Welcome to Ethics Consult — an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case. You vote on your decision in the case and, next week, we’ll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel’s 2019 book, Who Says You’re Dead? Medical & Ethical Dilemmas for the Curious & Concerned.
Don, a 40-year-old neurosurgeon, has been diagnosed with terminal pancreatic cancer and has only several months left to live. His colleague, Percival Pangloss, MD, suggests to him that his disease might afford them an opportunity to try the experiment they have both longed to perform — a human head transplant. Their goal is to attach Don’s head — and brain — to a human body healthy from the neck down.
Pangloss believes he can persuade the family of a skull trauma patient to donate such a body. He also believes that — with the help of surgeons from many fields — he can connect Don’s spine and blood vessels to the donor’s cadaver. Most likely, Don will end up paralyzed below the neck, but Pangloss holds out hope that some of the nerve fibers might connect and regenerate.
“The odds are against us,” said Pangloss. “But without daring, heroic measures, you’ll be dead anyway.” Except for his pancreatic tumor, Don is in excellent health and a great candidate for major surgery. Don and his family very much want to try the radical surgery. Private charities have agreed to cover the costs.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
Check out some of our past Ethics Consult cases:
Agree to Perform Voluntary Surgical Castration?
Biopsy Kids’ Brains Even Though They Won’t Benefit?
Let Researcher Create Mouse-Human Brain?