Friday, May 12, 2017

On this matter of head transplants

Image result for head transplant
Victor Frankenstein? Bah -- More Like Sergio Canavero!

Transplanting an organ- or body part- from one body into another body is arguably one of medicine’s most intriguing methods of intervention. There have been many cases when a medical doctor attempts to transplant a specific organ into another body to either save somebody’s life, or to help it last a little bit longer. For example, there was a patient who suffered from end-stage systemic right ventricular dysfunction, which basically means the patient’s heart was failing to pump the necessary amount of blood to the body[1], and was dying. Her doctor performed a heart transplant in 2002, and the patient recovered fairly quickly; in her last checkup in 2005, the doctor reported that she was, “doing well, and fully ambulatory.”[2]  However, one transplant that has never even been attempted, is a full head transplant; until now. Dr. Sergio Canavero believes that he can pull it off, and transplant an entire, fully-functioning human head onto another fully-functioning body with a not-so-functioning head.
This essay will be split into two parts. The first part will explain the procedure and provide reasons why these doctors believe that this is even possible. The second part of this essay will lay out the arguments against the procedure, the arguments for the procedure, and, whether the procedure is a success or a failure, what the procedure will entail for the future of ethics and philosophy. The argument of this essay will ultimately argue for the procedure, and why it can likely be done.  Nevertheless, it is best considered as unethical.


I. The Procedure


The Case of Valery Spiridonov
        The plausibility of a procedure of this nature to take place in the near future is rapidly becoming more and more likely. This past August, CBS reporter Ashley Welch presented breaking news of the an announcement made by Dr. Sergio Canavero, an Italian neurosurgeon. Dr. Canavero, with help from Dr. Xiaoping Ren, plans to become the first people to successfully undertake and complete a full head transplant.[3] The man who hopes to find himself on this seemingly fictional operating table is 30 year old Russian computer programmer Valery Spiridonov.[4] Spiridonov suffers from Werdnig-Hoffman Disease, a very rare genetic disorder which diminishes bone tissue, causes muscular atrophy, and kills off brain cells and spinal cells. Because of his condition, Spiridonov’s fully functional brain is stuck inside a shriveled and dysfunctional body, confined to a wheelchair, and capable only of functionality above the neck as well as hand and arm movement.[5] 
After hearing about Canavero’s work, Spiridonov contacted the Italian doctor in order to volunteer himself. Tired of being unable to care for himself, and of being deprived of many of the pleasures of a functional body, Spiridonov explained, “If I have a chance of full body replacement I will get rid of the limits and be more independent.”[6] He also added that, “Removing all the sick parts but the head would do a great job in my case … I couldn’t see any other way to treat myself.”[7] Although Spiridonov’s functionality and capabilities above the neck paired with his optimism and willingness may make him seem like the perfect candidate for this procedure, the whole thing is much more complicated than a simple Dr. Frankenstein cut and paste job. In fact it seems that the amount of detail which would go into the operation is more than we might have ever imagined.

The Proposal
        Of course, if the operation were to take place, the attention to detail would be so great and the margin for error so small, that the plan which Dr. Canavero carefully laid out in his proposal would need to be followed precisely.
Canavero explains that they would begin with finding a proper “young brain-dead male patient,” with which to transplant Spiridonov’s head.[8] The process would start with Spiridonov going under anesthesia and both bodies being lowered to a colder temperature in order to slow the rate of brain cell and spinal cell death caused by the lack of blood flow and oxygen to the head in the absence of connection to a functioning heart and lungs, giving the surgeon’s more time to work.[9] The surgeon team would then begin to remove both patient’s heads including a spinal cord cut, while simultaneously attaching the blood vessels of Spiridonov’s head to the new body through tubes.
Next, “A custom-made crane would be used to shift Spiridonov’s head – hanging by Velcro straps – onto the donor body’s neck” before Canavero and his team would then begin to reattach the spinal cord using a specially made blend of PEG, or polyethylene glycol, which Dr. Canavero and Dr. Ren have been perfecting through testing of animals in order to better promote the regrowth of spine cells.[10][11] Once the spine is reattached, the next step of the process would be to begin connecting nerves, airways, blood pathways, and muscles. Essentially, anything and everything that needs contact with the brain for its function, or that the brain needs for its own function must be operational and working through the neck area. Once this has been completed, the final touches on the exterior neck area will be finished, and Spiridonov’s new body will be left to recover.


The Time in a Coma
Canavero explains that in order to allow the nerves, muscles, and blood passageways to have the proper time and environment to heal without Spiridonov’s movement hindering or creating new problems, the newly combined body will be left for three-to-four weeks in a comatose state. During this time, Canavero says that the surgeon team would “implant electrodes” in the spinal cord in order to “stimulate” nerves, nerve endings, and muscles to nerve connections in order to prep the body for the consciousness of its operator. If the project is to be approved, Dr. Canavero and Dr. Ren estimate that although the surgery would need around 80 surgeons and would “cost tens of millions of dollars.” Canavero himself even predicted an overwhelmingly confident “90 percent plus” success rate for the transplant.[12] 
Now, of course, this all sounds great in theory. But there is so much more that goes into every aspect of this entire operation than even the step by step process listed above. From every single tiny muscle fiber, to every nerve ending, to every vein and artery, not to mention the reattachment of the spinal cord, the minute detail work required in this surgery is not only overwhelming, but is extremely important to consider if one wants to legitimately understand all that is at stake, and all that must go correctly.

Reflex Arc
        The nervous system is perhaps one of the most complicated system in the study of Anatomy. Not only are neurons only connected with a synapse, or gap, between two neurons, but the nerve cells communicate using an electric and chemical factor.[13] For example, if a person were to step on a nail, then the pain stimulation will start at the afferent sensory neurons in the foot, use different neurotransmitters- acetylcholine, nicotinic cholinergic receptors, adrenergic receptors etc.- to travel up the peripheral nervous system neurons of the leg. Once the pain signal reaches the spinal cord, it crosses over through the dorsal root to travel up to the brain, where the parietal lobe then perceives the signal as pain and sends a signal back down to the foot. However, this time the signal travels down the efferent motor neurons, and crosses over through the ventral root of the spinal cord to travel back down to the foot, telling the foot to jerk back or move.[14]

Spinal Cord Repair
        Now, that paragraph is a rough summary of what happens during a reflex arc of the foot; that was the shortened version. One of the current situations of the nervous system, is that the neurons have very little healing or regeneration on their own if damaged. Neurons actually form cysts, or gliosis at the site of injury if there is any type of tissue damage, blocking regeneration.[15] That is why there are so many people who are paralyzed are likely paralyzed for life. However, there has been research that points to a way in which the spinal cord can be stimulated with biodegradable polymer scaffolds (which can be compared to a template that can be used for regeneration[16]), which when coupled with various different growth-promoting cells- like Schwann cells, neural progenitor cells, and mesenchymal stem cells- and growth factors- like GDNF (Glial Cell Derived Neurotrophic Factor, which encodes a gene that makes up a superfamily of protein that stimulates growth)[17] to bridge the gap of the damage by promoting axonal regeneration.[18] This method has been tested in different rats and mice, and have been successful.
        As mentioned before, Dr. Canavero is planning on using a solution known as polyethylene glycol. Now, the use of PEG 3350 is a laxative, but this is not the same medication being used for the spinal cord repair. PEG has actually been tested, and successful in resealing the axonal membranes of the spinal cord in multiple in vitro and in vivo models. PEG has also shown to decrease the amount of mitochondria-derived oxidative stress on intracellular components. These results point to a theory that PEG can help repair mechanical injury in two different ways: to reseal the plasma membrane, and mitochondrial protection.[19] 

Spinal Cord Fusion
        The main problem that Dr. Canavero is facing is the spinal cord fusion. According to a TED Talk at which Dr. Canavero spoke, he states that “spinal cord injury releases 26,000 Newton’s of force. It’s unrecoverable.” He then went on to explain that HEAVEN; “Gemini” (the procedure) will be using an ultra-sharp blade that will only release 10 Newton’s of force. He believes that the spinal cord can be brought back to life using the ultra-sharp blade, coupled with the use of PEG.[20] 
        PEG is the key ingredient in this procedure. According to Dr. Canavero, PEG is the “magic” ingredient that can rejoin severed peripheral nerves without the need for “perfect” alignment of the nerve fibers. The first case that PEG was applied to the spinal cord dates back to 1986. He also stated that a group of German doctors severed the spinal cord of a rat, used PEG, and the rat was up and walking around within weeks. Dr. Canavero is convinced that HEAVEN is going to work without a doubt.
        This is the procedure, and why Dr. Canavero believes that it will work. However, we can sit and talk about if it will work in theory, but until it happens, we will never know if the patient will survive or not. Now that the possibility question has been answered, an even greater question must be asked. Should this procedure take place? That is the central focus of the second half of this essay.


II. The Ethical Dilemmas of the Procedure
        The procedure has caused an uproar in the ethics and medicine field, because a good number of people do not believe the procedure should be done. Even if the procedure seems to be possible, they do not believe that a head transplant is something that humans should be able to do. Stephen Latham, a bioethicist at Yale University is not even convinced that the procedure will work, for he states while laughing in an interview, “If you’d have the technology to attach spinal columns, you’d have certainly developed the technology to repair somebody’s broken spinal column.”[21] There are a good number of students on campus who would also agree.
        However, there are also arguments for the procedure. Dr. Canavero is of course the loudest voice in trying to convince the public that the transplant is ethical, and that there is nothing immoral about the procedure. There are some scientists who would support Dr. Canavero’s claim that there is nothing immoral about the procedure, and that even if we deem it unethical in the present, humans will always move closer and closer to God-like control of health.[22] 


Arguments Against the Procedure
        As has been mentioned, the proposal of this first ever head transplant has received a fair amount of negative attention from ethicists, scientists, doctors, and even average citizens alike. From scientific and medical reasoning to ethical understandings of life, and the philosophical understanding of the significance of an individual’s brain, countless people have come forth expressing their disapproval in the operation since Canavero’s initial announcement of intent in early 2015.


It Can Not Be Done


Spinal Difficulties
        The first genre of arguments against Dr. Canavero’s work with Spiridonov is the large amount of critique that the operation has received for the legitimacy of the medical science involved. The most specific portion of the operation which seems to garner the most criticism is the reconnection process for the spinal cord. Scientist are arguing that our capability to reattach a spinal cord just simply is not a reality yet. Dr. Eduardo Rodriguez, the doctor behind the world’s most complete facial reconstruction surgery on Richard Norris, is among those in disbelief. After more than 16 years of experience in plastic surgery and spinal research, Rodriguez explains, “I don’t think it’s possible,” and that he does not believe our research is quite there yet. Because we still have yet to find full success refusing the spinal cord of an injured human, Rodriguez tells LiveScience, that combining two separate sections of spinal cord from two completely different individuals only poses a more difficult challenge.
Rodriguez feels that the central nervous system of the human body is far more complicated than Canavero is implying. Even the surgery which Rodriquez and his team completed in 2012 for a retired firefighter and burn victim, although being labelled as the most comprehensive and functional facial transplant surgery done to date, did not restore 100% functionality, feeling, and maneuverability because of the difficulty in restoring nerve connections.[23] 


Organ Preserving
On top of the difficulty of attaching the spinal cord, Dr. Canavero has also caught much controversy in his treatment of the head as a basic organ. Dr. Canavero’s plan for preserving the head after its detachment from the body is to lower its temperature to between 10-15 degrees Celsius, and although this is typical protocol for organs such as kidneys, livers and hearts, according to Business Insider's Erin Brodwin, the head proves to be a much more difficult and complex organ. The head poses all sorts of new issues that have never been fully handled before, including the preservation of “not just the brain, but your eyes, ears, nose, mouth, and skin, as well as two separate gland systems: the pituitary, which controls the hormones that circulate throughout the body, and the salivary, which are responsible for producing saliva.”
This of course is assuming that the head is able to make it to the preservation process. Successfully detaching the head itself is a major endeavor. After decapitation, a major issue that will present itself will be the sudden loss of blood pressure and oxygen rich blood, which because the effects of a lack of oxygen to the brain can be so serious and so quick, this may pose to be a huge obstacle. Another challenge which may prove to be impassible for Dr. Canavero and his team is the battle that the new body will wage against the donor head.


Immune System Complications and Time
When a body comes into contact with a foreign substance, whether that be a bacteria, a virus, a new organ or, in this case, a new head, the body’s immune system will do everything in its power to protect the body from this foreign substance, and although organs are rejected by bodies during and after surgery all of the time, the repercussions of the body rejecting its own head have yet to be seen, but could prove to be fatal for Spiridonov. The icing on the cake for the whole operation, is the fact that Dr. Canavero himself has predicted that he will only have around an hour for the operation to take place.[24] Even as his history making, and science shattering predictions stood, the odds did not seem to be in Canavero’s favor, however such a small time limit upon such an intricate and precise operation happening in under an hour is one final stipulation which puts the entire procedure outside of the faith and believe a large majority of the science and medical community.[25]

It Should Not Be Done
        The second main argument against the procedure comes from the ethical side of the conversation. One specific person who has really taken it upon himself to interact with and debunk the entire operation for the sake of ethics is bioethicist and New York University professor Arthur Caplan. Caplan exclaims that “I think it's ludicrously stupid, [and you should] ... be charged with homicide if you chop somebody's head off before they're dead.” Another argument that has been used heavily comes from the question of donor versus receiver. Because it is the deceased individual who is contributing more for the operation, the question arises: Who is the donor in this operation and who is the receiver? If Spiridonov is not designated as the receiver, then does this mean that the product will assume the identity of the body, regardless of the consciousness mentality of the person following the surgery.
Many believe that the identity of an individual is heavily based in the physical body of said individual, however this procedure seems to beg for an exception from this.[26] Along this argument, still others have a hard time accepting that this boundary of personhood is being violated for someone who is not in a critical condition. Spiridonov is not facing life or death, this is simply a fact of the matter. Because of this, many feel that his request for the operation is not one that should be granted. Not only are we using a good healthy body which could have likely gone out in different organs to individuals in more dire need for these parts, but this also has the potential to open up more and more interest in being involved in scientific achievement and scientific history in the future. Granted, the people involved are obviously signing off on the procedures, but is it ethical to allow people to sign themselves up for what is essentially scientific experimentation, if A. it is not necessary to their survival, and B. it becomes a waste of time, money, energy and other resources which could have been spent on patients in critical condition?[27]


Arguments For the Procedure
        Dr. Canavero loves this procedure; one could assume that it is “his baby.” He has been working and planning for this procedure for thirty years, and he believes that there is nothing unethical about it, and he has assembled a team of 150 doctors (80 of them being surgeons) and nurses to back him up. He and Spiridonov agree that there is nothing wrong with heart transplants, and doctors do those every day. Spiridonov went on to say, “I think it's the normal way of technology to evolve. It would be strange to stop at this point when the neurosurgery is ready to take the next step."[28]
        One argument for the procedure is as follows: if the head donor is cognitively willing to participate in the procedure and the body donor’s family willingly gives up custody of their brain-dead patient, then the procedure also has no reason to be refused. The head donor is cognitively willing to participate in the procedure. The only thing that Dr. Canavero is waiting on, is the body donor.[29] Therefore, contingent on the donation and the acceptance of a body donor, there is no reason the procedure should be refused. This argument is one to which Dr. Canavero and Spiridonov are partial, and a lot of background arguers would agree.

Lack of Arguments For
        One of the downfalls of the argument for the procedure, is that there is a substantial lack of articles that argue for the head transplant. This is troubling, and could be due to either the lack of support of the procedure, or the people who do support the procedure are too scared of scrutiny to speak out. This could be a potential problem for other issues as well. If there are topics that people are too afraid of scrutiny that they do not speak out, then the issues cannot be resolved as efficiently as possible. This is likely not the case in this predicament, but there must be enough support behind this procedure for it to be as far along in the process as it is.

III. The Future for Ethics and Philosophy

        Regardless of the success or failure of the procedure, there will be a substantial change in the subject of philosophy. One subject in particular is the idea of the “soul.” Famous philosophers such as Plato and Descartes believed that the mind is detached from the body, and is its own separated “body” to phrase it simply. On the other hand, famous philosophers such as Locke, Berkeley, Hume- rejected the idea of the soul, but for still had this view-, and Kant all believed the mind is a part of the brain. Both of these theories will be rocked depending on this procedure. If the procedure is a failure, then we only have to wait until the next, further research is needed to accomplish this feat.

Mind-Body Separation
        For example, hypothetically, the procedure is a success, and Spiridonov wakes up in this new body and he has full functionality of his new and improved 2.0 body. However, in this example, Spiridonov wakes up as if he is an animal, and has no human cognition. In this hypothetical situation, it could be argued that the mind of the body and the mind of the head would be fighting over the possession of the whole organism. So then, maybe the rationalists would be correct in their conclusion that the mind is something apart from the body. However, this is an improbable situation, because there has been evidence to back up that the mind is indeed a part of the brain, and philosophers such as William James seemingly agree with this view.[30]


“Soul-Mind” or Mind just part of the Body
        Another hypothetical situation could be this: the procedure is a success, and Spiridonov wakes up in this new body and he has full functionality of his new and improved 2.0 body. However, Spiridonov’s mind works perfectly, and he goes on to live a happy life frolicking through physical therapy and psychological therapy. This situation would point to the conclusion of the empiricists, and occasional rationalists, view that the mind is only a part of the brain.


The Future of Ethics
        The future of ethics is also brought into question, and the possibilities that are being brought up. If this surgery is deemed ethical, given that it is successful, the future of the ethics committee of medicine will be forever changed. If a head transplant is granted and successful, then what else will be deemed appropriate? A brain transplant is even more invasive and would have even more of an uproar, because that is taking the “mind” in this example, and putting it in a completely different body. Ethics will forever be changed, because there will be an entirely different mindset when approaching these issues.


Conclusion
         After careful analysis of how the procedure is done, and why the doctors believe it will work, the arguments for the procedure, and the arguments against the procedure, one may conclude that the transplantation of a head could be done with current research, even if success is unlikely; but, it should not be attempted. First, the initial cut could potentially kill the patient involved, and then there would be a waste of $10 million and a perfectly healthy body donor. Also, given that if Spiridonov survives the procedure, there is no guarantee that the whole process will be a success. One possibility could be that if Spiridonov wakes up, he could be worse off than he is now. He has control of his hands, so at least he can type. However, there is a possibility that he could not ever regain the ability to move from the neck down at all, and he would be trapped in a body that is not his, and that he cannot move at all.
        While the research done with PEG is definitely convincing, it was only effective in re-growing the same spinal cord. There were no studies done on trying to use PEG to rejoin two different spinal cords from two different bodies. If there have not been studies to join two different spinal cords together, then there is a possibility that the surgery could not even be successful. Therefore, there is a possibility that the surgery could not even be successful. There is a possibility that the team of 150 doctors and nurses could be responsible for killing a man who wanted to die; also known as euthanasia. If the reader of this essay would replace “head transplant” with “euthanasia” then there would be a multitude of people against the procedure.[31]

[1] Hindawi. "Right Ventricular Dysfunction and Failure in Chronic Pressure Overload." Cardiology Research and Practice. Hindawi Publishing Corporation, 23 Mar. 2011. Web. 02 May 2017.
[2] MailOnline, Richard Gray for. "EXCLUSIVE: Doctor planning world's first head transplant says he is preparing for his 'Frankenstein' surgery by REANIMATING human corpses ." Daily Mail Online. Associated Newspapers, 21 Sept. 2016. Web. 02 May 2017.
[3] Welch, Ashley. "Russian man volunteers for first human head transplant." CBS News. CBS Interactive, 29 Aug. 2016. Web. 02 May 2017.
[4] MailOnline, Richard Gray for. "EXCLUSIVE: Doctor planning world's first head transplant says he is preparing for his 'Frankenstein' surgery by REANIMATING human corpses ." Daily Mail Online. Associated Newspapers, 21 Sept. 2016. Web. 02 May 2017.
[5] Welch. Web. 02 May 2017.
[6] "Russian Man Set for World's First Head Transplant." The Telegraph. Telegraph Media Group, 20 Sept. 2016. Web. 02 May 2017.
[7] Welch. Web. 02 May 2017.
[8] Welch. Web. 02 May 2017.
[9] "Russian Man Set for World's First Head Transplant." The Telegraph. Telegraph Media Group, 20 Sept. 2016. Web. 02 May 2017.
[10] Welch. Web. 02 May 2017.
[11] MailOnline, Richard Gray for. "EXCLUSIVE: Doctor planning world's first head transplant says he is preparing for his 'Frankenstein' surgery by REANIMATING human corpses ." Daily Mail Online. Associated Newspapers, 21 Sept. 2016. Web. 02 May 2017.
[12] Welch. Web. 02 May 2017.
[13] Fox, Stuart Ira. Human Physiology. 13th ed. New York: McGraw-Hill, 2013. Print.
[14] O’Mealy, Gary. 12 February 2017. Class Lecture.
[15] "Neuroregeneration - Center for Regenerative Medicine - Mayo Clinic Research." Mayo Clinic. N.p., n.d. Web. 02 May 2017.
[16] Hsu, Shan-hui, Kun-Che Hung, and Cheng-Wei Chen. "Biodegradable polymer scaffolds." Journal of Materials Chemistry B. The Royal Society of Chemistry, 26 Oct. 2016. Web. 02 May 2017.
[17] "GDNF glial cell derived neurotrophic factor [Homo sapiens (human)] - Gene - NCBI." National Center for Biotechnology Information. U.S. National Library of Medicine, 18 Apr. 2017. Web. 02 May 2017.
[18] "Neuroregeneration - Center for Regenerative Medicine - Mayo Clinic Research." Mayo Clinic. N.p., n.d. Web. 02 May 2017.
[19] Shi, R. "Polyethylene glycol repairs membrane damage and enhances functional recovery: a tissue engineering approach to spinal cord injury." Neuroscience bulletin. U.S. National Library of Medicine, 29 Aug. 2013. Web. 02 May 2017.
[20] TEDxTalks. YouTube. YouTube, 18 Sept. 2015. Web. 02 May 2017.
[21] "Would a human head transplant be ethical?" BioCentre. N.p., n.d. Web. 02 May 2017.
[22] Raza, Malika, Hasnain Abbas Dharamshi, Syed Zohaib Ahsan, Zehra Naqvi, Tahira Naqvi, Ali Abbas Mohsin Ali, and Jamaluddin Malik Abbas. "The Future of Ethics in Medicine." Iranian Red Crescent Medical Journal. Kowsar, 18 June 2016. Web. 02 May 2017.
[23] Lewis, Tanya. "Why Head Transplants Won't Happen Any Time Soon."LiveScience. Business Insider Inc., 27 Apr. 2015. Web. 02 May 2017.
[24] MailOnline, Richard Gray for. "EXCLUSIVE: Doctor planning world's first head transplant says he is preparing for his 'Frankenstein' surgery by REANIMATING human corpses ." Daily Mail Online. Associated Newspapers, 21 Sept. 2016. Web. 02 May 2017.
[25] Brodwin, Erin. "In 2017, a surgeon wants to perform the world's first head transplant - here are his biggest obstacles." Business Insider. Business Insider, 27 Apr. 2015. Web. 02 May 2017.
[26] Lewis, Tanya. "Why Head Transplants Won't Happen Any Time Soon."LiveScience. Business Insider Inc., 27 Apr. 2015. Web. 02 May 2017.
[27] "Would a human head transplant be ethical?" BioCentre. N.p., n.d. Web. 02 May 2017.
[28] UK, The Week. "Head transplant: how would it work and is it ethical?" The Week UK. The Week UK, 24 Apr. 2015. Web. 02 May 2017.
[29] UK, The Week. Web. 02 May 2017
[30] Pomerleau, Wayne. "William James (1842—1910)." Internet Encyclopedia of Philosophy. N.p., n.d. Web. 02 May 2017.
[31] Thanks to Logan Luker and Russell Frisbee for content related to this blog post.





Works Cited.
Brodwin, Erin. "In 2017, a surgeon wants to perform the world's first head transplant - here are his biggest obstacles." Business Insider. Business Insider, 27 Apr. 2015. Web. 02 May 2017.
Dittmer, Joel. "Applied Ethics." Internet Encyclopedia of Philosophy. N.p., n.d. Web. 02 May 2017.
Fox, Stuart Ira. Human Physiology. 13th ed. New York: McGraw-Hill, 2013. Print.
"GDNF glial cell derived neurotrophic factor [Homo sapiens (human)] - Gene - NCBI." National Center for Biotechnology Information. U.S. National Library of Medicine, 18 Apr. 2017. Web. 02 May 2017.
Hindawi. "Right Ventricular Dysfunction and Failure in Chronic Pressure Overload." Cardiology Research and Practice. Hindawi Publishing Corporation, 23 Mar. 2011. Web. 02 May 2017.
Hsu, Shan-hui, Kun-Che Hung, and Cheng-Wei Chen. "Biodegradable polymer scaffolds." Journal of Materials Chemistry B. The Royal Society of Chemistry, 26 Oct. 2016. Web. 02 May 2017.
Lewis, Tanya. "Why Head Transplants Won't Happen Any Time Soon."LiveScience. Business Insider Inc., 27 Apr. 2015. Web. 02 May 2017.
MailOnline, Richard Gray for. "EXCLUSIVE: Doctor planning world's first head transplant says he is preparing for his 'Frankenstein' surgery by REANIMATING human corpses." Daily Mail Online. Associated Newspapers, 21 Sept. 2016. Web. 02 May 2017.
Messner, Gregory N., Igor D. Gregoric, Thomas Chu, Branislav Radovancevic, Biswajit Kar, Scott D. Flamm, and O. H. Frazier. "Orthotopic Heart Transplantation in a Patient with D-Transposition of the Great Arteries after a Mustard Procedure." Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. Published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute, 2005. Web. 02 May 2017.
"Neuroregeneration - Center for Regenerative Medicine - Mayo Clinic Research." Mayo Clinic. N.p., n.d. Web. 02 May 2017.
O’Mealy, Gary. 12 February 2017. Class Lecture.
Raza, Malika, Hasnain Abbas Dharamshi, Syed Zohaib Ahsan, Zehra Naqvi, Tahira Naqvi, Ali Abbas Mohsin Ali, and Jamaluddin Malik Abbas. "The Future of Ethics in Medicine." Iranian Red Crescent Medical Journal. Kowsar, 18 June 2016. Web. 02 May 2017.
"Russian Man Set for World's First Head Transplant." The Telegraph. Telegraph Media Group, 20 Sept. 2016. Web. 02 May 2017.
Shi, R. "Polyethylene glycol repairs membrane damage and enhances functional recovery: a tissue engineering approach to spinal cord injury." Neuroscience bulletin. U.S. National Library of Medicine, 29 Aug. 2013. Web. 02 May 2017.
TEDxTalks. YouTube. YouTube, 18 Sept. 2015. Web. 02 May 2017.
Toman, Barbara J. "Harnessing the Body's Healing Power." Neuroregenerative Medicine. Mayo Clinic, n.d. Web. 02 May 2017.
UK, The Week. "Head transplant: how would it work and is it ethical?" The Week UK. The Week UK, 24 Apr. 2015. Web. 02 May 2017.
Welch, Ashley. "Russian man volunteers for first human head transplant." CBS News. CBS Interactive, 29 Aug. 2016. Web. 02 May 2017.
Pomerleau, Wayne. "William James (1842—1910)." Internet Encyclopedia of Philosophy. N.p., n.d. Web. 02 May 2017.

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