Guest blogger Ron Belgau writes:
I read your blog post today on face transplants, and it provoked a tangential train of thought. It’s not one I’d want to endorse, but thought I’d send it along for your enrichment (if that is the right term).
Two things caught my attention: first, the prohibition on brain transplants due to the fact that the brain is the seat of the personality, and second, the statement that brain death may be a legitimate criterion for death.
It seems to me that, based on those two considerations, one could make an argument for brain transplantation, with a twist.
Suppose that A receives a gunshot wound to the head which causes brain death (we will assume brain death of a sort that would be acceptable to the most pro-life physician, not just medical community vulture brain death), but leaves his body undamaged. Meanwhile, B is in a very serious car accident in which his body is damaged beyond all repair, but his brain is undamaged.
It seems to me that within the framework you have offered, one *could* argue that, if it were technically feasible, it could be morally justifiable to transplant B’s brain into A’s body.
In any case, the proper description for this situation would be to say that A had died, and that B was alive in A’s body. Although from the medical perspective, it probably makes sense to say that we transplanted B’s brain into A, from the moral perspective, what we would want to say is that we had transplanted A’s body to B.
I’m not sure what I want to say about a case like this. It seems like it could be justified, on the grounds that if we don’t do it, both A and B will die (assuming brain death is a legitimate criterion for death, which *seems* legitimate if we say that the brain is the seat of the personality), while doing it will allow B’s personality to live on, and potentially live a long and productive life.
At the same time, the personal and social identity issues with this case are far more problematic than those involved in the face transplant issue. One can also imagine a number of particularly ugly ways that this kind of technology could be abused: criminals seeking a new identity, aging Hollywood stars and starlettes looking for the ultimate makeover, etc.
No, you’re quite correct. IF "brain death" (suitably defined and verified) is an adequate criterion for death then you could do PRECISELY this kind of full-body transplant.
Under the scenario you describ you could also snip off both their heads and sew B’s head onto A’s body.
This is one of the things that causes me and others to have significant questions about whether "brain death" in an adequate criterion for somatic death. While the death of the brain may be a necessary condition for the death of the body, it isn’t clear to me that it’s a sufficient condition for the death of the body. I kinda want the rest of the body to die, too–as a whole. I’m not talking about fingernail beds and hair follicles and minor systems like that. I kinda want overall systemic failure before I say that the system of the body is dead, not just the technologically irreversible cessation of brain or higher brain function.
I also think that what counts as technologically irreversible cessation or brain or higher brain function is going to look VERY different once nanotechnology comes online over the next 20-30 years, making our present understandings of what counts as brain death JUST AS INVALID as the cessation of heartbeat definitions of death that were used a hundred years ago.
If you started cutting someone up back then just because their heart stopped beating 20 seconds ago then you would be cutting up someone who was really not yet dead.
People back then weren’t dead the moment their hearts stopped beating. More has to happen to the heart for death to occur than just a cessation of its activity. If it can be jumpstarted then the person simply was not at the point of death, even if his heart could not THEN have been brought back online due to lack of technology.
In the same way, just because a person’s brain has ceased functioning does not mean he’s dead if it turns out that there’s a technology 30 years from now that will jumpstart his brain.
If nanotechnology has the promise that it seems to at this point and we use brain death as a criterion then half a century from now we are LIKELY to find out that we’ve been cutting up people for parts who were STILL ALIVE, we just didn’t have the ability to bring their brains back online yet.

