X-Message-Number: 3115 Subject: CRYONICS:Risks, good and bad From: (Charles Platt) Date: Sun, 11 Sep 94 22:14:35 EDT Regarding "risk": There is a lot of potential for confusion here, because the word "risk" is being used by different people to mean different things. Let's break it down as simply as possible. Storage risk, we all agree, is bad risk. We want to be stored as safely as feasible, though we may disagree about how this should be done. Risks taken during standby/transport/perfusion are another matter. Here, there are two kinds of risk: good and bad. Bad risks may result from ignorance, haste, poor equipment, missing equipment, delays, inexperience, misunderstandings, and imperfect assessment of a situation. There are cases where patients have been subjected to some or all of these risks, despite the good intentions of all concerned. I will say however that BioPreservation has minimized these risks to such a degree, it currently has a better record than any other organization in the standby/transport/perfusion phase of cryopreservation. The records of BioP's two recent cases provide documentary proof of this. Now, let me turn to the concept of "good risks." These are the risks in standby/transport/perfusion which are taken *on behalf of the patient.* For example: a hospital may demand that the standby team should not administer any medications to the patient--even after legal death is declared--until the patient is off the premises. The hospital may even refuse to allow the patient to be packed in ice. The standby team may feel that this will result in so much damage to the patient (because of a long period of ischemia) that it is "worth the risk" to disobey hospital rules and administer the treatment that the patient needs. This, of course, is good from the patient's point of view, but it may get the standby team into some sort of trouble. If the standby team is employed by the same organization which also maintains patients in long-term storage, there is a problem. If the team "breaks the rules" of some instituion on behalf of a new patient, legal backlash can threaten the whole organization--including patients who are currently frozen. Thus, the "good risk" (from the new patient's point of view) turns into "bad risk" for the patients who are frozen. In the past, there has been a lot of argument about how best to balance out these conflicting considerations. The obvious answer (I think) is to have a standby team that does NOT work for the company that stores patients. Once this decoupling has occurred, the standby team can take any good risks it feels necessary on behalf of the new patient, while the patients that have already been frozen are protected by being under the control of an entirely separate company. This is the happy situation which we now have with BioPreservation, which provides "emergency cryonic care" before passing the patient to a separate company for long- term storage. >From the above, it seems obvious that the "risk debate" which caused a lot of discussion during Mike Darwin's tenure at Alcor is no longer relevant (except to Alcor's current suspension team, led by Tanya Jones, who probably has opinions of her own on this subject). Mike Darwin can risk his ass on behalf of CryoCare or ACS patients without any repercussions affecting patients who are frozen, because the frozen patients are elsewhere. The "risk debate" is, in fact, a tired old bogeyman which has been resurrected presumably for the sole purpose of making people nervous--a tactic which does not surprise me, but does sadden me, because it stands in contrast to the much higher level of discussion we have seen here recently. --Charles Platt, vice-president, CryoCare (I believe the above statement represents a fair summary of CryoCare's policy on this topic, which is why CryoCare currently contracts for the services of Mike Darwin and his company, BioPreservation, for standby/transport/perfusion.) ##################################################################### Charles Platt / 1133 Broadway (room 1214) / New York / NY 10010 / phone 212 929 3983 Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=3115