(Crossposted from Depressed Metabolism)

Today is the second anniversary of Depressed Metabolism. As of writing, this website has close to 200 feed subscribers. On an average day the website has 150 unique visitors, which is an encouraging increase in traffic since our last update. This is even more remarkable in light of the fact that new blog entries with social and political themes have been eliminated and given a new destination on the separate blog Against Politics. The emphasis of Depressed Metabolism remains cryonics advocacy and life extension from a secular, empiricist perspective.

Our most popular piece since our first anniversary was “Is That What Love is? The Hostile Wife Phenomenon in Cryonics,” a review of the phenomenon of hostility of (female) partners and relatives towards cryonics, co-authored by Mike Darwin, Chana de Wolf, and Aschwin de Wolf. This article was not only widely discussed on cryonics forums, but was made the subject of a blog entry by the economist Bryan Caplan on the widely visited libertarian-leaning EconLog blog. We have refrained from commenting on discussions about the piece. An interesting pattern we observed, though, is that most people who have cryonics arrangements, and a long history of cryonics activism, praised the article for documenting a disturbing aspect of contemporary cryonics, while those who are observing cryonics from the outside paid more attention to some of the “politically incorrect” themes in the piece.  Since we wrote this article, there have been new cases of hostile relatives interfering with a “loved” one’s cryonics arrangements, in one instance leading to irreversible death. Hostility from (female) partners remains a non-trivial problem in cryonics. As of writing, we are aware of two major improvements in cryonics that cannot materialize because of intense partner hostility to the idea of cryonics. In any case, it has become clear that cryonicists and those sympathetic to the right to choose cryonics have a lot of work ahead in protecting vulnerable patients from greedy, ignorant, and insensitive relatives.

Another piece that generated a lot of traffic was “The political philosophy of bailout,” a brief meditation on the authoritarian and teleological mindset that was displayed during the debates about bailing out failed companies and policies to stimulate the economy. An alternative to looking at society, or “the economy,” as a tool that needs to be manipulated by experts (technocrats) to optimize the common good is the work of social philosopher Anthony de Jasay on the presumption of liberty. These pieces were followed in November 2008 by a three-part series on the mysterious phenomenon of voting, the widespread addiction to politics,  and the idea of a depoliticized society.  Recognizing the disadvantages of too much social and political content on a blog that is supposed to be about cryonics and life extension, the old website Against Politics was re-launched as a blog to cover these topics.

By far, most of the blog entries and articles dealt with the philosophy, science, and practice of human cryopreservation, ranging from the publication of historical cryonics documents to discussions of technical and practical problems facing cryonics today. Some of the most important entries include the use of sugars in organ preservation solutions, life in non-aqueous solutions, cryonics in the United Kingdom, perfusion impairment in cryonics patients, cryonics as an example for emergency medicine, the sensationalist reporting on “suspended animation” research with hydrogen sulfide, and a series of technical entries about the resuscitation of rodents from hypothermic and subzero circulatory arrest by Chana de Wolf. Aschwin de Wolf posted a blog entry about the lack of relevant empirical research in cryonics, which prompted an informed response from Mike Darwin. Both authors agree that cryonics care could be greatly improved if more research would be carried out in models that incorporate the warm- and cold ischemic insults that characterize most, if not all, cryonics cases. There is a real need for what is called Evidence Based Cryonics, as opposed to mindlessly extrapolating procedures from conventional medicine in the expectation that what will work for (relatively) healthy patients will work for cryonics patients as well. After the landmark interview with Ben Best, Depressed Metabolism published an interview with Regina Pancake, Alcor’s Readiness Coordinator and one of the most dedicated cryonics activists around.

There are lot of misunderstandings about cryonics but some of them are even shared by those sympathetic to, or signed up for, cryonics. Five dangerous ideas about cryonics were discussed in a piece in January 2009. The ongoing logistical and recruitment issues that characterize cryonics were discussed in a contribution about the emergence of local cryonics. Last, but not least, Mike Darwin contributed a series of articles on new developments in cardiopulmonary resuscitation and its relevance to cryonics.

The fate of cryonics is inevitably bound to the fate of  science in general. To distinguish scientific reasoning from mere speculation, wishful thinking, and excessive rationalism, it is important to encourage a culture in which logical reasoning and empirical research are recognized as important tools for understanding the world around us. This vision was clearly expressed by logical empiricist thinkers like Rudolf Carnap and Hans Reichenbach during the first half of the 20th century. Five classics of empiricist philosophy were featured on Depressed Metabolism to introduce readers to the enduring relevance of empiricism an an outlook on science and life. A passage in Nassim Nicholas Taleb’s seminal book Fooled by Randomness was used as a starting point for a critical note on the critical rationalist philosopher Karl Popper.

One of the major obstacles to adopting a scientific conception of the world is the wide-held view that sciences that are based on physics (such as chemistry and biology) have little to offer to the study of society or public policy. As a consequence, many debates on these topics are as enlightening as medieval scholasticism.  Recent advances in neuroscience and genetics provide strong support for the  thesis of the Unity of Science, a theme that will be explored in more detail on this website in the future.

As mentioned in our First Anniversary post, running a blog is less expensive than publishing a paper magazine but not costless (e.g., website hosting, domain registration, reproduction of papers and book chapters, etc). The work we have done for the blog has been very rewarding but often very labor-intensive and time consuming. Please help us keep the blog running and click on the “donate” button on the right sidebar (below) to give a Paypal donation or purchase books featured on this website through the links to Amazon. Thanks for your support!

(Crossposted from Depressed Metabolism)

Real estate is all about location, location, location. Location matters in cryonics as well.

The objective of standby and stabilization in cryonics is to limit injury to the brain after pronouncement of legal death. Unfortunately, many cryonics patients have not been stabilized promptly after pronouncement of legal death because the cryonics organization did a poor job of tracking the health condition of its members, was not made aware of the pending death of a member, or the case was one of rapid decline or sudden death. In other cases, the cryonics organization was aware of the critical condition of the patient but was faced with the challenge of providing services in a geographical area where few other cryonics advocates live. This creates a non-trivial challenge because premature deployment of a standby team can expose the cryonics organization to a prolonged standby in which resources are “wasted” but delayed deployment can arrive too late for the patient to receive meaningful stabilization procedures. Even in cases where a cryonics standby team is able to intervene promptly after cardiac arrest, the distance between the location of stabilization procedures and the cryonics facility in combination with the legal and logistical challenges of transporting a patient across state lines produces harmful periods of cold ischemia.

Some members who have recognized these challenges have decided to relocate to the state, or even the city, of their cryonics organization. As a general rule, these decisions are made when the member in question has retired or recognizes a high probability that the cryonics organization’s services are needed in the near future. As a consequence, the Phoenix/Scottsdale area has a larger proportion of (retired) people with cryonics arrangements than could be expected based on location alone.  So far this phenomenon has not really caught on with  Cryonics Institute (CI) members, although the desire of relocating to Michigan is a recurrent topic in discussions among CI members. In a sense, the issue is even more important for CI members because the organization itself does not offer standby and stabilization services. Unless a person has made arrangements with another organization for such services, CI members should expect non-trivial periods of warm and cold ischemia, producing brain injury and perfusion impairment during cryoprotectant perfusion (if perfusion is possible at all) as a consequence.

A useful medical analogy for this situation is to picture the fate of a critically ill person in a state with limited medical emergency services, who, after a 911 call, needs to be flown thousands of miles across state lines to a medical facility without the possibility of treatment during transport. It should not be surprising, then, that some people who have recognized this problem advocate that cryonics organizations should be local in nature. Not only in the sense of building a strong local community and emergency response system, but also by strictly confining itself to members in that area. A technical criterion to determine the area of coverage for such a cryonics organization is that the service area of the cryonics organization should not exceed the distance that, in principle, permits stabilization of a patient without loss of neurological viability of the brain by contemporary criteria.

The vision of a cryonics organization that confines itself to a specifically defined geographical area (a state or a few neighboring states) raises many practical questions but the most important question concerns its financial feasibility. Can a cryonics organization that confines itself to one state support itself and its operations? On the one hand, one is inclined to answer this question in the negative because the absolute number of people interested in cryonics is so small that even cryonics organizations that accept members from all parts of the world remain dependent on (large) donations and bequests to sustain their operations. On the other hand, a cryonics organization that operates in a strong local community of life extensionists can draw upon the enthusiasm of its members, the resources available to them, and focused regional outreach efforts.

Location is also important to cryonics because it can make or break the prospects of a viable cryonics organization. One major problem facing cryonics today is that the locations of the two major cryonics organizations (Alcor and the Cryonics Institute) offer little appeal to (young) people who could make a contribution to the science and practice of cryonics. This is not just conjecture. Alcor has great problems in attracting talent to Arizona (as evidenced by the ongoing saga of finding a suitable CEO). People who turned down offers to become more involved with Alcor (or those who left) have mentioned location as the most important reason. The situation is even worse because a number of people who are involved with Alcor in Arizona are known to dislike the location and have indicated their desire to move on in the future. Suffice it to say that such a situation limits the prospects of recruiting skilled people with long-term commitments to the organization.

The first thing that should be done is to recognize the problem and take it seriously. After this happens, efforts can be made to stimulate areas of vibrant cryonics activity with the objective of drawing more people to them. One development that is striking is that locations with a strong “cosmopolitan” identity such as New York and the Bay Area have no or little serious cryonics activity going on any longer. This is particularly painful in light of the fact that these areas have been historical hotbeds of cryonics activity. Good and dependable cryonics capabilities cannot be created overnight but there are no obstacles for creating  local organizations with a strong emphasis on education and local response capabilities.

Another important reason for creating strong local cryonics and life extension communities is  to reduce the vulnerability to political and legal events that threaten the operation of a cryonics organization. The importance of diversifying risk, and the limited ability for cryonics organizations in the US to deliver good stabilization services in Europe, is one of the major reasons why European cryonicists should be encouraged to create their own cryonics facility, complemented by basic standby and stabilization capabilities in other countries.

In the United States the author has been involved in stimulating vibrant cryonics activity in Portland, Oregon which so far has culminated in the rejuvenation of local cryonics meetings, a viable research program, and the formation of a non-profit organization to educate the general public about the benefits of cryonics. Other plans that are currently being pursued by other people in the region include the fabrication and acquisition of stabilization equipment and even preparations for the formation of a viable cryonics organization. It is hoped  that these developments will motivate more people to move to Oregon or stimulate people in other parts of the country to engage in similar activities.

(Crossposted from Depressed Metabolism)

The 2008-3 issue of Alcor’s Cryonics Magazine contains a number of articles about the pitfalls of (excessive) scientific optimism and its potential adverse effects on the organizational and practical aspects of cryonics. My own contribution contrasts cryonics as medical conservatism with the kind of scientific meliorism that is often associated with movements such as transhumanism and singularitarianism. In particular, I express reservations about the arguments that intend to show that reversible cryopreservation and resuscitation of cryonics patients is inevitable because the required technological advances do not contradict our current understanding of the laws of physics. Instead of relying on abstract “rationalist” arguments I propose to focus more strongly on generating and disseminating empirical evidence that people who are engaged in science and medicine today will find persuasive, especially as it pertains to revising our contemporary definitions of death.

The same issue also contains an important contribution by Glen Donovan about the relationship between science and cryonics. Is cryonics a science? If it is not a science, what is it? This piece discusses cryonics from the perspective of the philosophy of science. This is an approach that has received little attention to date but it seems to me that the status of cryonics and its associated research programs can benefit from  discussing cryonics utilizing the tools and concepts of analytic philosophy. In particular, one project that could constitute an  important contribution would be to give specific empirical meaning to a concept like information-theoretic death.

Aschwin de Wolf – Scientific Optimism and Progress in Cryonics (2009)

(Crossposted from Depressed Metabolism)

According to this news item the Alcor Life Extension Foundation is taking legal action against the brother and sister of an Alcor member who “denied the foundation’s request for his body and didn’t notify them of their brother’s death until months after he was buried.” Although some may question the wisdom of pursuing this case in light of the current condition of this Alcor member, Alcor is honoring its contract with the member. As Reason points out in this excellent post about the issue:

I can only imagine that the lawsuit is being undertaken as a point of principle and for the purposes of education: don’t break contracts with Alcor or this will happen….Switching around a family member’s post-mortem arrangements is little different from bullying and controlling folk who are too old and frail to defend themselves. In the case of acting to prevent cryopreservation that was organized and chosen by the deceased, it becomes something like fractional murder: removing that person’s shot at whatever the unknown probability of future revival happens to be.

Spouses and relatives of an Alcor member should not feel confident that if they hide the death of an Alcor member long enough to make cryopreservation no longer meaningful or practical that the cryonics organization will just give up and refrain from pursuing the case. There have been too many cases where hostile, greedy, or indifferent relatives have frustrated the wishes of a person who wants to be cryopreserved. Cryonics organizations should not even give the semblance that this is something they let people get away with. Alcor is to be commended for fighting back and honoring this member’s wishes, even in the most miserable of circumstances.

This episode should be another important wake-up call for potential and existing members of cryonics organizations. There are various  ways situations such as these can be minimized and we should start thinking about them. Most of all, cryonics members should execute living wills that rule out scenarios where greedy relatives will benefit from the patient not being cryopreserved. Furthermore, cryonics members should execute a Durable Power of Attorney for Health Care to ensure that the person who is authorized to make medical decisions on the cryonics member’s behalf has a strong commitment to honoring this person’s wish to be cryopreserved. This often will require giving this authority not to the person who is closest to you but to the person who  is most knowledgeable and respectful of  your cryonics arrangements (such as a long time friend with cryonics arrangements). Last, but not least, cryonics organizations should further expand their methods of determining high risk cases and improve communication with existing members. Although it is not possible, nor reasonable, to expect from cryonics organizations that they can avoid scenarios such as these in every single case, there is an urgent need to beef up membership tracking and response capabilities.

Cryonics organizations are in a delicate situation. We expect them to fight for each of their members without putting existing patients at risk. One solution that has been pursued in the past, and may have to be revived again, is to separate the service delivery aspect of cryonics from long term patient care. If such changes would allow more aggressive action on behalf of existing members with no, or decreased, risk for existing patients, such changes should be pursued.

(Crossposted from Depressed Metabolism)

Hans Reichenbach’s The Rise of Scientific Philosophy is among the most accessible and illuminating statements of logical empiricism. Although the book can be read as an introduction to philosophy, the central message of the work is that most of what constitutes philosophy is either (outdated) pre-scientific speculation or incoherent reasoning.

One of the most powerful chapters in the book is  about evolution. Reichenbach starts by contrasting the inorganic world, which obeys the laws of physics, with the organic world, which is goal directed. But then he goes on to show that the semblance of design and purpose can be accounted for by an evolutionary explanation, and that all biological phenomena can be reduced to physical phenomena. We do not need two separate sciences to account for non-living and living phenomena and can have a unified science about matter. Anticipating synthetic biology, Reichenbach suggests that future science should be able to create life through purposeful manipulation of inorganic matter.  Then Reichenbach moves from the evolution of the microworld to the evolution of the universe and reviews how contemporary findings in physics and astronomy affect questions about the past and the future of the universe.

Throughout his discussion of the relationship of science and philosophy, Reichenbach presents a number of distinct logical positivist positions:

It has become a favorite argument of antiscientific philosophies that explanation must stop somewhere, that there remain unanswerable questions. But the questions so referred to are constructed by a misuse of words. Words meaningful in one combination may be meaningless in another. Could there be a father who never had a child? Everyone would ridicule a philosopher who regarded this question as a serious problem. The question of the cause of the first event, or of the cause of the universe as a whole, is not of a better type. The word “cause” denotes a relation between two things and is inapplicable if only one thing is concerned. The universe as a whole has no cause, since, by definition, there is no thing outside of it that could be its cause. Questions of this type are empty verbalisms rather than philosophical arguments.

At the end of the chapter, Reichenbach criticizes the widespread view that there are other means of establishing knowledge which can answer questions that science cannot:

The elimination of meaningless questions from philosophy is difficult because there exists a certain type of mentality that aspires to find unanswerable questions. The desire to prove that science is of a limited power, that its ultimate foundations depend on faith rather than on knowledge, is explainable in terms of psychology and education, but finds no support in logic. There are scientists who are proud of when their lectures on evolution conclude with a so-called proof that there remain questions unanswerable for the scientist. The testimony of such men is often invoked as evidence for the insufficiency of a scientific philosophy. Yet it proves merely that scientific training does not always equip the scientist with a backbone to withstand the appeal of a philosophy that calls for submission to faith. He who searches for truth must not appease his urge by giving himself up to the narcotic of belief. Science is its own master and recognizes no authority beyond its confines.

This passage raises the important question of whether the position of logical empiricism is self-applicable. The same issue has been encountered by critical rationalists. One “solution” to this challenge is to make critical rationalism coherent by holding all positions open to criticism, including critical rationalism itself. This approach, called “pancritical rationalism” or “comprehensive critical rationalism,” has been proposed by the philosopher William Warren Bartley in his book  The Retreat to Commitment. Bartley’s solution has been criticized for producing logical paradoxes and its vacuous nature.

Logical positivism thus found itself in the peculiar situation of struggling with its own internal consistency while at the same time seeing many of its basic tenets reflected in contemporary scientific practice.

(Crossposted from Depressed Metabolism)

Cryonics patients can greatly benefit from rapid stabilization after pronouncement of legal death. One fortunate feature of stabilization procedures is that the most effective and validated procedures are relatively inexpensive and easy to perform.  The difference between no stabilization procedures at all and procedures that aim to rapidly restore blood circulation and drop the patient’s temperature is likely to be bigger than that between such basic stabilization and procedures that include administration of a large number of medications and remote blood washout.  This observation gains even more importance when it is considered that there is a serious lack of empirical data to support these more advanced procedures.

To date, no single neuroprotective agent has been approved for the treatment of global or focal ischemia. Despite this fact, cryonics organizations like Alcor and Suspended Animation administer an unorthodox number of medications to protect the brain and prevent impairment of circulation. While there are peer reviewed papers that combine a number of medications, there is no precedent in mainstream medicine or biomedical research in using such a large number of medications (in contemporary cryonics, medications protocol exceeds 12 different drugs and fluids). The only existing justification for using current protocol reflects work done at Critical Care Research in the 1990s. Although scattered reports exist about the effectiveness of this protocol in resuscitating dogs from up to 17 minutes of normothermic global ischemia, no detailed (peer reviewed) paper has been published about these experiments.  Another concern involves the extrapolation of these findings to cryonics. It would go beyond the general nature of this piece to document all the differences between these controlled experiments and cryonics as practiced in the real world, but suffice it to say that the factors of shorter and longer delays, longer  drug administration times, suboptimal “post-ischemia” circulation, and induction of hypothermia introduce many unknowns about the efficacy of these drugs for cryonics patients.  In the case of some medications, like streptokinase, heparin, and dextran 40, a case could be made that the potential benefits outweigh the unknowns, but should this argument be extended to all medications?

Even more complexity is introduced when cryonics organizations make an attempt to wash out the blood and substitute it with a universal organ preservation solution. The rationale for this procedure is found in conventional organ preservation and emergency medicine research. The question in organ preservation research is no longer whether hypothermic organs benefit from blood substitution with a synthetic solution, but what the ideal composition of such a solution should be. In emergency medicine research asanguineous hypothermic circulatory arrest is increasingly being investigated to stabilize trauma victims. But it is a major step from these developments to the practice of remote blood washout of ischemic patients with expected transport times of 24 hours or more. At present the only sure benefit of remote blood washout is that it enables more rapid cooling of the patient, a benefit that should not be underestimated. But when liquid ventilation becomes available to cryonics patients, rapid cooling rates will be possible without extracorporeal circulation.

The lack of relevant published data to support the administration of large numbers of drugs and remote blood washout in cryonics is not just a matter of risking performing redundant procedures. A lot of time and resources are being spent in cryonics on obtaining and maintaining equipment and supplies for these procedures, in addition to the licensing fees paid to use some of these technologies and the training and recruiting of people to perform them. But perhaps the most troublesome problem is that the preparation and execution of these procedures during actual cryonics cases can seriously interfere with rapid and effective cardiopulmonary support and induction of hypothermia.

There is an urgent need to move from extrapolation based cryonics to evidence based cryonics. This will require a comprehensive research program aimed at creating realistic cryonics research models. It will also require vast improvements in the monitoring and evaluation of cryonics cases.  The current debate should no longer be between advocates and opponents of standby and stabilization but about what stabilization procedures should be used by cryonics organizations given our current knowledge.

Viewing cryonics as an experimental medical procedure does not necessarily commit one to the position that substantial amounts of money and resources should be allocated to recruiting medical professionals and expensive equipment. The most common sense implication of the views outlined above is that the most effective measures to improve the care of cryonics patients are encouraging members to relocate to the area of their cryonics organization, improved health tracking of existing members, and cryonics training aimed at teaching the basic procedures and techniques that confer real evidence based benefits.

(Crossposted from Depressed Metabolism)

Under ideal circumstances cryonics patients are stabilized immediately after pronouncement of legal death by restoring  blood flow to the brain, lowering temperature, and administering medications. In most cryonics cases, however, there is a delay between pronouncement of legal death and start of cryonics procedures. In some cases there are no stabilization interventions at all. Provided that these periods of warm and cold ischemia are not too long, such patients can still be perfused with a vitrification agent. But how thorough cryoprotectant perfusion (and thus vitrification) in these cases can be remains an unresolved issue.

Since the late 1960s a number of studies have been published that document that cerebral blood flow cannot be completely restored after prolonged periods of cerebral ischemia. Brains that have been perfused with black  ink after increasing periods of ischemia have shown progressive development of no-reflow areas in the brain (as evidenced by the absence of ink). In 2002 Liu et al. used a technique that allows direct visualization of trapped erythrocytes by treating fixed brain tissue with sodium borohydride (NaBH4), which renders trapped erythrocytes fluorescent. In a rat model of focal ischemia the authors found that a significant fraction of the capillary bed (10% to 15%) in the penumbra (the area surrounding the ischemic core) is blocked by trapped erythrocytes, even after 2 hours of reperfusion.

The authors discuss a number of clinically relevant issues. They propose that the lower density of trapped erythrocytes in the ischemic core of the brain reflects hypoxia-induced lysis (which releases cytoxic hemoglobin). They further speculate that the older ink methods may have underestimated the degree of no-reflow because areas that are not accessible to red blood cells may still be accessible to other molecules. This presents an opportunity to deliver oxygen to the brain by using small oxygen carrying molecules such as perfluorocarbons.   The authors did not investigate variations in perfusion pressure or the efficacy of volume expanders to restore no-flow areas to circulation.

A focal ischemia model is not a good model for cryonics and one can only speculate what the effects of various periods of complete ischemia would be on cerebral blood flow and erythrocyte trapping. Older studies on ischemia and perfusion impairment, however, indicate that periods of 30 minutes of complete ischemia can produce substantial areas of no-flow in the brain. Unless these areas are opened to circulation during either stabilization or cryoprotectant perfusion, straight freezing of  pockets of the brain is a real possibility. It remains to be investigated if areas that are obstructed by trapped red blood cells are accessible to cryoprotectant agents and  how much of  these areas can be opened by a combination of hemodilution and non-penetrating perfusate components (through dehydration). Although cryopreservation of  ischemic brains is the norm in cryonics, our knowledge about the effects of ischemia on vitrification of the brain remains limited.

(Crossposted from Depressed Metabolism)

Following the news that mice have been cloned from 16 year old frozen tissue comes an announcement that scientists have made advances in resurrecting  the extinct Pyrenean Ibex. This does not only offer hope that someday other extinct species may be resurrected and returned to nature, it further reinforces the power of low temperatures to preserve life and biological information.  DNA can be extracted from tissue that is preserved with crude  freezing techniques, including cryopreservation with no cryoprotection at all (straight freezing).

Successful resuscitation of cryonics patients requires reversal of the aging process (for most patients) and  advanced molecular cell repair technologies. Such demanding requirements are not necessary to clone a cryonics patient. Although the objective of cryonics organizations is not to resurrect a clone of the person but that particular individual, the recent success stories about cloning animals from frozen tissue highlight that the debate about the feasibility of cryonics should not be so much about “revival” but personal survival.  Biological revival should not present major obstacles.

People usually do not make cryonics arrangements to allow a the creation of a genetic copy of themselves in the future. One use of human DNA storage is to assist with the identification of remains of cryonics patients that have died under circumstances where such identification will be difficult (for example, the cryonics organization only receives a brain). DNA preservation is also an option for people who would like to have a  closely similar pet in the future. Futuristic possibilities such as combination of human cloning and mind uploading to recreate the person come to mind as well.

The Cryonics Institute offers human and pet DNA preservation for members with and without funding arrangements.

(Crossposted from Depressed Metabolism)

The cryonics organizations Alcor and the Cryonics Institute have taken great care to correct some of the persistent myths about cryonics. With so much widespread misinformation being circulated in the media it seems trivial to pay attention to some of the misconceptions that some people who are sympathetic to cryonics hold. But the price of ignoring these opinions is that progress in the science of cryobiology and practice of human cryopreservation is adversely affected. What follows is a list of 5 “dangerous” ideas (or misconceptions) about cryonics and their consequences.

1. First in, last out.

A popular expression in cryonics is that the first person who was cryopreserved will require the most extensive repair technologies and therefore will be the last person to be resuscitated. The underlying assumption in this view is quite reasonable: when advances in cryopreservation technologies are made, demands on advanced future repair technologies will be lessened. The problem with this view, however, is that it assumes that advances in cryobiology and neuroprotection are the only factor influencing the quality of care in cryonics. Unfortunately, advances in the science of cryopreservation will not automatically translate into better patient care.  Other factors, such as the delay between time of “death” and start of procedures, and the protocols, equipment and personnel of the responding cryonics organizations, matter as well. For example, if a cryonics standby team is not able to get to a patient before 24 hours after cardiac arrest, pumps him full of air during remote blood washout, and ships him back to the cryonics organization at subzero temperatures, that patient will not benefit from advances in human cryopreservation such as rapid induction of hypothermia, neuroprotection and vitrification.

A professional cryonics organization with “old” technologies may on average do better than an incompetent cryonics organization with “new” technologies. The important lesson to be drawn here is that the concept of “patient care” is a meaningful concept  in cryonics and consumers of cryonics services need to evaluate their cryonics providers on their ability to provide good care.

2. Only the future will tell us how good our cryonics procedures are.

It is true that only the future will tell us whether cryonics patients will be resuscitated or not; but that does not mean that we cannot say anything meaningful about the quality of care in individual cryonics cases. The most obvious point is that we can compare actual patient care to the published protocols and objectives of the cryonics organization. More specific observations can be made during a cryonics case using medical equipment. In a well-run cryonics case a number of physiological and chemical measurements are made to determine the response of a patient to various interventions. As a general rule, the objective of cryonics stabilization procedures is to keep the brain of the patient viable by contemporary medical criteria. The danger of thinking of cryonics as one single experimental procedure that can only be evaluated in the future is that it ignores the fact that actual cryonics procedures consist of various separate procedures that can be monitored and evaluated using existing medical tools. The least that a cryonics consumer should expect from his cryonics organization is that it discloses its cryonics procedures to the general public and produces detailed case reports.

3. Cryonics patients are no longer being frozen.

Because not all cryonics patients will be “ideal” cases, this view is vulnerable to the same objections as the “first in, last out” rule, but there are some other issues that are important to mention in this context. The most important fact to be stressed is that ice formation is not a binary all or nothing thing but a continuum ranging from straight freezing (cryopreservation without cryoprotection) to complete elimination of ice formation. Although there have been many cases where patients have been frozen without the use of a cryoprotective agent, its opposite, complete vitrification, should be considered  a theoretical ideal. The degree of ice formation is determined by the nature and concentration of the cryoprotective agent. For example, low concentrations of the cryoprotectant glycerol will result in more ice formation than higher concentrations of glycerol.

What has changed in the recent years is that both major cryonics organizations are now offering cryopreservation using vitrification agents. Although these vitrification agents are formulated to eliminate ice formation, it is generally believed that such a result is not achievable in all tissues and organs in the human body at the moment.  Another important point to be made is that not all solutions that can eliminate ice formation are equal because they can differ greatly in toxicity.  The technical challenge in cryonics is not so much to eliminate ice formation but to develop vitrification solutions with no or limited toxicity. Although it is correct that contemporary vitrification solutions  can solidify without ice formation, delays in response time, poor patient care, and high toxicity can offset most of these advances.

4. The probability that cryonics will work is X.

Both critics and supporters have made specific probability estimates about how likely cryonics is to work. In its worst form such probability assessments convey nothing more than putting a number on overall feelings of pessimism or optimism. More serious attempts have been made to calculate a specific probability that cryonics will work. Such attempts usually go as follows: A number of independent conditions (or events)  for cryonics to work are distinguished, these conditions are “assigned” a probability, and the total (or joint) probability is calculated by multiplying them. Although such calculations give the semblance of objectivity, they are  equally vulnerable to the fundamental objection that assigning one single number to the probability that cryonics will work is just a lot of hand waving.  How many independent events are there and how do we know that they are independent? What is the basis for assigning  specific probabilities to these conditions? What are the effects of minor changes in the numbers?

Probability calculations are not completely useless.  They can help us in identifying important conditions that need to be satisfied for resuscitation. They can also help identify weak links  that can be improved. But probability estimates can be dangerous as well when we take them too seriously and discourage people from making cryonics arrangements. The point here is not that we should refrain from being skeptical but that if we make quantitative estimates we should be able to back up our statements with rigorous arguments or just confine ourselves to more qualitative statements. Another objection to  making cryonics probability estimates was made by the cryonics activist and mathematician Thomas Donaldson. He makes the common sense point that many of these conditions are not independent of what we do. We can make a contribution to increasing the probability that cryonics will work.

Last but not least, what does it mean when we talk about “cryonics working?” It is conceivable that cryonics will work for one person but not for another, reflecting improved technologies and protocols. Perhaps asking the question if cryonics patients can be “revived” is the wrong question. As the cryobiologist Brian Wowk has pointed out,  the real question is how much original personality would survive the many possible damage/repair scenarios, not revival per se.  Survival in medicine is not a simple black-and-white issue, as evidenced by people who recover from stroke or cardiac arrest but with personality and memory alterations.  And it is worth  mentioning once more that how much of our personality survives is depended on what we do to improve the quality and long-term survival of our cryonics organizations.

5. I will sign up for cryonics when I need it.

It should be obvious without much reflection why this is a dangerous idea. At the time a person really needs cryonics, he may no longer be able to communicate those desires, lack funding to make arrangements, or encounter hostile relatives. A more subtle variant concerns the person who expects that aging will be solved before cryonics will be necessary. This person may or may not be right, but such optimism may not make him more immune to accidents than other people. This mindset is often observed among young “transhumanists” and practicing life extensionists. A related, but rarer, variant is to postpone making cryonics arrangements until the cryonics organization makes a number of changes including, but not limited to, hiring medical professionals, stop wasting money, becoming more transparent, giving members the right to vote, etc. Such issues are important, and need to be addressed, but a safer response would be to join the organization and influence its policies, or, if this will be necessary, combine with others to start a competing cryonics organization without such flaws.

There are not many people who think that it is sensible to make cryonics arrangements, but there are even fewer people who have actually made such arrangements.

As we have seen, some of these dangerous ideas share the same or related assumptions and produce identical effects: decreased scrutiny of cryonics organizations and a decreased chance of personal survival. An important common theme is that cryonics cannot be treated as one single monolithic technology and that the fate of our survival depends as much on the state of the art in human cryopreservation technologies as on the competence of cryonics providers. Caveat emptor!

(Crossposted from Depressed Metabolism)

Robert J. White is most known, or perhaps most notorious, for his work on primate head transplants. Less known, but more relevant to the practice of human cryopreservation, is his work in cerebral ischemia, hypothermia, and brain preservation. Most of White's innovative work was published in the 1960s and 1970s. White also published a substantial number of opinion pieces on a variety of topics. One of these topics is brain death.

In an 1972 editorial for the publication Hospital Progress, "The Scientific Limitation of Brain Death," White notes that:

...we have to acknowledge the probability that eventually all of the major cellular complexes of the human body will be replaceable either by transplanted organs (man or animal) or by sophisticated engineering modules.

As a consequence, the clinical definition of death is shifting from cardiopulmonary criteria to the central nervous system. But unlike other organs,

...this system is not replicatable, representing as it does the repository of the highest functions of man...when this elite cellular system fails it would seem reasonable to assume that what is characteristically 'human' is also being lost from the body.

But just as the cardio-respiratory definition of death has evolved and changed with the clinical practice of cardiopulmonary resuscitation,  a similar fate may be in store for the definition of brain death. The clinical use of general anesthesia and hypothermic circulatory arrest, in which the brain can be put "on pause," emphasize how important the aspect of "irreversibility" is.

As presently defined, the definition of brain death puts much emphasis on brain function upon physical examination. A major limitation of this definition is that it categorically ignores the prospect that brain function could be restored in the future by technologies more advanced than practiced today, provided the material basis of brain function is preserved.

Another challenge is that the science of cryobiology has advanced to such a state where brain slices can be preserved at subzero temperatures and recovered without loss of viability through vitrification. When recovery of organized electrical activity can be demonstrated in vitrified mammalian whole brains, the prevailing definition of brain death will need to be challenged again because it will open the practical possibility to maintain critically ill people in a state of low temperature circulatory arrest without producing one of the indicators of irreversible brain death. Such advances would be an extension of the  experiments Robert White did on isolated hypothermic brains.

As White stresses in the final paragraph of his paper:

...like all biological activity, life and death merge into one another representing a continuum and the neuro-scientist can only in the final analysis determine the point of irreversibility of this highly complex system at which the possibility of organized activity that characterizes human behaviour  has been exceeded.