1. My comments derive from an objective (trying to minimize fuzziness) rather than a subjective perspective (ignoring, also, questions related to the validity of such binarization);

2. This study is very interesting from a sociobiological perspective: Are these foster organisms (the patient's parents' "helpers") being "altruistic"? Cui bono both proximately (immediately) and ultimately (evolutionarily)? What are the economic tradeoffs ($$, T & E, health, etc) to each individual involved, including the patient? Do we learn anything from analyzing this case with signaling theory (sender ----> receiver), including, potential for deception or possible import of "handicaps"? What are the differential costs and/or benefits for networks of the organisms involved? Is exploitation (in a biological sense--such as "social parasitism") a factor? Considering each organism in the equation, are there increases or decreases in status or rank? etc, etc.

3. Organisms in the case described can be classified as either "dominant" (high-rank) or "subordinate" (low-rank). Thus, any of the questions attendant to analyses by animal behaviorists, behavioral ecologists, or evolutionary biologists are applicable. Theoretically, say, with agent-based modeling, the case can be quantitatively expressed and expanded in numerous fascinating ways (e.g., Case as described may have negligible or some positive effects for individuals involved and for other groups and for society;however, what if larger %s of population adopted similar behavior in same or comparable [very high risk] conditions? Is the mated pair "sterile" or otherwise non-reproductive? Does their reproductive status tell us anything about potential for eusociality in humans? See ALotka 1927 PNAS; CBJones 2011 Arch Sex Behav etc etc).

4. It seems clear that, from an applied scientific perspective, the patient is an experimental subject. I think that there may be interesting questions related to research protocols regarding this elective procedure that may not be characterized as elective...I'm not clear about what's going on @ this level, and I am still trying to view the case objectively (trying to minimize fuzziness). 

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