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Quandary

Quandary column

Get Your Head Screwed on Right

By Michael Cook

Claims of the successful transplant of a human head may have been met by derision but they also reveal bioethical blindspots among ambitious surgeons.

What can you do if you become a quadriplegic after a catastrophic injury, or if you’re getting old, weak and fat? One solution is head transplantation – once the theme of very bad science fiction films and now the theme of press conferences.

Controversial Italian neurosurgeon Dr Sergio Canavero announced to media in Vienna recently that a team from Harbin Medical University led by his colleague Dr Ren Xiaoping has carried out the world’s first head transplant experiment. (In his line of business, they call it cephalosomatic anastomosis.)

Last-Minute Complications

By Michael Cook

Botched executions provide a timely warning that assisted suicide does not necessarily lead to a peaceful death.

The gold standard for experiments on human beings is a randomly assigned double-blind placebo-controlled study. Naturally, organising one of these to assess the effectiveness of lethal drugs is unlikely. Unless you live in North Korea, the chances of getting approval from an ethical review committee is very low.

Instead, we need to rely upon experience from the United States. And this suggests that there can be glitches in choosing the date of one’s death.

Ethics for an Edited Embryo

By Michael Cook

Editing of a gene in a human embryo may have ticked some regulatory boxes but this does not address some huge ethical issues.

It will probably be described as one of the most important inventions of the 21st century. After just 4–5 years, CRISPR gene-editing technology is racing ahead, creating myriad opportunities for improving medical treatment.

Take the possibility of replacement organs. Since pigs are roughly the same size as humans, why not use their hearts or lungs? One very good reason not to is that pig DNA contains porcine endogenous retroviruses (PERV). But just a few weeks ago a team bred pigs whose PERVs have been removed. A pig-to-human organ transplant may only be 2 years away.

The Facts About Surrogacy

By Michael Cook

The dismal death of Brooke Verity illustrates the need for longitudinal studies of the long-term outcomes of surrogacy.

Whether you are pro-this or anti-that, a passionate believer in human dignity or an ultra-rational utilitarian, your bioethics always has to begin with the facts. While knowledge of consequences is only part of ethical decision-making, it is an essential part.

Surrogacy is one issue in which the public gets only a very partial vision of the consequences. Normally the media focuses on the joy of the commissioning parents, while the surrogate mother remains anonymous and her story untold. But her life after surrogacy is part of the consequences as well.

Turning Psychopaths into Nice Guys

By Michael Cook

If moral bioenhancement of psychopaths becomes obligatory, who will benchmark standards?

Our culture is fascinated by psychopaths. Go shopping on Amazon and you will find books like The Wisdom of Psychopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success; or Without Conscience: The Disturbing World of the Psychopaths Among Us; or Snakes in Suits: When Psychopaths Go to Work; or The Psychopath Test: A Journey Through the Madness Industry.

Two bioethicists at The University of Rijeka in Croatia, Elvio Baccarini and Luca Malatesti, recently argued in the Journal of Medical Ethics that moral bioenhancement for psychopaths ought to be obligatory.

Locked-in’s Challenge to Autonomy

By Michael Cook

Four patients with locked-in syndrome have communicated that they are happy as long as they receive adequate care at home.

The craze for Marvel superheroes encourages us to think that merely being human is too easy. We need to exceed our limitations by adding superpowers – breathing underwater, eternal youth, colossal strength, regeneration, flying, spinning spider webs and so on. Of course, that’s just comic book stuff, but the same dynamic is at work in the Olympic goal of going “faster, higher, stronger”.

Frozen Stiff

By Michael Cook

Cryonics is a growing industry even if its feasibility is questionable and its ethics murky.

A 14-year-old British girl dying of cancer recently won a court battle to be cryogenically frozen after her death. The world-wide publicity has revived public interest in this peculiar end-of-life option.

The teenager’s divorced parents could not agree about whether to carry out her wishes, so she sought permission from the UK High Court. In a touching letter to the judge, the girl, known only as JS, wrote,

Patient Zero

By Michael Cook

An analysis of blood tests has revealed that HIV was widespread in the 1970s, and that the notion that Gaétan Dumas was the epicentre of the epidemic is flawed.

Dr Hannibal Lecter, of the Silence of the Lambs, has been voted the Number 1 Hollywood villain of all time by the American Film Institute. But there are scarier characters. Psychopath Hannibal the Cannibal only killed about dozen people, while sociopath Gaétan Dugas, a real-life character in a 1993 docudrama, was responsible for hundreds.

Grim News for Immortals

By Michael Cook

A recent paper in Nature has cast a wet blanket over the dreams of immortality researchers.

An analysis of global demographic data by researchers at Albert Einstein College of Medicine suggests that the limit to human lifespan is about 125 years. Maximum lifespans around the globe kept rising until the 1980s, but they seem to hit a plateau at about 120.

The longest-lived person on record is Jeanne Calment, a French woman who died in 1997 at the age of 122 years and 164 days. Twenty years later, her record of longevity is unbroken.

How IVF Is Changing Human History

By Michael Cook

Since IVF bypasses infertility it must also be having an effect on human evolution.

Evolution works because of differential reproduction. If an organism has a harmful gene, it will perish before reproducing or fail to have offspring. Infertility may be nature’s way of decreeing that this man or this woman, or this couple, are not “fit” in the evolutionary sense.

So surely IVF, which enables people to bypass their infertility, must be having an effect upon human evolution.