Ethical Questions Raised by Medical Research

• Until now the subject of horror/science fiction a head transplant could be possible in the foreseeable future.

Scenario: An ill and aging, but very wealthy, man finances unscrupulous scientists in a project to transplant his head onto a young, healthy body. Until this year, that was the subject of fiction.

But that was then; this is now.

"Surgeons have transplanted monkey's heads onto fresh bodies, paving the way for a new era in human transplant technology," writes Lois Rogers, medical correspondent for the Sunday Times of London. According to the story, by maintaining the brain stem, which deals with reflexes such as breathing, hert function and digestion, an American research team has been able to keep the new heads supplied with fresh, oxygenated blood.

To date, the monkeys with transplanted heads have lived for several days.

The latest developments in the 20-year project, including the vital step of achieving respiration in the transplanted heads, have been reported by Robert White, professor of neurosurgery at Case Western Reserve University in Cleveland.

"I have devised the operation that would need to be done in humans,' White says. "I have been to autopsy rooms and dissecting rooms, and examined the sort of incisions which would have to be made, and at what level, and how the various vessels would need to be reconnected."

Commenting on "possible" versus "ethical," the professor said, "We are talking about an operation that could be done on humans. Whether it should be done is another question."

A series of experiments involving up to 30 animals has allowed surgeons to perfect a technique of minimizing loss of blood supply to the heads during severance operations.

The researchers also believe there was little disturbance to the monkey's higher brain functions as a result of the procedure.

So far, the bodies pumping blood through the transplanted brains have remained completely paralyzed because researchers have been unable to reconnect the nerve fibers from the spinal cord in the body to the brain.

The brains can think and are conscious, but cannot communicate with the limbs. "I have no doubt this treatment will be available in the public arena within the next 25 to 30 years." White said. "There will be a lot of ethical and moral arguments, but I think they are inappropriate.

"What we are trying to do here is to prolong life," he added. "The human spirit or soul is within the physical structure of the brain. I don't think it's in your left arm or anywhere else.

The neurosurgeon admitted the definition of "brain dead" would have to be altered to allow bodies -- possible those in a persistent vegetative state in which there was still some brain stem activity -- to be used as donors.

In Britain, scientists reacted with incredulity to White's work. Researchers in the UK are investigation the possibility of treating paralysis by regrowing severed spinal nerves -- not by transplanting bodies.

The Sunday Times reported that Peter Jamlyn, a leading neurosurgeon at St. Bartholomew's Hospital in London, who helped set up the British Brain and Spine, Foundation, said the work was cruel and irrelevant.

"Your head might as well be in a jar as attached to another body," he said. "The fact that it is tied to a body acting simply as a pump would just be an inconvenience because you would have to drag the body around.

"There might be a few cranks who would want it done, but for normal people, the whole point of having a brain is that it interacts with the body,' Jamlyn added.

"It is indicative of the disastrous route that Western medicine is taking,' says Richard Nicholson, editor of the Bulletin of Medical Ethics. "I any individual so important to society that we should tolerate attempts to lengthen their existence in a way which most people would find abhorrent?"

In past decades, a heart transplant was considered in the same light, and to day it is considered commonplace, if not routine.