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Who Gets To Set Limits On Science?

gloved hand reaching for something on a surgical insturment table

Some people may regard the idea of a full-body transplant as a Frankenstein fantasy come to life – or potentially come to life, since such a transplant has never been done and is probably not possible with today’s technology.

But as with almost anything else in human history, as soon as something can be done, somebody will likely go ahead and do it, regardless of what anyone else thinks.

When it comes to the idea of placing one person’s head atop another person’s body, there is a good chance that, when it becomes possible, it may get done first in China. The New York Times recently reported that Ren Xiaoping, an orthopedic surgeon based at Harbin Medical University, is conducting research into how to achieve full-body transplants and that he and his team would attempt the operation “when [they] are ready.”

Ren has experimented with head transplants on mice and has practiced with human cadavers, but many medical experts have made clear that they believe the practical problems remain insurmountable for the time being. Most critically, reconnecting severed neurons in a way that restores function is currently impossible. Ren’s proposed solution to this hurdle would be “like if the trans-Atlantic phone cable is cut by half, and someone wants to put it together using Krazy Glue,” according to Abraham Shaked, the director of the Penn Transplant Institute.

Chinese medical research, like much else in the country, is not transparent to international observers. But even so, it seems fair to take those with a background in the field at their word when they claim a full-body transplant is technically impossible for now. Yet the history of medicine suggests that overcoming practical hurdles is often simply a matter of time. Less than 20 years ago, a functional hand transplant was impossible; now, while still not common, the procedure is an established success. Incidentally, Ren assisted in the first U.S. hand transplant back in 1999.

So while Ren may be overly optimistic in thinking a full-body transplant will be possible soon, it is hardly absurd to imagine it will be possible someday. Which leads us to those who object to Ren’s plan on ethical, rather than practical, grounds.

The serious ethical implications of the procedure are obvious. Chinese law can be applied both harshly and arbitrarily, and the country has some of the highest numbers of prisoner executions in the world. Amnesty International declines to publish precise figures due to China’s lack of transparency, but its most recent report indicated that China executes thousands of people annually. The country also regularly harvested organs for transplant from executed prisoners, though it claimed to have stopped this practice in late 2014. As recently as this year, however, international scientific organizations have rejected Chinese research due to the use of prisoner organs, violating global ethical norms.

Is it conceivable that if, say, a future Chairman Mao is in extremis and a prisoner can be found who is a good match, that prisoner’s execution might be accelerated on a timetable that preserves the life (or at least the consciousness) of the top boss? I would have to say yes, it is conceivable. And it is a horrific scenario to conjure.

I am old enough to remember the news of the first human heart transplant back in 1967. Dr. Christiaan Barnard performed the first transplant in Cape Town, South Africa, instantly making himself an international celebrity. But of course it did not take long for a lot of discussion to emerge over the circumstances and procedures for ethically harvesting vital organs. These discussions continue today, even though only the most extreme opponents argue against transplants under any circumstances.

On one level, a full-body transplant can be viewed as simply a bulk transfer of human body parts. If each individual organ were harvested and transplanted to a different recipient, nobody would bat an eye today, assuming reasonable ethical procedures were followed. Why should it matter if a single recipient receives the entire kit and kaboodle?

The debate will no doubt rage in Western academia when and if such an operation ever comes to pass. If it does, there is a good chance that the Chinese will regard such debate as, well, academic. The procedure will certainly be a point of pride as a display of the nation’s growing technical and scientific prowess. Some Chinese scientists have already chalked up Western ethical concerns to envy over their country’s scientific progress, brushing off objections to research using prisoner-harvested organs and experiments that include the controversial process of germline editing. While Western scientists debate where to draw the lines, Chinese researchers continue pushing forward.

For good or ill – and the reality is, for both – China’s rise is a byproduct of what we loosely call “globalization.” The thing about globalization is that it actually is global. Western values and priorities are not likely to exclusively drive the way in which science is conducted and applied in the decades to come.

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