St. Edward's University, Austin, Texas, USA.
J Med Philos. 2022 May 11;47(2):240-256. doi: 10.1093/jmp/jhab045.
Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? For the purposes of this paper, I set aside questions regarding the surgical operation's technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others.
脑移植长期以来一直只是科幻小说和引人入胜的思想实验的主题。但现在已经不再如此。神经科学家已经宣布打算将一名志愿者的头部移植到一具捐赠的身体上。对此的反应是混合的。我们应该如何思考头部移植的道德允许性?这是一个拯救生命/增强生命的机会,是否适当地扩大了医学实践的边界?或者,这是一个不应该尝试的生物伦理困境?为了本文的目的,我将与手术操作的技术可行性相关的问题搁置一边,而是专注于与个人身份和头部移植的道德相关的基本问题。分析首先探讨了人的体现。它考虑了一个人是否可以从其身体的所有部分中概念上区分出来,即使没有失去人格就无法将其与某些部分物理分离。它认为,在大多数情况下,用合理相似的部分替换身体部分不会破坏维持人格的条件。然而,正如我所探讨的,人格的现象学表明,一些身体上的变化可能证明是过于显著的,以至于无法随着时间的推移成功地维持个人身份。鉴于这种复杂性和所涉及的成本的重要性,头部移植的道德允许性可能取决于认识到,个人可能会允许合作进行共同的活动,包括与他人严重分歧的项目,只要他们只利用自由和同意的他人的服务和资源。