieties of cognitive enhancements or deteriorations. (shrink)

Studying personal identity, the continuity and sameness of persons across lifetimes, is notoriously difficult and competing conceptualizations exist within philosophy and psychology. Personal reidentification, linking persons between points in time is a fundamental step in allocating merit and blame and assigning rights and privileges. Based on Nozick’s closest continuer theory we develop a theoretical framework that explicitly invites a meaningful empirical approach and offers a constructive, integrative solution to current disputes about appropriate experiments. Following Nozick, reidentification involves judging continuers on (...) a metric of continuity and choosing the continuer with the highest acceptable value on this metric. We explore both the metric and its implications for personal identity. Since James, academic theories have variously attributed personal identity to the continuity of memories, psychology, bodies, social networks, and possessions. In our experiments, we measure how participants weighted the relative contributions of these five dimensions in hypothetical fission accidents, in which a person was split into two continuers. Participants allocated compensation money or adjudicated inheritance claims and reidentified the original person. Most decided based on the continuity of memory, personality, and psychology, with some consideration given to the body and social relations. Importantly, many participants identified the original with both continuers simultaneously, violating the transitivity of identity relations. We discuss the findings and their relevance for philosophy and psychology and place our approach within the current theoretical and empirical landscape. (shrink)

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 in China. The BHT procedure involves attaching the donor body to the head of the recipient, 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: What are the implications for transplantology in the U.S., inclusive of issues of expense, distributive justice, organizational procedures, and the cost of novel insight? How do bioethical and neuroethical principles, and legal regulations of human subject research apply? What are the legal consequences for Canavero performing a BHT? 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 realistically viable procedure.Notably, the permissibility of conducting the BHT in China fosters additional, important questions, focal to 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; if the models of responsible conduct of research are identical, similar, or applicable to the intent and conduct of research in China; and what economic and political implications 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. (shrink)

This article consists of four parts. In the first part it briefly describes the history of body‐to‐head transplantation (BHT) and the surgical plan proposed by Drs. Sergio Canavero and Ren Xiaoping on a human subject. In the second part it argues that the BHT procedure that they propose is scientifically invalid and technically infeasible so therefore would end in failure. In the third part it argues that the present conceivable procedure of BHT cannot be ethically justified because it would bring (...) great harm to the human subject, it is uncertain who would be the possible beneficiary, and valid informed consent cannot be obtained. In the fourth part it argues that the action of performing the procedure of BHT might violate China’s current criminal and civil laws. The conclusion that follows from the arguments above is that BHT should be prohibited now and also in the near future. However, this conclusion does not preclude scientists, neurosurgeons and bioethicists doing research into scientific, technical, surgical and ethical issues raised by BHT. (shrink)

The primary intention of Ren and Canavero's article (2017) is to respond to various criticisms raised by their proposal of the head anastomosis venture (HEAVEN) procedure. Before we launch a deeper analysis of Ren and Canavero's article, I would like to draw attention to a sentence, “Unfortunately, humility is not a part of medical lore,” where they refer to the arrogance and unsuccessfulness of medical science to recognize the importance and breakthrough of the HEAVEN procedure. Interestingly, with this repeated citation, (...) they acknowledge a familiar criticism of medical lore, so that we would expect that they provide a good example of the appreciation of humility in their present article. (shrink)