Patterico's Pontifications

2/28/2015

Heads-Up: It Depends On What The Definition Of A Medical Advancement Is (With update)

Filed under: General — Dana @ 1:45 pm

[guest post by Dana]

I thought it surely had to be a bit of internet fakery, but apparently not and is according to Dr. Mike K. But as to the feasibility of the proposition, well, you be the judge.

Italian surgeon Dr. Sergio Canavero of the Turin Advanced Neuromodulation Group announced that he believes human head transplants could begin in two years. Positively Frankensteinian:

[He] wants to use the surgery to extend the lives of people whose muscles and nerves have degenerated or whose organs are riddled with cancer. Now he claims the major hurdles, such as fusing the spinal cord and preventing the body’s immune system from rejecting the head, are surmountable, and the surgery could be ready as early as 2017.

Further:

The key, Canavero wrote, is extreme cooling of the bodies of the recipient and the donor and the reattachment of the donor head within the hour.

Surgeons would dissect tissues around the neck and link blood vessels with minute tubes. The spinal cords would be cut with an extra-sharp blade, making a “clean cut” that is essential to the surgery’s success and theoretically allowing the two spinal cords to fuse.

After the surgery, the patient would spend about a month in a medically-induced coma to let the body heal without risk of movement.

Canavero contends the patient would be able to feel his or her new face and speak in a natural voice — and could eventually be able to walk.

(Note: head transplants on animals have already been conducted.)

Canavero intends to announce the project this spring at the annual conference of the American Academy of Neurological and Orthopaedic Surgeons (AANOS). And, according to Canavero, he already has volunteers lined up. For the surgery. Oh. Come. On.

Anyway, all of this naturally begs the age-old question: Because it can be done, should it be done?

Aside from what is being discussed as the biggest hurdle of many hurdles – that of successfully being able to attach one spinal cord to another – there is the pesky issue of ethics. A trauma surgeon notes some viable concerns:

• Prior to attempting this feat in humans, we would have try it using small animals followed by monkeys. What ethics review board would approve such a thing? Would this not be considered animal cruelty?

• If the trials were approved and then proved successful, who then would be the first human guinea pig?

• What if the head survives the surgery but not the body? What if the body survives but not the head?

• Are either of those scenarios even possible?

• How would the person react to someone else’s body on his head when he woke up? The psychological trauma alone would be immeasurable.

• What if the head is rejected? Would they then try a second body transplant?

Aside from the immense and seemingly insurmountable issues with the surgery itself, this frankly seems so ghastly, surreal and wholly rife with ethical problems, that it’s hard to imagine it would ever be taken seriously, let alone happen. And yet, there are ghastly and unethical medical procedures being lawfully done on a regular basis without batting an eye, even as the ethics surrounding said procedures have successfully been squelched by supporters lobbyists media government all parties involved.

And if this surgery is, or becomes, even a remote possibility some years out, then considering man’s base nature and insatiable quest for power and penchant for playing God, what about that inevitable slippery slope?

*I would love to hear what Patterico’s medical professionals make of all this.

–Dana

UPDATE: Mike K. pooh-poohs head transplants as bunk. While I agree with him, I do think there is almost always an ethical question regarding advancements in medical sciences and how we respond to the real possibilities on the horizon.

64 Responses to “Heads-Up: It Depends On What The Definition Of A Medical Advancement Is (With update)”

  1. Hello.

    Dana (86e864)

  2. faster please

    happyfeet (831175)

  3. i wonder if they could put my head on top a giant pteradactyl

    hey look at me i’m flying i’m flying

    happyfeet (831175)

  4. I don’t see this being covered by Obamacare.

    papertiger (c2d6da)

  5. If its cool to mutilate your reproductive organs to satisfy a severe mental disorder, what’s wrong with getting a whole new body?

    edoc118 (8b952d)

  6. Hello Dana. Doesn’t this sort of thing get announced every few years — scientists/doctors think we will have head or brain transplants in the next couple years, then the next couple years come without any breakthroughs and the cycle just repeats itself? Have Dr. Canavero get back to us once it’s past the speculation phase.

    JVW (854318)

  7. I see a Ted Williams comeback.

    mg (31009b)

  8. One major problem with this procedure Yoda sees. Healthy bodies from donors, where do you get them.

    Yoda (bb7c24)

  9. Yoda most correct is. Same problem my first thought was.

    kishnevi (9c4b9c)

  10. There are people who die of severe head trauma that probably have perfectly good bodies. Case in point, the Missouri state auditor committed suicide on Thursday with a gunshot to the head. There was probably nothing wrong with his body, and it could have been used as a transplant for someone who was looking for something like that.

    David

    David, infamous sockpuppet (12a5ec)

  11. Also, we are not that long from being able to grow parts from our own DNA. There has been a lot of talk about the ethics of cloning, but if someone could grow you a young body from your DNA, and the new body had no brain, would there really be any ethical issues around this?

    David

    PS When I say they are grown with no brain, I mean that the scientists posit that they will be able to manipulate the DNA so that only vestigial brain matter develops. Enough to maintain the body’s functioning without there being any possibility of it being a viable human being. Because if you fully cloned yourself, I agree there would be ethical issues in using the body of something that could, potentially, be a viable human being.

    David, infamous sockpuppet (12a5ec)

  12. Of course, this also brings us the brain-bleach worthy image of Nancy Pelosi’s botox-fuelled plastic surgery rictus-like smile pasted on top of a Marilyn Monroe like body. [shudders]

    David

    David, infamous sockpuppet (12a5ec)

  13. Decomposition starts immediately. In other words, a procedure to immediately store the trauma victim’s body must be in place,within minutes of death (meaning peopke need to know of the death immediately) and you can not wait for police to decide it was suicide and not homicide. Nor could you have an autopsy, which may or may not be mandatory in those circumstances. And of course suppose the trauma victim turns out to be in the initial stages of cancer, MS, or something not fatal but definitely negative impact?

    kishnevi (91d5c6)

  14. The matter is utter nonsense.

    What is important, and there may be progress in the next decade, is spinal cord injuries. A spinal cord that is severed does not recover. A peripheral nerve that is severed has a living sheath, something like insulation on a telephone wire, that does not die like the neuron does. The regenerating neurons grow back but have to find their way down the right channel. This takes months and may take years and not all find their way. The result is patchy areas of abnormal sensation or motor function.

    There has been some interesting work with stem cells, especially derived from the nerves of smell in the nose.

    Current Drug Targets. 2005 Feb;6(1):63-73.
    Adult stem cell application in spinal cord injury.
    Schultz SS1.

    Abstract
    The mechanical force incurred by spinal cord injury results in degenerative neural tissue damage beyond the site of initial injury. By nature, the central nervous system (CNS) does not regenerate itself. Cell therapy, in particular, stem cell implantation has become a possible solution for spinal cord injury. Embryonic stem cells and fetal stem cells are the forefathers of the field of stem cell therapy. Isolation and preparation of specific populations of adult stem cells have evolved to the point of stable, long-term culturing with the capability to differentiate into neural phenotypes from all three of the neural lineages: neurons, astrocytes, and oligodendrocytes. Thus, adult stem cells will transcend ethical concerns, technical difficulties, and probably immunorejection. A variety of adult stem cells have been implanted in a rat model of spinal cord injury, ranging from olfactory ensheathing cells, cultured spinal cord stem cells, bone marrow derived stem cells, dermis derived stem cells, and a few others. Although no definite decisions on which adult stem cells are most effective for this CNS injury, their ability to incorporate into the spinal cord, differentiate, and to improve locomotor recovery hold promise for a cure.

    The literature is pretty esoteric but that Italian story is bunk. That article is old but there is still mostly stuff about rat models.

    Mike K (90dfdc)

  15. Thanks, Mike. I’m curious, though, when organ transplant were in their nascent stages, or face transplants, what was the ethical concern (if any) and did the medical community scoff at the possibility, or had there been enough trials and success in those over a long period of time, that it was obviously the next stage in the process?

    Also, when someone like Canavero suggests such a surgery, why do some in the medical community entertain the possibility if it’s an impossibility?

    Dana (86e864)

  16. Eh, first question is poorly worded, but you catch my drift…

    Dana (86e864)

  17. The biggest hurdle would be the acquisition of an intact and disease free body.
    Meaning only a death by limited head trauma as cause of death could be used.

    That’s a very rare situation so this would be a multimillion dollar operation
    from the git go.

    And what purpose would this serve? the person would have to be someone rich,
    and with a persona uniquely qualified for life extension of this sort with a
    situation that would result in their complete body shut down or organ failure.

    Not too many candidates for that either.

    This is just click bait and some Italian surgeon’s wet dream expressed in print.

    And if it was successful and became easier to do, this would not bode well for
    the poor and disenfrancised of the world.

    jakee308 (49ccc6)

  18. With head transplants we could do away with gender reassignment surgery and hatey hater transphobi people who have a problem with chicks with dicks.

    daleyrocks (bf33e9)

  19. that’s a beautiful dream

    happyfeet (831175)

  20. If they ever get around to brain-transplants, DC will be a good donor source as they are very rarely used.

    askeptic (efcf22)

  21. Oh, and Tom Wheeler Sucks!

    askeptic (efcf22)

  22. I’d say it should be allowable where people want it. Doesn’t have to be a standard practice or anything, nor do I think it would. I’d imagine it would only be conducted with donor bodies and pre-arranged contracts (like freezing a body or head at death).

    Eventually we’ll pass into the Futurama head in a jar phase anyways. I mean, isn’t this all the goal of Transhumanism anyways?

    Dejectedhead (75dfa4)

  23. Seems like this could cause a real problem for cops and others who use DNA samples to solve crimes and all.

    elissa (0d1a05)

  24. And the Innocence Project……Horrors!

    askeptic (efcf22)

  25. I’ve updated the post: Mike K. pooh-poohs head transplants as bunk. While I agree with him, I do think there is almost always an ethical question regarding advancements in medical sciences and how we respond to the real possibilities on the horizon.

    Dana (86e864)

  26. I have some candidate for a head transplant … assuming a sufficiently intelligent head could be identified …

    SPQR (4764ea)

  27. Whether or not it is bunk today, the time will come when it is not. Personally I cannot see any ethical issues here at all. A dead body being grafted to a live head is not all that different from being stripped of organs for implants destined for other people. In the event of the transplant failing in whatever way, the patient dies. As happens now.

    What exactly is the issue I’m supposed to be horrified about?

    Mr Black (f1b3a7)

  28. Heh! I liked the movie with Ray Milland and Rosie Greer.

    I might take this seriously if there were successful operations for sciatica and slipped lumbar disks, let alone severe cervical injuries. Let me know when you’re making paraplegics and quads walk again.

    nk (dbc370)

  29. There is always an ethical issue when offering a patient other-than-standard care. Even when the new idea seems as though it will be better or less-troublesome, or both. You are going outside the known body of statistics and if you are wrong — no matter how good the idea seemed at the time — you had better have checked all those ethics boxes or there will be real trouble.

    Example: let us say there is a treatable cancer. Over 90% of this type of cancer is curable, but the treatment regime often has life-long unhappy side effects. Still, it beats death. Then someone comes along and says “There are actually two types of cancer here, not one, and it looks like type B responds better. Maybe we don’t have to be so aggressive in our treatment.”

    If true, many patients would still be cured, but run less risk of collateral damage. If false, more will die that could have been saved. Ethical issues abound.

    Kevin M (25bbee)

  30. The free market will sort them out (the ethical issues). We should take care not to overburden the process with stupid government regulations.

    nk (dbc370)

  31. Maybe those ISIS guys are conducting Phase I clinical trials.

    steveg (794291)

  32. what was the ethical concern

    Most of the early liver transplants died.

    Despite the development of viable surgical techniques, liver transplantation remained experimental through the 1970s, with one year patient survival in the vicinity of 25%.

    Only one of John Gibbon’s open heart cases survived and after the next four died, he quit.

    Mike K (90dfdc)

  33. Nk,

    What if the free market deems the unacceptable, acceptable? Then what, just live with it?

    Dana (d5d5ba)

  34. Dana! You didn’t take me seriously?! I was yanking some anarcho-libertarian chain. The ethical concerns are horrific when you need the donors alive when the operation starts. And I mean the head donor, too. What if they decide to do the trials on the profoundly handicapped? The ones they euthanize in Holland and Belgium.

    nk (dbc370)

  35. Oh, I don’t have the energy and time to repeat my stories of how some medical ethicists like to be avant-garde and get into trouble by being too smart for themselves.
    http://www.scientificamerican.com/article/gene-therapy-an-interview/

    But it appears that the public response is that there should be no limits to medical experimentation (unless it would somehow threaten “reproductive rights” and the right to be the gender and gender-preference you want to be). There has been no critical thinking about embryonic stem cell therapy, just the condemnation of those who would “stand in the way of the advancement of science”.

    So, if one of the unassailable gods of the age is “the advancement of science”, then the answer is no, nothing is beyond being ethical,
    unless for some reason the loudest voices in the media decide it’s so,
    but don’t expect it to be based on some coherent principle,
    other than “I want it”.

    MD in Philly (f9371b)

  36. What if they decide to do the trials on the profoundly handicapped? The ones they euthanize in Holland and Belgium.
    nk (dbc370) — 2/28/2015 @ 5:48 pm

    Hey, in the eyes of some it would give euthanasia greater justification,
    just like fetal stem cells give additional reason to protect abortion.

    MD in Philly (f9371b)

  37. Nk @ 35,

    Heh. I confess to a WTF! double-take reaction to your comment. Thanks for reassuring me you are still on this side of sanity.

    Dana (86e864)

  38. SF is way ahead of this character. The idea is to grow clones and then insert your consciousness into this perfectly adapted vessel. It’s a little clumsy trying to sew all the bones, ligaments, nerves, muscles, etc., together so most far-seeing SF guys go with a digital download of the brain from the dying body into the freshly grown host.

    The clone thing is a little beyond our technology right now, but South Korea is said to be working the problem. In the meantime, all we need to do is get a couple of identical twins to volunteer. Instead of them pretending to be their sibling, they will actually get to do it. The stiches on the neck would be a dead give away, but perhaps that could be camouflaged with an appropriate tattoo, like “Cut Here”.

    bobathome (f208b6)

  39. the answer is no, nothing is beyond being ethical,

    If this is where we are headed, and I don’t see how we’re not, what a dangerous place to be. It is the inevitable end to the battle of reproductive rights. The door to almost anything has been opened wide, never to close again.

    Dana (86e864)

  40. Is it true that our President and the recently resigned AG are identical twins?

    bobathome (f208b6)

  41. Dana,
    it’s happened before
    “And everyone did what was right in their own eyes”
    But it didn’t have bizarre technological twists back then.

    MD in Philly (f9371b)

  42. bobathome (f208b6) — 2/28/2015 @ 6:52 pm

    No, just “peas in a pod” as my grandma would say.

    MD in Philly (f9371b)

  43. bobathome: the problem with digital downloads (besides the quantum mechanical impossibilities of cloning consciousness) is that YOU are still dead. There is a body walking around with all your memories that thinks it is you, but YOU are still dead. Proof: What do you do with the old you, if it is still breathing after the transfer copy.

    Kevin M (25bbee)

  44. This was McCoy’s existential problem with transporters.

    Kevin M (25bbee)

  45. When I was a kid, I was afraid that’s what happened every time I fell asleep. It could be true. What is “I”?

    nk (dbc370)

  46. Was Zelazny the first to come up with this brain transfer into replicants, BTW? Lord of Light was my favorite book for too long a time.

    nk (dbc370)

  47. Not *brain transfer*, electronic brain image transfer to blank brain.

    nk (dbc370)

  48. Kevin M., but with identical twins, they’ll each be walking around. Nothing existential here! Of course, this is just a phase in the development of the technology, but it would serve a purpose. Especially if Obola and the recently retired AG are the first test subjects.

    bobathome (f208b6)

  49. Oh my gosh:

    An Italian neuroscientist researching the possibility of human head transplants believes that the procedure could help people with gender dysmorphia, Dr Sergio Canavero, of the Turin Advanced Neuromodulation Group, published a summary of the technique, known as ‘Gemini’ spinal cord fusion, in the Surgical Neurology International journal this month. In an interview with Newsweek, Dr Canavero said that the procedure could have wide-ranging implications for those who feel trapped in their own bodies, a condition he says prompts many to commit suicide. “Why not give them a chance?” he says.

    Paris Lees, a prominent UK journalist and transsexual activist, says: “This isn’t going to be the answer to the transgender problem. The answer is making sure we identify people as soon as possible so we can help them as soon as possible so they can have the body they want.”


    This from Newsweek via NRO.

    Dana (86e864)

  50. The answer is making sure we identify people as soon as possible so we can help them as soon as possible so they can have the body they want.

    ISIS Caliphate, faster please, in the name of God!

    nk (dbc370)

  51. Oh, nk!

    Dana (86e864)

  52. Paris Lees, a prominent UK journalist and transsexual activist, says: “This isn’t going to be the answer to the transgender problem. The answer is making sure we identify people as soon as possible so we can help them as soon as possible so they can have the body they want.”

    Dana – I’m thinking ebay for heads and bodies.

    daleyrocks (bf33e9)

  53. Dana, when barbarians invade a decadent culture, they both benefit. The barbarians contribute their genetic material which still contains the instincts to survive and advance, and they receive the technology, art, and luxuries of the dying breed. The human race continues stronger than before. It’s the history of civilization, really.

    nk (dbc370)

  54. Why do you think those Muslim kids, boys and girls, are leaving Europe to join the jihadis? It’s not for Paradise. It’s because they can’t see themselves living with “Paris Lees, a prominent UK journalist and transsexual activist”.

    nk (dbc370)

  55. nk #47/48 – Isn’t “Lord of Light” the Zelazny book that was written around a single pun-chline ? (I need to find my copy again, to remind myself of the page number for it) …

    The first time I read the book, I got about a page past that pun-chline, and then did the classic cliché double-take and had to go back to confirm I had indeed read what I had read …

    It’s still one of my preferred books …

    Alastor (2e7f9f)

  56. the procedure could help people with gender dysmorphia – /Star Trek cross over invasion of the next thread.

    papertiger (c2d6da)

  57. Which particular pun is that, Alastor? It has more than a few double entendres.

    nk (dbc370)

  58. Albert Einstein’s head on Marilyn Monroe’s body????

    bobathome (f208b6)

  59. When the fit hit the shan.

    luagha (1de9ec)

  60. If the trials were approved and then proved successful, who then would be the first human guinea pig?

    Anyone who considered themselves to have not much to lose? Someone with severe body trauma but an intact brain and neck-spine, whose body was effectively destroyed by accident and/or cancers?

    Worst case, they wind up dead. Next worst case, they wind up in the exact same situation they were already in. Third worst case… it works at least partly.

    Yeah, I can’t see how anyone would make that choice…. no, no, nosirreee…?

    Are you nuts? Given those alternatives, of course you would.

    IGotBupkis, "Si tacuisses, philosophus mansisses." (225d0d)

  61. And as to how it might happen, clearly, someone’s head is crushed by trauma, but the body is still unharmed and fully functional. DUH. Contrasted with the opposite scenario.

    IGotBupkis, "Si tacuisses, philosophus mansisses." (225d0d)

  62. The whole thing reminds me of Greg Egan’s “The Extra,” and I can’t help but think that anything done in reality would wind up no better than in sci-fi.

    bridget (d922d6)

  63. The daughter’s mother says that in the medical field nobody takes Italian studies seriously. Nobody has been able to duplicate an Italian study. In other words, they fake it.

    nk (dbc370)


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