X-Message-Number: 7584 Date: 28 Jan 97 21:05:50 EST From: Mike Darwin <> Subject: SCI.CRYONICS Response to Fred Chamberlain Fred Chamberlain raises a number of points in his posts to Cryonet (#7564 and #756X) which I would like to discuss further. First, I wish to agree that the tone and some of the comments in Steve Harris' post regarding Visser and Alcor were unproductive. The substantive issues in Steve's post were the very real concerns relating to Ms. Visser's putative AIDS treatment/cure and the way its release, promotion, and prospective funding have been handled. Unfortunately, I think the context of Steve's post degraded his real message. Having said this, I would like to deal with some specific statements Fred Chamberlain has made: >The Visser technology can do nothing to improve the >state of affairs for the frozen patients, since they are >suspended with other cryoprotectants. Pursuit of the >Visser technology, thus, was exclusively for the benefit >of the living members, paid for by *research donations* >given by those living members, and by their dues. In my years at Alcor a great many things were done to benefit frozen patients which were not intended to _immediately_ improve their condition. Yes, patients treated in the past and cryopreserved now cannot directly benefit from a new cryoprotectant. But, to suggest that benefits from advances in technology (or liabilities from them!) are confined to the living is, at best, naive. It takes little imagination to conceive of the positive impact on the general well-being, financial security and market share of any cryonics organization (nonprofit or for-profit) which gains exclusive access to vastly improved methods of cryopreservation and/or suspended animation. In fact, both CI and Alcor noted that their agreement with Visser was "exclusive." Exclusive agreements are made precisely because they often carry with them powerful economic leverage. I think most people would agree that their chances of survival as members and patients are improved by having a cryonics organization that enjoys financial and technical leadership, as opposed to being in a position of poverty and technical inferiority. It then, of course, becomes a "gray area" as to where exactly the line is drawn between _direct _ benefit to cryopreserved patients and _indirect_ benefit as a result of increased credibility, solvency and market share from activities such as biomedical research, cryogenic (storage) research, promotion, public relations, and so on. Fred goes on to say: >To state that Alcor doesn't care about its patients, in fact >to put this in obscene terms, is to say that we do not care >about our own relatives, our own friends who are among >those patients, and about those living relatives of those >patients who are counting on Alcor to keep them safe from >the sort of destruction which could come about from taking >extraordinary risks to marginally improve suspensions in a >select number of cases. I can understand Fred's anger at what he correctly perceives as Alcor's ethics being impugned. However, the matter in question here is unfortunately, as is so much in life, not so simple, no so black and white or all or nothing. Fred states regarding Alcor's duties to its members and patients that it is (sic) incumbent upon "Alcor to keep them safe from the sort of destruction which could come about from taking extraordinary risks to marginally improve suspensions in a select number of cases." This statement looks like a fine and unarguable one. But, to evaluate it we must "check its premises" to quote Ayn Rand. When Fred talks about "extraordinary risks to marginally improve suspensions in a select number of cases" being taken he opens himself to a number of questions which I now ask of him: 1) The first and foremost is what constitutes "marginal improvement" and "extraordinary risks?" These seemingly straightforward statements rest, in fact, on context and value judgements which are not very clear cut and are often situational. 2) For instance, would Fred consider sparing a patient 4 or even 6 hours of normothermic cerebral-cortical ischemia a "marginal improvement?" If so, what evidence does he have that this period of ischemia is trivial or will not result in failed cryoprotective perfusion in large areas of the brain, and autolysis of many neurons and degradation of the neuropil, and an ultrastructurally far worse outcome (as evaluated in both the frozen and the post-thaw states)? 3) If a loved one of Fred's were to experience cardiac arrest at home during a blizzard (such as the one that immobilized the Tahoe area just a few days ago, where Fred used to live) hours away from rescue or outside help would it be worth the risk to inject that person (post mortem) with heparin to prevent clotting, remove their clothing and pack them with snow in the bath tub in order to minimize ischemic injury? Would these interventions be worthwhile even if they had the potential to trigger medico-legal intervention at worst, or a firestorm of negative press and questions over such a "bizarre" practice at best? 4) Is the very real risk of premedicating a patient with, say vitamin E and other over the counter "nutrients" worth the benefit? How much benefit is there in premedication? How much risk? I would like Fred to answer these questions. And, in fairness to Fred, I will tell you that my thoughts on these matters have evolved a great deal as I have struggled with them and confronted them personally. My own conclusions are that a lot depends upon your own situation. If it is your wife or your child or your husband your horizon of "acceptable risks" expands considerably. If it is someone else's loved one and their actions could jeopardize _your_ well being or that of someone you love (either cryopreserved or clearly alive today) then your criteria are likely to be a lot more conservative. This is known as the problem of the commons and it is a knotty area and one in which all or none solutions usually do not work well. This is frustrating to engineers and people who do not deal well with "fuzzy" situations. In fact, it is frustrating to human beings in general who as a rule, usually want at least clear choices and not complexity and equivocation. Fred concludes his post by saying: >Alcor cares enough about its patients, both those who are already >suspended and those who might soon be suspended, to avoid >working relationships with those who are inclined to take >extraordinary risks, even at the cost of losing the services of >some persons, such as Dr. Harris, who clearly have a great deal >of valuable technical knowledge. >Cryonics is not a one year or ten year proposition. We must >see our patients through many decades ahead to a time when >it may turn out that even severely compromised patients can be >fully recovered by repair methodologies, or, when it may turn >out that only those who have suspensions well beyond any >present or near term technology will have severe losses of >memory and identity. But however it turns out, we must *see >them through* and provide an adequate standard of care for all >patients, even those who receive less than optimum suspensions >for the technology available at their points of suspension >(due to circumstances, legal intervention, or non-availability >of the highest possible technology). These are fine and eloquently written sentiments with which I think most of us involved in cryonics would heartily agree. But these sentiments alone are not very useful. They are like saying: "I want to be a good person!" Most people do. But it is not intent or desire that are at issue here. It is specific risks such as euthanasia (both active and passive), premedication, civil disobedience, and legal but extremely antagonistic challenges to the medico-legal and political system which have to be weighed and considered in the context of just _who_ will likely benefit and _who_ will likely be harmed? And, to make matters worse, just how "likely" (i.e., what is the probability) that harm will occur and if it does, how bad it will be and how it will be distributed? Without a consideration of these specific questions and specific situations what we have is political rhetoric with someone cast as the bogeyman and a set of ideals (safe and quality care for members and patients, which all parties in the debate can agree with the need for!) used by either side against the other. It is ironic that Fred goes on to respond to Brian Wowk's call for a change in emphasis in the paradigm in cryonics (the tension between improved cryopreservation methods versus recruitment of new members and patients) by noting _exactly_ the sort of relativism and the acutely personal or "situational" nature of making such choices: >Finally, even with the availability of perfected vitrification or even >perfected suspended animation, there will be persons suspended (into the >indefinite future) who will be severely compromised, due to circumstances or >the intervention of legal authority. Perhaps at such times there will be >criteria which create so much confidence that certain classes of cases are >"hopeless" that (in those cases) no cryonic suspension will even be >attempted, or the patients will be suspended, evaluated, and then >desuspended. We do not presently have such criteria, other than might be >established on an individual preference basis, (again, such as "Don't >suspend me in the event of more than 24 hours warm ischemia.") >WILL WE EVER KNOW WHICH CASES ARE "HOPELESS"? >Will we ever have so much confidence that we will fail to suspend certain >classes of cases, other than as determined by personal preferences? That is >a matter for speculation. My inclination is to anticipate that (barring >personal preference prohibitions) we will always preserve whatever we can, >but that the "whatever" will evolve to fit certain reanimation scenarios (in >the very worst cases) such as cloning and information based "memory/identity >synthesis", which are (at present) just as speculative and unconventional as >the postulation of molecular markers where we cannot presently observe them. >Even after suspended animation is perfected, I would expect "less than >perfect" preservation scenarios to be driven by personal preferences, rather >than being mandated by controversial philosophies debating "who we can save >and who we cannot". The standards established by personal preferences might >be in terms of recovery criteria...(lists criteria) Here Fred runs the argument in reverse. He says in effect, "look, what is considered an acceptable course of action here is almost completely dependent upon the situation and values of the person making the decision. Here again it is hard to argue with Fred's logic. But once again we must examine the premises implicit in the above remarks. The above remarks made by Fred do not address any costs (psychological, financial, social, political, moral, ethical or otherwise) that are associated with human cryopreservation. For instance, some people are only willing to put up with the costs and inconveniences of cryonics under certain circumstances. In fact, I submit this is true of almost all, if not all cryonicists. For instance, very few cryonicists would choose to have their ashes stored in liquid nitrogen in hope or anticipation of revival if they were inadvertently cremated! However, between cremation and hopping up on the operating table while in perfect heath to be frozen _now_ lies a vast sea of gray. The fact is that there are tremendous financial (and perhaps more importantly) non-financial costs associated with cryonics. The longer I have practiced cryonics, the more I have come to appreciate these other costs; costs measured in anxiety, worry, ruined relationships, disrupted medical care, and even early death. These costs are not trivial. Tacit also in Fred's discussion above is that there are no real or potential "community" or "shared" costs (i.e., problems of the commons) involved in cryopreserving members or nonmembers under very unfavorable conditions. The costs of this could be quite high, depending upon the situation. These may be immediate and direct such as litigation, adverse publicity, violent retaliation by next of kin or authorities, or they may be more indirect. Implicit in Brian's argument is that there have been and continue to be substantial costs involved in the cryonics paradigm which Fred has articulated above. One problem with cryonics is that it is fundamentally not science. There is a powerful price to be paid for this. Science rests not upon what can be _disproven_ but rather upon what can be _proven_. This means that a core part of science is that statements or claims made must be testable; must be reproduceable by others using the same methods, technologies and conditions. This keeps things from spinning out of control. In modern parlance it constitutes a "reality check." This is so because it is not possible to disprove negatives. Cryonics rests not on _what is_ so much as on _claims_ about "what will be or what could be based on current insight." This is very different than saying "look, with procedure X I can take a person in Y specified condition and recover them from liquid nitrogen temperature Z percentage of the time." Fundamentally, cryonics rests on the unknown. We have no particular way at this time of proving that a given situation is hopeless. So, all comers are candidates and whatever we can scrape up or otherwise get hold of we freeze (If that was the person's wishes). Fair enough. But let's not fail to understand the hidden price we are paying for that and let's not mistake cryonics for science. Cryonics is speculation _about_ science and individual cases may be regarded as experiments. But cryonics is not conducted in the framework of an experiment. It is conducted as an enterprise aimed at saving our lives and the lives of people we care about. And it is free from meaningful real-time feedback and thus can be (and often has been) extremely mischievous. When you have no "testable system" you have no objective criteria with which to make decisions, and Fred goes on at some length about this, ultimately concluding that it's everybody's guess. So be it. However, lack of objective criteria leads to lack of consensus and that leads to conflict in human affairs. This is especially so when such a belief structure is wedded to deeply emotional issues such as personal survival, morality, and the wellbeing of family and friends. One has only to look at cryonics' kissing cousin, religion, to understand what untestable claims can do. What Brian is arguing for is what I proposed myself when I first came out from under the ether of seeing cryonics as a "you can't lose" proposition" and as a clinical science. It is certainly true that you cannot disprove a negative. And it is certainly true that we can't be sure that even someone with 24 hours of ischemic time who is cryopreserved today isn't going to come back without so much as a scratch. But, just as there is a large territory between being cremated and being cryopreserved under optimum conditions, so too there is a large territory between no objective criteria for successful cryopreservation and fully reversible suspended animation. What Brian is saying is that we need to call a spade a spade. Cryonics as it is currently practiced and pursued has terrible problems associated with it. Yes, as Fred points out, these problems are not likely to go away on any event horizon we can now foresee. But this is not say that things cannot be vastly improved with the shading of that gray territory moved closer to the light and away from darkness. Continued pursuit of cryonics as it was first articulated in 1964 is no longer tenable. Such a course is too free of meaningful feedback and leads to deceit of one's own self first, and then deceit of others as a more or less inevitable consequence. It leads to bad shipbuilding because of the comforting premise that "there will be lifeboats on board" the vessel. It leads, in fact, to statements like the following one, which appeared in the last issue of the _Alcor Phoenix_ describing Linda Chamberlain's beliefs about the cryopreservation of her mother and father-in-law in the context of what she wishes for Alcor and its members: "Had Alcor not been ready, they both would have been lost. Instead, they are both on their way into the future." Regrettably, we do not yet know whether they are "lost" or not, or are "on their way into the future" or not. A more accurate statement would be that we _hope_ they are both on their way to the future. The more we separate un-disprovable hope and conjecture from provable advances in cryopreservation, the better the situation will become for everyone who wants, as the endpoint of cryonics, survival and indefinitely long life in good health. --- Mike Darwin, BioPreservation, Inc. 10743 Civic Center Drive TEL: (909)987-3883 Rancho Cucamonga, CA 91730 FAX: (909)987-7253 Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=7584