X-Message-Number: 7480
Date: 10 Jan 97 23:23:58 EST
From: Mike Darwin <>
Subject: Euthanasia and autopsies


Robin Helweg-Larsen suggests some firsts steps in dealing with ME's cases.  This
is constructive as it constitutes the first time someone has done more than I
and others have, which is to moan about the problem (albeit, a useful first
step).

Euthanasia first:

There are many possible approaches to dealing with this problem.  I favor a
straightforward acknowledgement of it early on, and the preparation of FACT
SHEETS or discussion of the issue in the primary literature cryonics
organization's use.  For instance, if I were writing CRYONICS: Reaching for

Tomorrow all over again, I would include at least two new chapters.  One chapter
would deal extensively with the unapparent or "hidden" costs of cryonics
(lifetime outlay large amounts of money, prejudice against getting into
experimental treatment programs when dying, anxiety about arresting under good

circumstances, family problems, etc.).  The other chapter would deal with active

and passive euthanasia and would inform prospective members, the public, and the

press of the personal, ethical, legal, logistical, and public relations problems
associated with these choices.  I would also do what I planned to do before I
left Alcor which was to append several case histories of actual patients which

highlight the very serious ethical and legal problems cryonics can create.  What

do you do if you're faced with a choice between a bowel resection that might buy
you a year or two of added quality life, but at the cost of getting
cryopreserved?  With viatical companies buying life insurance policies for cash
this becomes a real option!  In fact, CryoCare and BPI were already confronted
with just such a case (although insurance was not at issue).

I think it is important to have open discussion up-front because then the media
and the public know we are thinking about such issues and that we are dealing
with them honestly and openly.  Most importantly, if the discussion is handled
right, issues confronted by cryonicists regarding euthanasia can be related to
similar situations confronted by noncryonicists.  For instance, many

noncryonicists will have to make decisions to stop treatment to safeguard values
they hold higher than a few months of relatively low quality life.  There are
many other analagous situations that people confront today irrespective of
cryopreservation arrangements.

Finally, I think all responsible cryonics organizations and service providers
should at least _try_ to sit down and come up with some general guidelines
dealing with these issues.  It is not sufficient to say "Well, we just won't

discuss the fact that this dying patient is dehydrating because they want a good
cryopreservation."  That won't work.  Family that is very supportive of this
decision at the time may turn on the cryonics organization with time.  Family
hostile to cryonics from the start may make an issue shortly after the patient
is cryopreserved.  Trumped up accusations of mental incompetence or actual
malfeasance may be used.  This is no idle issue, since many patients who elect
to "die early" by dehydrating are doing so because they have brain involvement

(primary brain tumor, metastases, stroke, etc.) in their disease and do not want
it to get worse.  This opens the door to the issue of mental competence.  And
that issue cuts both ways.  In two cases (Dick Jones and Jeannie Curran) people
who were clearly incompetent were ruled competent by the courts.  The reverse
not only can happen, but I predict inevitably WILL happen.

If cryonics grows more popular it will begin to cause social and economic
dislocation.  I have already seen poor family members (people with minimum wage

jobs) spend virtually all available cash from their loved one's esate to get the
badly decomposed body of their relative cryopreserved.  There will be more of

this, and great resentment will be generated by diversion of resources from next
of kin to cryonics organizations.  I predict that the issue of passive
euthanasia in the context of cryonics will be made a major issue in the courts.
Preparation for this needs to start now, and open discussion of these issues,

and more importantly, a _history_ of such open discussion will, I believe, serve
cryonics organizations well.

Medical Examiner's Cases:

If you want people to meet your expectations or satisfy your needs, the first

step is to articulate those expectations and needs clearly.  There are certainly

many things that would go a long way towards helping improve the quality of care
delivered to cryopatients who become ME's cases whether they are autopsied or
not.  Here are some thoughts in no particular order:

1) A nonthreatening fact sheet for Coroners and ME's needs to be made available

which provides basic background on cryonics, and suggests simple things that can
be done to facilitate cooperation and avoid trouble.


2) Getting agreements from State and national organizations of ME's and Coroners

to recommend allowing implementation of simple things like direct ice cooling at

the time of death or discovery, beginning the PM exam in the anatomical location
most likely to yeild cause and mode of death in non-criminal cases, and

arranging for prompt transport and prompt release of cryopatients would be a big
first step.

3) Getting data from noninvasive means is another item that can also be laid on
the table.

However, it has to kept in mind that people do not surrend power or authority
easily.  Coroner's and ME's have great power and take great satisfaction from
their work -- work which is both scientifically intensely interesting and
socially useful.  It remains the case that their interests and those of
cryopatients will often be at serious odds with each other.  This understanding
is pivotal because it tells cryonicists that negotiation will go only so far,

and further, that if cryonics grows in popularity it will likely cause a serious
backlash in medicolegal circles.

Finally, I have spoken of the high cost of cryonics in my recent posts.  I wish
to elaborate a little:  cryonics upsets, overturns and distorts the social
fabric in a way few things can do.  It impacts third parties more than abortion
or pornography do, and it disrupts conventional ideas about death, inheritance,

privacy, and immortality.  It will cause a "graying" of criteria for "when death

is"  in a way that makes abortion's shading of the criteria for "when personhood
is" pale by comparision.  While the social system is elastic, it also has
recoil.  We are in the elastic phase now (after a previous SMALL distortion and

recoil).  But it will not last.  People who deform the system beyond its elastic
boundaries permanently usually pay a high price for this.  Bruno, Gallileo,

Vesalius, Goddard, Semmelweiss... I could list pages of people who stretched the

system to its breaking point.  True, there are people like Darwin (who set off a
powerful corrosion of Judaeo-Christian values) who escaped relatively unscathed
(he wisely stayed away while Huxley did the dirty work ;-).  And there were
people like Copernicus who waited until they were safely dead before unleashing
their socially corrosive ideas.

Cryonics is a very mischevious idea and a very corrosive one to the existing
social, political and moral order.  It removes one more absolute from life: the
certainty of death in a fixed period of time.  This will be a very disruptive
thing to do, and thus will cost those who will do it a LOT.  In fact, I think
many people interested in cryonics instinctively understand this and avoid more
active involvement for this very reason.

In mechanical systems the recoil which occurs after distortion is understood as
a manifestation of the law of conservation of matter and energy.  In social
systems, a similar law operates.  I submit that you cannot overturn the
fundamental basis of this civilization without a fair amount of cost (or energy
expended). So, the first thing that needs to be brought to the table in any
discussion of these tough issues is an awareness that doing what cryonicists
want to do isn't going to be the equivalent of an ice cream social.  If you

think you're going to get cryonics at bargain basement prices there is simply no
basis for meaningful discussion.

This is the root of a great deal of trouble in the world at large, and the
cryonics community in particular.  As Bob Dylan said: "It may be the Devil, or
it may be the Lord, but you gotta _serve_ somebody."  

Mike Darwin


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