Head transplant: questions but no answers

Publié le 9 Oct, 2017

Repeated comments from neurosurgeon, Sergio Canavero, about head transplants are raising a certain number of questions and creating a  “legal headache”. This “mad project”, which first came to light in 2013, will probably be carried out in China with a Chinese donor and recipient. The procedure would be carried out by Ren Xiaoping at the Harbin School of Medicine (China).

 

First and foremost, the announcement seems premature and questions the purpose of the procedure: “Will it really benefit the patient?”  No pre-clinical animal study has been carried out to date. The recipient will certainly have “major neuromuscular dysfunction“, but may also die during surgery or life expectancy may be reduced because of immunosuppressants. Furthermore, in this case, the transplant will be irreversible. There are, in fact, numerous cases in which patients are no longer psychologically capable of tolerating organ transplants such as hand transplants, and ask for them to be removed.

 

How will the recipient’s consent be obtained? And what about the consent of the donor, who is declared brain dead? “China is reputed to adopt a more liberal approach to these ethical issues” and is regularly suspected of harvesting organs without donor consent.

 

What will be the legal identity of the transplanted patient? “The brain will be that of the ‘recipient’ but the other organs will be those of the ‘donor’ (microbiota, heart, digital imprint, etc.)”. How will this patient “with a completely new identity be supported, and what about his relationship with others?”  Furthermore, the recipient “will be able to reproduce but any offspring will be that of the donor. What impact will this have on parenting rights? (…) Can the recipient request that the donor be sterilised prior to surgery? Can sterilisation be proposed to the donor? (…) is post-mortem donor sterilisation feasible?”

 

For Emmanuel Hirsch, Professor of Medical Ethics at the University of Paris Sud, “Benchmarks may well be missing in innovative biomedicine and there is a risk of transgression unless appropriate supervision is put in place”. Two international bodies could issue a statement in the lead-up to this project, namely UNESCO, with its International Bioethics Committee (IBC) and its Intergovernmental Bioethics Committee (IGBC), or the Council for International Organisations of Medical Sciences (CIOMS), a body created by the WHO and UNESCO. 

 

Sciences et avenir, Iris Joussen (22/09/2017)

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