X-Message-Number: 2009
From: 
Subject: CRYONICS Funding and Suicide
Date: Tue, 23 Mar 93 00:04:50 PST

March 22, 1993
To Cryonet
>From Steve Bridge, President
Alcor Life Extension Foundation

In response to Message: #1987 - Funding Patients
               Date: 18 Mar 93 22:05:33 EST
               From: Clarissa Wells <>
               Message-Subject: CRYONICS Funding Patients

>As I understand it, an Alcor member decided to commit suicide. 
>Consequently, his life insurance was not valid, and there was only a 
>$10,000 trust fund to pay for cryonic suspension, instead of the 
>$41,000 which is what a head-only suspension normally costs. (It 
>doesn't say whether he was whole-body or head-only, but I will assume 
>it was head-only.) The Alcor people went ahead and froze the patient 
>even though the money was less than a quarter of what should have 
>been available.
 
     Ms. Wells asks a very important series of questions here, ones 
that go to the heart of what cryonics and Alcor are about.  Some of 
her concerns will become partly irrelevant as she has more 
information.  Two reports on this suspension are in the April issue of 
Cryonics magazine (which has just gone to press).  

     One of Ms. Wells's questions is discussed at length in the 
magazine, so I will only address it here briefly (and out of order):

>The second issue here is the whole idea of freezing someone who 
>obviously decided he didn't want to be frozen. I think that if I 
>choose to kill myself, I would want to stay dead. Now, you might say 
>that by choosing to kill myself, I have proved that I am irrational, 
>and therefore other people should not respect my judgment. But this 
>is a dangerous argument. It puts Alcor in the position of "knowing 
>what's best." I don't like the sound of this at all. I think Alcor 
>should respect the wishes of a person, even if those wishes happen to 
>contradict Alcor's own ideas about the situation. 

     This kind of question has been around cryonics for several years, 
but the need to address it has never been stronger than right now.  
Ms. Wells asserts that freezing the patient would mean that Alcor was 
deciding it "knows what's best."  Yet she also presumes to "know 
what's best" when she says that suicidal patients don't want to be 
frozen.  It seems that Ms. Wells is trying to read patients' minds 
here, not Alcor.

     Just as Alcor cannot assume that it knows what the patient is 
thinking and "knows what's best", we cannot assume that a person who 
commits suicide does not want to be frozen.  In my admittedly limited 
experience (but which appears to be backed up by conversations with 
professionals during the past few weeks), most suicidal people do NOT 
in fact want to be DEAD.  They want to stop the agony they are in.  At 
the point they kill themselves, they are unable to think of reasons to 
go on living, although they may have plenty.

     I know several Alcor members who have had problems with severe 
depression, and some have specifically told me that this will never 
mean they do not want to be suspended.  I would be completely remiss 
in my duties if I took the attitude that suicide was always a rational 
statement that meant, "Do not freeze me.  I want to be dead forever."

     In this case, we know that the patient DID want to be suspended.  
As will be reported in the magazine, Alcor staff had many telephone 
conversations with him in the weeks preceding his deanimation.  He did 
not want to be dead; he just did not know how to live.  We WERE 
respecting his wishes.  I hope that Michael Riskin, Steve Harris, or 
other professionals can speak to the subject of clinical depression 
here more thoroughly than I can.

>This seems very strange to me for two reasons. First, the same 
>minutes of the same board meeting state that Alcor has a "moderately 
>serious cash flow problem." In that case, I wonder why Alcor is 
>taking on a patient without sufficient payment for his suspension. 
>After all, the shortfall here must be at least $30,000! This means 
>that the fund which pays for upkeep of frozen patients has less in it 
>than it should have. I wonder how the other frozen patients would 
>feel about that, if they knew what had happened?
 
     First, this patient's suspension did not increase our cash flow 
problems.  Cash flow problems are in the Operating Fund.  The Patient 
Care Trust Fund is quite different and is relatively robust.  Also, 
the "shortfall" in real terms is much less in this case, because the 
costs of retrieving this member's brain were very low.  Details below. 

     The amount of thought and contradiction that went into this 
decision may be hard to imagine to the vast majority of Cryonet 
readers who have never made a life-or-death decision.  While this was 
the first one I have had to make, I have been part of the discussions 
on at least two other equally difficult situations, decided by Carlos 
Mondragon, Mike Darwin, Jerry Leaf, and others.  These situations are 
always agonizing for everyone involved.  I assume that several of the 
frozen patients would be very happy about this (if they had the 
opportunity to know it) because their own circumstances were the 
results of agonizing decisions, sometimes including underfunding.

     Here are some of the questions we asked in this case:

     *Is Alcor primarily a business or is it primarily a non-profit 
charitable institution?*  (The answer, of course, is "Yes.")  

     *Can we perform a charitable act in this case without causing 
severe financial hardship?*  Tough call.  We knew we could not afford 
to send a team to Texas.  We knew we could not afford to fly the 
patient's remains back to California.  The $10,100 trust left us the 
smallest amount of leeway.  We could probably afford to fly one person 
to Texas, take custody of the member's brain for a straight freeze (no 
surgery, no perfusion -- it was too late for perfusion anyway--, none 
of the expensive upfront costs), have the rest of the body cremated in 
Texas, and fly the one person back with the member's brain on ice.  We 
estimated we could do this for under $2,500, leaving $7,500 to be 
placed into the Patient Care Trust Fund.  This is one half the usual 
amount; however, the "usual amount" is DOUBLE the amount we have 
estimated is the minimum required to earn enough interest to pay 
patient care expenses.

     Our numbers turned out to be a very close estimate, and we had 
very good cooperation from the Medical Examiner's office in this city.  
We WERE able to place $7,500 into the PCTF.

     *What if we decided not to suspend this gentleman and his 
insurance paid off anyway?*  --  Ms. Wells says "Consequently, his 
life insurance was not valid."  First, suicide only invalidates most 
policies during the first two years.  (This member's policies were 
less than two years old.)  Second, we have been told that occasionally 
insurance companies do indeed pay off on suicides during the 
contestability period.  We have filed claims with the insurance 
companies just in case.  (We may at least receive a return on the 
premiums the member paid.)  The $10,100 trust fund appeared to give us 
the option.

     *Can we do anything else to hold costs down?*  We decided to see 
if a neurosuspension canister (used for one suspended head) was large 
enough to contain two suspended brains.  It appears that it IS, so 
this patient will be stored in the same unit as the other separate 
brain Alcor has in suspension (properly labeled, of course).  Note 
that this does not reduce the level of care for the other separate 
brain, yet it keeps a full slot open for a future neuropatient.

     *Does our involvement in conversations with the member over the 
previous weeks create any special responsibility for this member?*  We 
knocked around different ethical considerations on this for several 
minutes, but gave them up as something that would require weeks of 
discussion.  We only had about 6 hours to make this decision.  To be 
honest, though, this was probably an unspoken factor in the decision.

     *Should we be taking on responsibility for underfunded patients, 
even if their underfunding was created by a suicide?  Is this fair to 
other patients?*
     I don't know.  Alcor has taken on similar responsibilities 
before, even though the hard-nosed decision would be to ignore anyone 
whose funding became incomplete.  I guess we're not hard-nosed enough 
here to let people rot if we can find a way to save them.  Alcor 
members who feel they can make these decisions on a pure, emotionless 
basis are invited to practice on their friends first.

     *What is the "conservative" thing to do?*  Mike Darwin once wrote 
an article which described cryonics as the ultimate form of 
"conservative medicine."   To Mike, "conservative" was appropriate in 
two senses: 1) in the sense that we were "conserving" as much as 
possible of the patient and 2) radical medicine poses a greater risk 
to the health of the patient than conservative medicine, which aims at 
least to do no harm.  Burying someone certainly does more harm to 
their body than freezing them.  

     By the way, I do not regret we did this.  It seemed like the 
right thing to do at the time and it still does.  This member 
certainly got a poor suspension, from everything we understand about 
ischemia and cryoprotection, although we have other patients in at 
least as bad a situation.  And maybe we really should be offering some 
kind of a cut-rate, straight-freeze suspension option.  That is beyond 
the scope of this answer (the concept engenders several pounds of 
argument every time it is proposed).


>Also I wonder if I am an Alcor member, and I only make arrangements 
>to pay $10,000, will Alcor freeze me too? 

     If you try to make arrangements that way, no.  But if you have 
acceptably funded arrangements and something goes wrong at the last 
moment, I hope we CAN find a way to do it.  We're human and we feel 
that we have an obligation to our members.  I also hope that some 
people would rather be a member of an organization with that kind of 
attitude.  Further, I hope that most of such members will over-fund 
their suspensions to help Alcor cover a situation like this.  It might 
be their own suspensions that go wrong and THEY will need the help.

>Why should Alcor decide to do this kind of favor for one patient, but 
>not for another? And most important, doesn't this suggest that the 
>financial policy at Alcor is a bit loose? It seems to me, a cryonics 
>organization has to be very careful with its money, because if it 
>isn't, people won't trust it to last very long.
 
     Cryonics has always walked a fine line between saving lives and 
getting enough money to continue.  We've been fortunate in the past to 
have some members carry more than their share of the financial or time 
load for others.  If we charged the REAL cost of running this 
organization to the 350 members through increased dues and suspension 
minimums, we would probably have a lot fewer members.

     We are trying to reduce expenses at Alcor; but I do not see that 
this decision is evidence that we are not being careful with our 
money.  We didn't decide to suspend this member until we could 
determine that we would experience no adverse financial effects (in 
this carefully limited set of circumstances).  I call that being VERY 
careful.

>One last point. I imagine there are people suffering terminal 
>conditions who can't get life insurance. I imagine some of these 
>people are unable to pay $41,000, but would be able to come up with 
>$10,000. How will they feel, knowing they have to die "permanently" 
>because Alcor was willing to freeze someone else at a discount, but 
>won't do the same thing for them?  

     This misses one of the basic truths about cryonics that anyone 
who has been involved in cryonics for very long has dealt with many 
times.  WE CAN'T SAVE EVERYBODY.  This is true whether we charge one 
million dollars or one hundred dollars.  Many of us have lost parents 
or other loved ones that would not or could not be suspended.

     If we can't save EVERYONE, does that mean we should save NO ONE?  
We do what we can, and it seems right to be to expend more energy in 
saving those who have made the arrangements, even if those 
arrangements later go sour.  Even this does not always work and 
sometimes we have to give up on a member when his funding disappears 
or when someone else gets control of it.  

     I don't have a wise answer for this dilemma.  I can't begin to 
decide whether one person is worth more than another.  All I can do is 
operate from the assumption that if we accept someone as a suspension 
member, we should not give up on them lightly.  Perhaps a cryonics 
company should be started which offers neuro, straight-freeze only.  I 
would be in favor of such an organization, although I would not want 
to run it or be a member (except as emergency back-up, perhaps). 
Unfortunately, to do this on a regular basis would certainly cost more 
than $10,000 each.  In this case, we already had the staff and storage 
space.  

>If you're going to offer a "bargain rate," wouldn't it make better 
>sense to offer it to someone who desperately wants to live, rather 
>than someone who proved he wanted to die?
 
     Again, this shows a lack of understanding of depression and 
suicide.  Suicide is not proof that someone wants to die.  It is proof 
that they are very unhappy.

>It seems to me you run into all kinds of problems if you start making 
>special cases and exceptions in these life-and-death situations.
 
     That seems to be the nature of cryonics so far.  Maybe someday 
this will all be cut and dried.  Someday hospitals and insurance 
companies and Departments of Health will understand why we are doing 
cryonics -- and they will HELP us do it.  And make a lot of money from 
it, no doubt.  Right now, though, every suspension is a special case 
in some way.

      If Ms. Wells would like to submit a new version of this question 
to Cryonics Magazine, as a letter to the editor (after she has read the
relevant reports in the April issue, we could provide this answer for all
of our members and readers.

    Steve Bridge

Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=2009