Cryonics

Overview

The purpose of cryonics is to preserve human life and restore health. Today's medical technology can't always keep us alive, let alone healthy. A future medical technology based on a mature nanotechnology should be able to preserve life and restore health in all but the most extreme circumstances. Tissue preserved at the temperature of liquid nitrogen does not deteriorate, even after centuries of storage. Therefore, if current medical technology can't keep us alive we can instead choose to be preserved in liquid nitrogen, with the expectation that future medical technology should be able to both reverse any cryopreservation injury and restore good health.

A common misconception is that cryonics freezes the dead. As the definition of "death" is "a permanent cessation of all vital functions" the future ability to revive a patient preserved with today's technology implies the patient wasn't dead. Cryonics is actually based on the more plausible idea that present medical practice has erred in declaring a patient "dead." A second opinion from a future physician  one with access to a fundamentally better medical technology based on a mature nanotechnology  lets us avoid the unpleasant risk that we might bury someone alive.

The Debate

Each patient is a free agent entitled to full explanation and full decision-making authority with regard to his medical care. John Stuart Mill expressed it as: "Over himself, his own body and mind, the individual is sovereign." The legal counterpart of patient autonomy is self-determination. Both principles deny legitimacy to paternalism by stating unequivocally that, in the last analysis, the patient determines what is right for him. If the [terminally ill] patient is a mentally competent adult, he has the legal right to accept or refuse any form of treatment, and his wishes must be recognized and honored by his physician. American College of Physicians Ethics Manual. Part II: Research, Other Ethical Issues. Recommended Reading

The Ad Hoc Committee on Medical Ethics, American College of Physicians; Annals of Internal Medicine, July 1984; Vol. 101 No. 2, pages 263-267.

I, along with all of humanity, am terminally ill. I plan to treat this condition by cryopreservation when the symptoms of my progressive and otherwise untreatable illness become more severe. No hospital or physician will provide this service in the usual manner. I do not have the option of cryopreservation within the regular medical setting.

Alcor provides cryopreservation services, but has been forced, against my wishes, to perform this service only after I have been declared "legally dead".



The medical profession's proposed “treatment” is to either bury me alive or burn me alive. The medical profession attempts to force this upon me by declaring me "dead" at a point in time when my ability to dispute their claim is limited. However, their unilateral declaration that I am "dead" will be against my wishes, against a body of my written publications extending over decades, and against my publicly declared and publicly stated better judgment. Their declaration will be made despite there being good evidence that I could be revived in the future, and a striking lack of evidence that such revival is impossible.

What Should Happen: The medical profession should recognize and honor the rights of terminally ill (or legally dead) patients who wish to be cryopreserved and support their legal right to be cryopreserved regardless of circumstances.

The law should accept the right of such patients to be cryopreserved at a time and place and under circumstances of their own choosing.

Cryopreserved patients should be legally recognized as having appropriate rights, including the right to remain cryopreserved, the right to be revived if and when this becomes possible, and the right to own such property in trust as they or others might designate.

Those who wish to deprive the terminally ill of the right to be cryopreserved in the manner they desire must, at the very least, prove, beyond a reasonable doubt, that cryonics does not work. The terminally ill deserve at least the rights of accused murderers. Given the abundant evidence supporting cryonics, finding such proof will be very difficult.

Those who argue against the rights of the terminally ill and the cryopreserved should be called cryonics deniers. They say it won't work, but offer no evidence in support of their claim, let alone proof.

Evaluating cryonics

The main reason that cryonics isn't viewed more favorably by the medical community is easy to explain. Medicine relies on clinical trials. Put more simply, if someone proposes a method for saving lives, the response is "Try it and see if it works." Methods that haven't been verified by clinical trials are called "experimental," while methods that have been tried and failed are rejected.

In keeping with this tradition, we'd like to conduct clinical trials of the effectiveness of cryopreservation to determine whether it does (or does not) work. The appropriate trials can be easily described. Cryonics proposes to cryopreserve people with today's technology in the expectation that medical technology of (say) the year 2119 will be able to cure them. Thus, the appropriate clinical trials would be to:

Select N subjects. Cryopreserve them. Wait 100 years. See if the technology of 2119 can indeed revive them.

While this problem is not entirely unique to cryonics (the plight of a dying patient who wishes to know whether or not to take a new experimental treatment is well known), cryonics poses it in a qualitatively more severe fashion: we must wait longer to determine the outcome and we have no preliminary results to provide a clue about what that outcome might be. If a new treatment is being tested we normally have the results of animal trials and perhaps some preliminary results from human patients. Further, we expect to get reliable results in not too long. In the case of cryonics, we are quite literally awaiting the development of an entirely new medical technology. Preliminary results, even on experimental animals, are simply not available; and the final results might not be available for many decades.

Thus, while we can begin the clinical trials required to evaluate cryonics today, clinical trials cannot provide a timely answer about the effectiveness of cryonics. It is not possible (utilizing the paradigm of clinical trials) to draw conclusions today about whether physicians tomorrow will (or will not) be able to revive someone who was cryopreserved using today's technology.

The correct scientific answer to the question "Does cryonics work?" is: "The clinical trials are in progress. Come back in a century and we'll give you an answer based on the outcome." The relevant question for those of us who don't expect to live that long is: "Would I rather be in the control group, or the experimental group?" We are forced by circumstances to answer that question without the benefit of knowing the results of the clinical trials.

When we think about this question, it is important to understand that future medical technology will be no mere incremental or evolutionary advance over today's medicine. Think of Hippocrates, the prehistoric Greek physician, watching a modern heart transplant. Advances in medical technology in future decades and centuries will be even more remarkable than the advances we have already seen in centuries past. At some point in the future almost any infirmity that could in principle be treated is likely to be treatable in practice as well. In principle, the coming ability to arrange and rearrange molecular and cellular structure in almost any way consistent with physical law will let us repair or replace almost any tissue in the human body. Whether it's a new liver, a more vital heart, a restored circulatory system, removing some cancerous cells, or some other treatment -- at some point, nanomedicine should let us revitalize the entire human body and even revive someone who was cryopreserved today. We can describe today, with remarkable certainty, the ultimate capabilities of medical technology. While the technological route and development time might be uncertain, we will eventually be able to evaluate the molecular structure of your cryopreserved tissues, and restore every molecule to where it belongs in your healthy body. The expected eventual feasibility of such future capabilities makes the credibility of claims that cryonics won't work hard to take seriously.

Is the treatment worse than the disease?

What to do

Cryonics Payoff Matrix It works It doesn't work Sign up Live Die, lose life insurance Do nothing Die Die

How might we evaluate cryonics? Broadly speaking, there are two available courses of action: (1) sign up or (2) do nothing. And there are two possible outcomes: (1) it works or (2) it doesn't. This leads to the payoff matrix to the right. In using such a payoff matrix to evaluate the possible outcomes, we must decide what value the different outcomes have. What value do we place on a long and healthy life?

What does cryonics cost and what (presumably negative) value do we place on being dead? And finally, in the absence of direct experimental results in one direction or the other, what estimate do we make of the chances that it will work? Athough this analysis has been compared with Pascal's Wager, it avoids the logical problems that beset the latter.

When evaluating the possible outcomes, it's important to understand that if you sign up and it works, that "Live" does not mean a long, wretched and miserable life. Many people fear they will wake up, but still suffer from the infirmities and morbidities that the elderly suffer from today. This is implausible for two very good reasons. First, the kinds of medical technologies that are required to restore today's cryonics patients will be able to restore and maintain good health for an indefinite period. The infirmities of old age will go the way of smallpox, black death, consumption, and the other scourges that once plagued humanity. Second, as long as we are unable to restore cryopreserved patients to satisfactory good physical and mental health, we'll keep them cryopreserved until we develop better medical technologies. To put these two points another way, when that future day arrives when we have a medical technology that can revive a patient who was dying of cancer today, and was cryopreserved with today's technology, that same medical technology should be able to cure their senile dementia and restore their musculature; they'll walk out into a future world healthy in mind and body. If we can't restore full health to both mind and body, we'll keep our patients in liquid nitrogen until we develop a medical technology that can.

It's also important to understand that technology is moving rapidly, and accelerating. When you wake up, your children and your younger friends and acquaintances are likely to be alive and well, along with most of your awakened friends from the cryonics community. While several decades might have passed, your social network within the cryonics community will still be there and likely many of the younger members of the rest of your social network.

Present successes

Summary

At some point in the future we will have direct experimental proof that today's cryopreserved patients either can or cannot be revived by future medical technology. Unfortunately, most of us must decide today if we wish to pursue this option. If we wish to gain some insight today about the chance that cryonics will or will not work we must consider several factors, including most prominently (a) the kinds of damage that are likely to occur during cryopreservation and (b) the kinds of damage that future medical technologies might reasonably be able to repair. Those interested in pursuing this subject should read this web page which discusses the chances of success and The Molecular Repair of the Brain.

This page is part of Ralph C. Merkle's web site.

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