X-Message-Number: 3418
Date:  Thu, 17 Nov 94 15:43:39 
From: Bridge Steve <>
Subject: CRYONICS Legal Status of Patients


To CryoNet
>From Steve Bridge, Alcor
November 17, 1994

The following is a paper I made available to participants at the recent 
Life Extension Foundation Conference, as part of my appearance on a panel 
to discuss the Legal Status of Cryonics Patients.  Ben Best was also on 
the panel and had several interesting things to say about the 
international legal situation.  He hopes to make his information available 
in written form sometime in the next couple of months.

I plan to publish this summary in Cryonics Magazine, probably in the 1st 
quarter 1995 issue, after researching a couple of more legal points.  This 
is still a draft, and I would like to see if others have comments or 
criticisms that I can learn from.  I hope many CryoNet readers will gain 
new information from what I have posted here.

Actual text commentary should be sent to me at , although 
discussions of the general issues are certainly welcome here on CryoNet.

Note: I will be out of town from Nov 18-26.  I will check e-mail a couple 
of times but I won't be able to make detailed answers to questions or 
suggestions until I return to Scottsdale.  

Thank you,

Steve Bridge

****************************************************************

                  The Legal Status of Cryonics Patients

                             An Introduction
                       By Stephen Bridge, President
                     Alcor Life Extension Foundation
                             November 3, 1994


*The General Problem*

     There are no laws in the United States today that are specifically 
aimed at cryonics or which mention it by name.  That doesn't mean that no 
laws APPLY to cryonics.  Cryonics organizations, whether "full-service" or 
specialized, must be aware of -- and often find ways to circumvent -- laws 
intended to protect the public health from unburied or untreated corpses.  
Laws permitting anatomical donations have been beneficial to cryonics but 
pose their own set of problems.  The funding of cryonic suspensions is 
often trapped in a tangle of laws concerning trusts, tax-exemption, and 
insurance policies.  Eventually there WILL be laws which specifically 
attempt to regulate cryonic suspension and other forms of biostasis.  
Whether these laws are permissive or prohibitive will depend very much on 
our understanding of current laws and on our ability to cooperate with (or 
sometimes to outwit) elected and appointed government officials.

     Today, cryonics suspension patients are legally dead.  Not alive, not 
in-between, but DEAD.  How we as cryonicists think of our patients has 
absolutely no influence on this label.  We have to remember it is *merely* 
a label, and labels can be changed.  But until we can prove that cryonic 
suspension patients have a high likelihood of being revivable, we have to 
play the game from that viewpoint.  

     While this label of "dead" creates many problems for us, it also 
leads to some advantages.

     One very obvious advantage is that life insurance and various forms 
of trust can be used to fund cryonic suspensions, with the suspending 
company as beneficiary.  This is very standard law, and has been used 
successfully many times.  Some future legal determination that suspension 
patients were legally "alive" would lead to several years of chaos for 
suspension companies.  Would insurance companies pay the beneficiary if no 
death certificate were presented?  I suspect that eventually ways would be 
found around this problem by the more honest (or at least more creative) 
insurance companies, just as many companies have found ways to give pre-
death payments to terminal patients (especially those dying of AIDS).  
Besides, if cryonics becomes popular (a good bet if we can show that it 
works), there will be a lot of new customers for *some* form of insurance 
funding.

     Another advantage to the "dead" label for suspension patients is that 
it allows Alcor and other cryonics companies to use the Uniform Anatomical 
Gift Act (UAGA) to establish legal custody of the patients' "human 
remains."  Just as individuals are allowed to donate their bodies after 
death to medical schools or their organs for transplant, they can also 
donate their bodies to Alcor for "medical research."  When accomplished by 
a written pre-mortem declaration, this donation effectively removes the 
ability of family members to "dispose" of the individual in some other 
way.  All 50 states use one of two basic forms of the UAGA (the 
differences probably don't make much difference for custody of remains, 
although they may make a subtle difference in states where patients are 
*stored*).  In addition, many states (including California and Arizona) 
have very clear legislation which requires the state and the family to 
respect individuals' choices as to disposition of their own remains.  At 
least three court cases in California have affirmed that these laws 
protect an individual's right to choose cryonic suspension.  In effect, 
this means "dead people" have some rights.

     The use of the UAGA has another benefit.  Hospitals and medical 
personnel are used to the paperwork involved in whole body donations and 
to the requirement for rapid release of the body to the donee.  Saying "we 
are taking custody of this dead person because he donated his body to us" 
still goes over better at the hospital than "you aren't good enough to 
understand that this person is still alive, so we are going to do your job 
for you by freezing him until someone smarter comes along."

     Of course, labeling a suspension patient "dead" also creates a large 
number of problems.  Agencies which regulate funeral homes, cemeteries, 
and mortuaries may not appreciate our semantic balancing act between life 
and death and may assume we fall under their regulation.  Cryonics 
organizations in California were fortunate enough to escape this because 
of an Attorney General's opinion published in 1980.  But Alcor is 
currently facing a similar problem in Arizona (see below).

     Dead bodies are considered by most people to be empty husks, only fit 
for discarding.  The assumption has always been that death is the reverse 
of life and that life cannot be reclaimed.  While it seems clear to us 
that this is likely to be untrue, we are forced to deal with the reality 
that the close-minded are the ones in charge of society.  

     Someday a special status and a new label for suspension patients 
(Don't-Know-Yets; The Undead; Deanimates; Metabolically Disadvantaged) 
will be needed; but before then we will need to produce more research 
showing why such a status is deserved.


Some notes about individual states:

*California*

     Alcor was in California for almost 22 years years.  During that time, 
Alcor fought and won many legal actions to establish and protect the right 
of individuals to choose cryonic suspension.  Along we the way, we and our 
attorneys discovered several California laws which were useful for 
cryonicists to know.  Citations are provided so the reader may find the 
laws in question.  (Each state usually has several locations where the 
laws of the fifty states are kept.)


I.  UNIFORM ANATOMICAL GIFT ACT

     California Health and Safety Code 7150-7157, original 1968, revised 
1970, new Act 1988.

     While the act does not state anything about cryonic suspension, 
cryonic storage facilities depend on the following language to act:

"7150.5 (a) An individual who is at least 18 years of age may make an 
anatomical gift for any of the purposes stated in subdivision (a) of 
Section 7153, limit an anatomical gift to one or more of those purposes, 
or refuse to make an anatomical gift."

and:

"7153 (a) The following persons may become donees of anatomical gifts for 
the purposes stated:
  (1) a hospital, physician, surgeon, or procurement organization, for 
transplantation, therapy, medical or dental education, research, or 
advancement of medical or dental sciences."

     Our purposes are research and the advancement of medical sciences.

     The cryonics organization is the "Procurement organization," which, 
under the definitions in the 1988 law, means "a person licensed, 
accredited, or approved under the laws of any state or by the State 
Department of Health Services for procurement, distribution, or storage of 
human bodies or parts."

     This led to Alcor's great "Catch-22"-type problem in the *Roe v. 
Mitchell* case, where Alcor was told it was not an approved procurement 
organization.  "So how do we apply for such approval?" we asked.  "There 
is no procedure for approval," we were told.  After several years of 
litigation, the California Court of Appeals, 4th District, agreed that 
such a circle of unreasoning could not be used to deny Alcor the ability 
to store patients.  (A note on this decision is included in the 1994 
Annotated  Statutes.)


II.  RIGHT TO CONTROL DISPOSITION OF REMAINS

     California Health and Safety Code, 7100 et seq., current version 
1970, amended 1988.

     This act is the cornerstone of the legal rights of suspension 
patients in California.  It details the rights of a family to control 
disposition of remains, and the right of a decedent to direct that 
disposition.  Several courts have held that this act applies to cryonic 
suspension.

"7100(a).  The right to control the disposition of the remains of a 
deceased person, including the location and conditions of interment, 
unless other directions have been given by the decedent, vests in, and the 
duty of interment and the liability for the reasonable cost of interment 
of the remains devolves upon the following in the order named:"  [various 
relatives are listed.]

and

"7100(d)(1).  A decedent, prior to his death, may direct the preparation 
for, type, or place of interment of his remains, either by oral or written 
instructions, but a written contract for funeral services may only be 
modified in writing.  The person or persons otherwise entitled to control 
the disposition of the remains under the provisions of this section shall 
faithfully carry out the directions of the decedent subject only to the 
provisions of this chapter with respect to the duties of the coroner."

     Arizona has a similar statute (see below).

[It is notable that the list of "Law Review Commentaries" for this section 
includes "Cryonic Suspension and the Law" by Curtis Henderson and Robert 
C.W. Ettinger, UCLA Law Review (1968) 15:414.]


III.  RELIGIOUS OBJECTION TO AUTOPSY

     California Government Code, 27491.43.  Original 1984.

     This is an unusual but very helpful law which I have so far found (in 
differing versions) only in California, New York, and New Jersey.  It 
mandates that if the coroner is preparing to perform an autopsy or 
otherwise remove tissue from a decedent, and the coroner has "received a 
certificate of religious belief, executed by the decedent as provided in 
subdivision (b), that the procedure would be contrary to his or her 
religious belief, the coroner shall not perform that procedure on the body 
of the decedent."

     If the coroner is told that such a document exists, it must be 
produced within 48 hours.  Several rules are given for the form of the 
certificate.  Then two exceptions:  (c) "Notwithstanding the existence of 
a certificate, the coroner may at any time perform an autopsy or any other 
procedure if he or she has a reasonable suspicion that the death was 
caused by the criminal act of another or by a contagious disease 
constituting a public health hazard."   (d, paraphrased)  A court may 
overrule the certificate if such action is in the public interest or if it 
is determined that the certificate was not properly executed.  

     Interestingly, the certifier does not have to espouse a particular 
religion.

     The language in the New York and New Jersey statutes are somewhat 
different, but the effect is about the same.  This law has great potential 
for preventing many autopsies for suspension patients, and we strongly 
encourage all cryonicists residing in these three states to execute the 
appropriate forms immediately.  Alcor has these forms available for its 
members.

     Arizona does not have this law yet; but we hope to encourage such a 
movement among religious groups here.  Such a law in all fifty states 
would prevent autopsies in many suspension cases (heart attacks, for 
instance).

 
*Arizona*

I.  UNIFORM ANATOMICAL GIFT ACT

     Arizona Revised Statutes, Public Health and Safety, 36-841 et seq., 
1970, amended 1986, 1987.

     The language that applies to a cryonics facility is somewhat 
different from the California version, but still gives us plenty of room.

"36-843.  The following persons may become donees of gifts of bodies or 
parts thereof for the purposes stated:
  1.  Any hospital, surgeon or physician ...
  2.  Any accredited medical or dental school ...
  3. Any bank or storage facility, for medical or dental education, 
research, advancement of medical or dental science, therapy or 
transplantation."

     The definitions in 36-841 include this: "'Bank or storage facility' 
means a facility licensed, accredited, or approved under the laws of any 
state for storage of human bodies or parts thereof."

     Arizona, like California, has no procedures to license human body 
storage facilities.  But we didn't have to go to court for approval in 
Arizona.  Since the California Department of Health Services had finally 
signed the disposition permits in Riverside, Arizona accepted that as 
evidence that we were approved "under the laws of any state."


II.  RIGHT TO CONTROL DISPOSITION OF REMAINS

     Arizona Revised Statutes, Public Health and Safety, 36-831.01, added 
1990, amended 1991.

"36-831.01 A.  If the person on whom the duty of burial is imposed 
pursuant to 36-831 is aware of the decedent's wishes regarding the 
disposition of his remains, that person shall comply with those wishes if 
they are reasonable and do not impose an economic or emotional hardship."

     Since the "person on whom the duty of burial is imposed" would be 
Alcor, via the UAGA, I can safely say that Alcor would consider cryonic 
suspension to be reasonable, that it would not impose an emotional 
hardship, and that (assuming your arrangements are in place) it would not 
impose a financial hardship.


III.  LIVING WILLS AND HEALTH CARE DIRECTIVES

     Arizona Revised Statutes, Public Health and Safety, 36-3201 et seq., 
added 1992.     

     Arizona has added a law allowing Health Care Surrogates, a Health 
Care Power of Attorney (as one possible way of appointing a health care 
surrogate), Prehospital Care Directives, and Living Wills.  The law is 
fairly sweeping and should increase the ability of someone in Arizona to 
determine his health care.  

     It allows you to state whether or not you consent to an autopsy (this 
is very weak, though, since it does not limit the options of the coroner).  
And there is one other interesting paragraph that spells out a situation 
that has been handled informally locally in many locales:

"36-3207 C.  If a patient's death follows the withholding or withdrawing 
of any medical care pursuant to a surrogate's decision not expressly 
precluded by the patient's health care directive, that death does not 
constitute a homicide or a suicide and does not impair or invalidate an 
insurance policy, an annuity or any other contract that is conditioned on 
the life or death of the patient regardless of any terms of that 
contract."


IV.  FUNERAL PRACTICE

     One of the more aggravating situations in Arizona has been a recent 
effort by the State Board of Funeral Directors and Embalmers to claim that 
cryonics is part of "embalming."  Their justification for this is the 
definition in the Arizona Revised Statutes, Professions and Occupation, 
32-1301, original 1945, amended various times since, but this term appears 
to be in the original.

"Definition 7.  'Embalming' means the disinfection, preservation, or 
attempted disinfection or preservation of a dead human body.'"

     It's not a very precise definition, and could be read to include 
cryonics.  It seems a bit silly to us and ignores that cryonics uses 
different technology and chemistry to produce different effects and for a 
vastly different purpose.  One can imagine bureaucrats in the 1950's 
taking laws specifying the fuel that must be used in propeller airplanes 
and forcing them on jets, because "the damn things fly, don't they?"

     Still, many officials hide behind "the law's the law;" and there is 
likely to be some turf-protecting going on here.  Our mission is to 
provide continuing education for the Funeral Board and to continue to work 
this out without either endangering suspensions or engaging in a much more 
expensive discussion in court.

     These kinds of laws can come out of nowhere for any cryonics company.  
For instance, while California has no law defining "embalming" (that I 
could find), it does define "embalmer" as "one who is duly qualified to 
disinfect or preserve dead human bodies by the injection or external 
application of antiseptics, disinfectants, or preservative fluids...."  
(California Business and Professions Code 7640, added 1939, amended 1943, 
1955.)

     This could be used to provide a de facto definition of embalming in 
California every bit as aggravating as the one in Arizona.  Sometimes it 
is just the luck of the draw which official chooses to be aggravated at 
what time.  If you are from another state besides California or Arizona, 
you need to find out what variations on these laws could pose problems for 
you.


V.  REGULATIONS

     Not all problems are caused by statutes (laws).  Many can be created 
by obscure Department regulations added to support laws.  These may be 
harder to find and understand.  Alcor almost had a problem with this in 
Arizona, since one Department of Health Services regulation required dead 
bodies which had not been buried after 15 days to be placed in airtight 
containers.  We informed the Attorney General that such a requirement 
would invalidate most of the UAGA, since medical research cannot normally 
be completed in 15 days nor carried out in a sealed container.  
Fortunately, the Attorney General's Office agreed.  Still, there is a big 
lesson here.  If you're looking at doing cryonics transports or patient 
storage in another state, check the regulations as well as the laws.


*Other States*

     We don't *know* what the situation is like in most states.  No one 
has had the time or patience to look for similar laws and regulations.  
However, attorney H. Jackson Zinn has begun work on a legal guide to 
cryonics that will try to integrate the laws of the various states.  Let 
us know if you wish to help with this work by looking at laws in your own 
state.


*Out of the United States*

     As far as I am aware, most other nations do not have something 
similar to the Uniform Anatomical Gift Act, although they must have some 
way to handle organs for transplant.  It is hard to imagine the sort of 
regulations we will run into as Alcor and cryonics spreads into other 
countries.  We will need much assistance from the members in those 
countries.

[end]

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