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New Directions In Cryonics(Republished, with improved graphics)
By Fred Chamberlain, October, 1989 Presented at a Conference Hosted By the Cryonics Institute
TABLE OF CONTENTS (Hyperlinked-to-text)
I. INTRODUCTION
Identity Questions and Membership vs. Non-Membership Suspensions
II. AN IDENTITY CONTINUUM CONCEPT FOR CRYONICS
What do we mean by 'Identity'? "Prosthetic" vs. "Original" Agencies Is Total Loss of Memory and Identity Possible? Relating Degree and Type of Brain Repair to Identity. Significance of the Identity Continuum Idea to Cryonics. Future Factors Which Might Influence Procedures.
III. NON-MEMBERSHIP SUSPENSIONS
Why Provide for Non-Membership Suspensions in Any Way?
Why Can't People See The Necessity for Prearrangements?
(4) Financial Conflicts of Interest. (5) Reluctance To Be Part of a Minority.
How to Get from Point A to Point B. Fundamentals of a Non-Membership Suspension Program. Disclosures and Releases of Responsibility and Liability. Preliminary Nature of Concept.
Elements of a Non-Membership Suspension Program.
(1) Liability Containment Studies. (2) Sponsor Organization Go-Ahead. (3) Qualification of Funeral Directors (4) Modification of Publicly Distributed Information.
IV. RESEARCH AND EDUCATION
Long Range Outlook - Cryonics Organizations Assume Primary Role.
V. SUMMARY
APPENDIX A. "Post Mortem Suspensions" (Reprint)
APPENDIX B. "A Fictitious Journey to Nebraska"
APPENDIX C. Ethical Questions Concerning Non-membership Suspensions of Parents by their Children.
APPENDIX D. Increased Involvement of Funeral Directors In Cryonics.
APPENDIX E. The Informed Consent Dilemma.
NEW DIRECTIONS IN CRYONICS
[An identity continuum concept for cryonics is defined and linked to increased involvement of funeral directors and suspensions of those who lack prearrangements.]
I. INTRODUCTION
Cryonic societies increasingly receive calls from dying patients or their relatives, requesting cryonic suspensions without prearrangements. "Post-mortem suspension" is a phrase which has arisen in this context, since a decision to proceed with a suspension might be reached only after the patient is dead, or post-mortem.
But the usage is ambiguous. In a sense, all suspensions are post mortem. They begin only after the patients are legally dead (biologically alive; legally dead). If a cryonic society accepts a patient before death, no matter how shortly before, this is a membership suspension vs. a post-mortem suspension. A better term than "post mortem suspension", possibly, would be "non-membership suspension".
In a recent article [1] entitled "Post Mortem Suspensions", it was suggested that initial procedures be performed by funeral directors on the basis of an independent contract with relatives, pursuant to their rights to dispose of remains, after which the relatives could negotiate with cryonic societies as to permanent suspensions. This aroused much controversy, primarily in regard to possible liabilities. At the same time, many have indicated support for the idea, if risks of litigation can be sufficiently minimized.
This present paper was developed as the basis for a talk (on post-mortem suspension) at the Immortalist Society's October 1989 Conference in Michigan.
As one can gather from the title, the scope of material is broadened, compared with the earlier article cited above. A lengthy discussion of identity and memory losses which may result from compromised suspensions is included, since this relates directly to reasons non-membership suspensions are important. There is also an exploration of benefits which might result from generally greater involvement of funeral directors in cryonics. Lifepact [2] is mentioned in areas where its activities intersect with those proposed here, but the programs described below are not Lifepact projects, except in regard to research and public education concerning memory and identity, and in regard to the possibility of Lifepact's documentation being of value in solving problems with informed consent.
Providing for non-membership suspensions and increasing the involvement of funeral directors in cryonics could be of value to suspension organizations. Perhaps a group of them could take these tasks on as a joint effort. Details as to some aspects of such a possibility (see Appendix D) are so specific as to imply a turnkey methodology, but this is not the case. Much needs to be accomplished before a workable system free of liability is designed. This is a starting point, a collection of preliminary ideas, not a refined plan for implementation.
Identity Questions and Membership vs. Non-Membership Suspensions.
The procedures used in cryonic suspension range from those in which biological viability is preserved to below the ice point of water, with sophisticated cryoprotection, to those in which the remains of an autopsied deceased are straight frozen. While it is unsettling to contemplate losses of memory and identity, which almost certainly will accompany the more compromised suspensions, these are risks any cryonicist must face. Even those who have made elaborate arrangements may, due to accidents or other kinds of adverse events, suffer highly compromised suspensions.
What is to become of those who are suspended in a less than ideal way? This is one of the questions which inspired the formation of Lifepact. If we could be guaranteed we would step into the future with memories and identities intact, there would perhaps be less concern with reanimation, rehabilitation and reeducation (this collection of terms is combined as "reentry", from this point on).
No such simple outlook awaits us. Even while we begin to count our synapses and forecast how long it might take to repair them [3], we do not know to what extent they will be repairable (or identifiable as synapses, in highly compromised suspensions). Meanwhile, for those frozen under "perfect" circumstances, with the best techniques we presently have, we still cannot say with any surety how much memory and identity may be recoverable.
There is a nebulous misconception that we should think of a non-member frozen by a funeral director with no cryoprotection as relatively "hopeless", while a cryonic society member who suffers a compromised freezing "at least stands some chance". There is no basis for this differentiation. Total loss of identity is not within our capability to establish, presently. No fundamental identity issues rule out non-membership suspensions. All of the differences of membership and non-membership suspensions revolve around organizational risks and liabilities. On even that basis, can we claim that we will steadfastly hold to a principle of not taking on non-membership suspensions? That we cannot do!
If we look at the records of existing cryonics organizations, we find that in many cases they have taken the kinds of cases they earlier held to be unacceptable from a risk standpoint. Is there reason to believe they will cease to do so in the future? No; it is not in the nature of cryonicists to draw lines between hopeful and hopeless cases. Non-membership freezings are already institutionalized and in danger of runaway expansion, each case to be handled as a unique event without recourse to preplanning. This could easily become a greater liability than if a carefully thought out system were developed for handling these situations.
There are no reasons funeral directors cannot be qualified to independently carry out suspension procedures competently, with proper training and equipment. It is possible that those frozen with non-membership procedures by a funeral director ten or more years hence may be better off than those suspended with the most sophisticated methods today. Something so simple as an improved cryoprotective approach might make a dramatic difference. Ways of inducing vitrification after initial procedures are completed may become practical and inexpensive, whereas to do so today is totally impractical.
Ten to fifteen years from now, it is possible that funeral directors might be trained by cryonics societies in sternotomies, in viability support strategies and in many other methods we currently think of as "high tech" cryonics. Meanwhile, in the heat of political and social battles, we may have accumulated a multitude of compromised membership suspendees besides which the non-membership suspendees of tomorrow will be comparatively well suspended.
While we cannot, as yet, specify exactly what is achieved by cryonic suspension as to memory/identity preservation, we can derive outlines of possibilities and see how these relate to both membership and non-membership suspensions, across a wide range of circumstances and options. Within that context, non-membership suspensions may be seen to be reasonable. Benefits of greater involvement of funeral directors will be more apparent. The role Lifepact will play will become more evident. It has to do with what we are seeking to preserve: our "identities"!
II. AN IDENTITY CONTINUUM CONCEPT FOR CRYONICS
Ask an average person about cryonics, and you will find the concept is understood in terms such as, "It may work, but then again, it may not!" Even a distinctively non-average person may think in these terms. In a recent letter, a highly recognized author of science fiction, greatly respected for his non-fiction works about the future, made the statement (about cryonics) that he thought the probability "it would work" was in the range of ninety percent. He did not mention probabilities of memory loss or questions of acceptable fidelity of identity recovery. He did not quibble about compromised vs. non-compromised suspensions. It was a simple black and white issue, except for a single piece of guesswork, as to "whether or not it would work". [4]
Suppose we say, instead, "It is not a question of whether or not it will work, rather a question of how well it will work?"
(1) Objections arise that this implies an unwarranted claim of feasibility, but an answer might be that we almost cannot help but recover the basic genetic information of the person frozen.
(2) Then follow more objections, that no 'identity' of the kind we seek to preserve resides in genetic information by itself. We reply that there is almost certainly more than just genetic information. Our problem is we do not know how much more can be recovered.
(3) Debate thus moves from whether cryonics will 'work' to whether it will work well enough to be worth the cost and other difficulties. This is more realistic. The rocket's principle of thrust 'worked' long ago, in China, in ancient Rome, and elsewhere. It took twentieth century technology to bring it to a state of true usefulness (in both constructive and destructive ways).
[See Appendix B for a fictitious illustration of the "Will it work?" argument, in a non-membership vs. membership suspension context. Appendix B is not great literature, but it may help to consolidate these ideas in a down-to-earth way.]
What do we mean by 'Identity'?
'Identity' is a term we use frequently, but not with any great precision. Operationally, it implies a blend of memories, value responses, self images, habit patterns, and even physical capacities. If we lose some of this, presumably, we lose some identity. Every day, strokes, Alzheimer's disease and other forms of brain damage bring about losses of 'identity'. We do not write these people off, but we treat their illnesses and try to help them, even those who suffer from the kinds of amnesia (anterograde, for example) which can make their continued lives nearly meaningless. The relatives of those with anterograde amnesia do not 'give up' on them. Relatives of suspendees, in a like manner, do not give up because of the possible losses of identity their loved ones may suffer.
With cryonics, we say it is our goal to preserve identity, but all we can do is try to preserve biological structures, and it is not yet clear even how well the structures are preserved, much less the identity. Only with the passage of many decades will we know how well we have succeeded. Presently, we can only say that we have preserved something in between total identity (meaning the person reanimated is "identical" with the person frozen) and no identity of any kind.
If we assume a continuum of identity over the range between total identity and no identity, with piecewise continuity related to loss of brain structure (loss in that it is not possible to infer and then replace that structure), we may deal with "loss of identity" in terms of its consequences, even if we do not as yet have a way of relating such to the actual loss of structure which brings it about.
Clinical evidence gives us insights as to the effects of a wide range of brain damage, including incredible losses such as hemispherectomies (where one side of the brain is removed). Cumulatively, we can infer the results of drastic, global brain damage, and, we can crudely extrapolate what would be the effect of replacing damaged brain parts (not functional at all) with generic replacements (functional but not identical with the original neurocircuitry). More on this will follow shortly.
We may further presuppose that losses of brain structure will be some function of the cryonic suspension procedure used. While we cannot relate the two in a precise sense, we can hypothesize procedures ranging from "perfected suspended animation" (even if we do not yet have it) to "obliteration" (cremation/scattering). Surely over that range we will incur losses of identity ranging from "none" to "total".
Thus, although we may not be able to specify a relationship of variables [procedure / loss-of-structure / loss-of-identity], we may specify a range of procedures and a range of losses of identity, assuming piecewise continuity of the interrelationship. If we explore the territory of each range, we will be preparing ourselves for the best and worst we can expect, along with all else in between. At this point of development, that is about as much as we can do.
The Procedure/Identity Domain.
In Figure 1, the range of suspension procedures is shown at the left side, "perfected suspended animation" (PSA) at the top and lesser suspension procedures as one goes down the scale. To the right is shown a range of identity from "100%" to "DNA".
The "DNA" point at the right is at the bottom of the scale, but observe that the range could have been extended lower to a point where not even genetic information remained. Such would correspond to an extension downward below the bottom on the left side to a "virtual obliteration" point. On the right, the scale could have been extended above "100%", as an indication that a stroke or Alzheimer's victim might experience at least a partial recovery of memory as part of the repair process, in other words a "gain" in identity. (If "identity" is taken literally... that for it to be preserved, the person reanimated must be "identical" to the person suspended, any improvement ranging from radical rejuvenation down to simply a "cure of the disease from which the person died" reduces the "preservation of identity".)
A "Lifepact Threshold" is shown on the right side. This is a point above which the patient will recall an agreement to be responsible for the costs of reentry (reanimation, rehabilitation and reeducation) with sufficient clarity so that fulfillment of his/her obligations would be reasonable to expect. Below the Lifepact Threshold it would be questionable if the memory of this agreement would be sharp enough to justify insistence on it. In these cases, the person reanimated would be a responsibility of someone else, thus a "dependent". Ranges of "independence" and dependence thus extend above and below the Lifepact threshold.
In Figure 1, a single arrow leads from PSA (perfected suspended animation) to 100% (preservation of identity). This should be easy enough to accept, since perfected suspended animation would be expected to lead to (at least) recovery of 100% on an identity scale. In exploring the rest of the area, we will find a variance among points of view. Each person will have a different set of expectations. This leads to a spread of the sort of "scenarios" that will be envisioned.
Figure 2(a) shows an "Optimist" scenario, damage from all procedures equally repairable and identity recovery independent of the procedure used.
In Figure 2(b), the "Pessimist" scenario is considerably more extreme than the optimist's scenario. Even cryonic suspension procedures in the year 2000 and 2010 could be conceived of as futile.
A perhaps more realistic and hopeful (Guarded Optimism) scenario is shown in Figure 2(c), where even some ischemia may be repairable sufficient to bring the patient above the Lifepact threshold.
In Figure 2(d), "Tempered Skepticism", the idea is that as more is learned about potentialities for brain repair, acceptance from many people (however grudging) may be expected that some identity will be recovered regardless of the degree of compromise.
"Prosthetic" vs. "Original" Agencies.
In cases of loss of memory and identity, due to damage such that reconstruction of the original array of synapses is not practical, what is to be done about it? Suppose the traces of axonal/dendritic paths and the debris from which neurons are to be reconstructed are so nebulous that it is largely guesswork?
What sorts of solutions would be reasonable? Above, an approach was suggested in which an irreparably damaged portion of brain tissue might be replaced by a "standard pattern" neural circuit network. [5] The assumption is that there will be no need to "transplant" a blank section of a cloned brain into the damaged brain. A more reasonable approach, if we can reconstruct neurons from debris [6], is in "rebuilding" various parts of a brain, neuron by neuron, if not from patterns from the original brain, then from patterns "borrowed" from other brains. But what would be the effect on the identity of the person to be reanimated? In some instances, there might be little change. In other cases, there might be problems. These problems will not be discovered in the course of "experimenting" on suspendees, but rather from ordinary clinical practice. More about that a little later.
In Figure 3, the identity preservation scale is located on the bottom, starting at 100% on the left and descending to zero as we move to the right. On the vertical, you see the ratio of prosthetic to original brain structures. But what do we mean by a "prosthetic" brain structure? Consider the cerebellum:
The cerebellum is a seat of muscular coordination, clearly a lower evolutionary development, not intrinsically involved with conceptual content or associations. Its cortex delivers output to cerebellar nuclei (deeply seated control centers) solely by means of inhibitory neurons, meaning it acts to shut down neurons, filtering or downtoning rather than transferring information. [7] When there is damage to the cerebellum, the result is muscular discoordination, an inability in balance and control, and so forth. Fine control through cerebellar function is vital to gymnasts and ballet dancers, and to anyone who walks, runs or in other ways wants to manage bodily motions. [8]
Now, suppose the suspendee's cerebellum suffers damage, and the treatment is not to repair the cerebellum but rather to reconstruct it to a standard pattern, in effect replacing it with a prosthetic item, perhaps derived from the pattern of a gymnast, someone with a superbly developed cerebellum.
We're talking about something like an "artificial knee", but in the brain. A prosthetic cerebellum would be highly unlikely to interfere with memory or sense of identity, but it is quite plausible that it would impart a refined sense of balance, maybe generally improved muscular coordination.
One might feel, "I'm me, but very graceful! I bet I can now do things I never could have done before!" This might be the case, in fact, an unimpaired person wishing more perfect physical coordination might someday purchase a replacement cerebellum the way people of today obtain plastic surgery. This is conjectural, of course, but a baseline is needed for considering brain repair by way of prosthetic replacements. This is an example with which we may begin.
An objection will arise: Supposing we reconstruct a cerebellum, is it still not possible we will lose valuable elements of our identity? The answer is that long before this technique is used with suspendees, such repairs will have been perfected helping those with cerebellar damage. If rebuilding the cerebellum from a standard pattern is an accepted therapy for people with brain damage in that area, with no loss of identity, this will then be an acceptable procedure for suspendees. If losses of identity are involved with cerebellar rebuilding, we will at least know how much, before we use it in connection with reanimation.
This example may be generalized to other types of brain repair. If there is damage to a person's primary visual cortex and it is rebuilt to a standard pattern, will there be loss of memory or identity? Suppose the amygdala is damaged and replaced, what is the effect? What if a number of brain areas are involved, such as in cases of traumatic accident? What memory/identity deficits will take place? This will be clinical knowledge developed before suspendees with damage of these kinds are reanimated, through repair of brains which are damaged in living patients of that era.
By the time brain prosthetics are used in suspendees, they will have been proven out in standard medical practice. This point cannot be emphasized too strongly. We will know, in advance, what identity/memory impacts will be involved in rebuilding, to standard patterns, any part of the brain which is damaged by the suspension process.
Is "Total" Loss of Memory and Identity Possible?
"But what if it were necessary to rebuild the entire brain?" one might ask. "What then? Wouldn't that destroy the identity entirely? Wouldn't that take us back to the recovery of nothing except genetic material?" If the extreme were taken, of course, that might be the case. It is more likely that in the course of development of brain repair, we will find certain areas which are exquisitely sensitive to damage where losses of memory and identity are concerned. [9]
For those who suffer various degrees of brain damage in areas critical to identity, at the future time of which we speak, there either will or will not be means adequate to deduce the neuronal structures that were present and rebuild them, if only from mere clues of cellular debris remaining, with acceptable recovery of memory and identity. [3]
If, for future accident victims, the repair of certain kinds of brain damage exceeds criteria for acceptable loss of memory and identity, then such victims may well be frozen, in prospect of a day when better methods of repair exist. Such people will be in the same state, effectively, as the early cryonics suspendees whose brain damage is of the same nature and extent. When a way to recover identity is found for the future accident victims, the same repair procedures will be applied to those suspendees.
Relating Degree and Type of Brain Repair to Identity.
In Figure 4, the vertical bar suggests a case example with considerable rebuilding to standard patterns in areas of the brain where there are few identity related impacts, and minor rebuilding in areas where memory/identity is particularly critical. By reference to repairs on non-suspendees with similar brain damage, we would expect to be able to project the degree to which memory and sense of identity might be weakened.
Where there is reason to suspect even minor loss of memory, suspendees will no doubt receive extensive testing using archived data sources. In cases of extensive losses, even with concrete recollections quite hazy, it still should be possible to measure memory by recognition tests. Suppose pictures of places/persons once known are placed alongside similar but unfamiliar material? Will the frequency of correct answers exceed that due to chance alone? Although there might not be the same satisfaction as if there were clear recollections, it will be possible to determine to what degree memory and (thus) identity are conserved.
Similar testing would be useful to detect losses of memory due to diseases such as Alzheimer's or stroke, or simply from the passage of time. How many of us can clearly recognize the faces of schoolmates from high school yearbooks (assuming that many years have passed)? How many of us can easily find our ways around cities in which we lived decades ago, even if the street names and buildings have changed but little?
It is a little disconcerting to realize that, in many ways, we lose as much identity from the passage of time as from events which in other cases would be the consequence of traumatic brain damage. But we gain new identity, don't we? There are new cities to live in, new friends we get to know, and the reanimated suspendee will be gaining 'new' identity rapidly after he or she wakes in the future. Perhaps, in some ways, that will be a sufficient consolation for the person who otherwise might sit about bemoaning the loss of the memories of a childhood which vanished over a hundred years ago.
If for no other reason than the passage of time and the loss of memories unrelated to disease or suspension damage, pictures and diaries and other memorabilia will be of value to us, as time rolls by, century after century. Even now, most of us now and then take out the things we have saved and go through them, in some cases remembering events which prompted us to store those trinkets, in some cases not recalling at all why we kept them.
Significance of the Identity Continuum Idea to Cryonics.
The benefits of a widened public perception of cryonics in terms of "continuum of identity" can be many-fold:
(1) The perception of the type of suspension procedure as a factor of importance will be sharpened, and it will be easier for people to see that lack of prearrangements jeopardizes one from the standpoint of what kind of procedure one might have to accept. [10]
(2) The idea of a continuum implies that even in the worst of circumstances, all may not be lost, and hope may exist that lesser procedures or storage modalities may have value. What is sought here is not blind faith, but open mindedness. Research to explore all areas of compromised procedures is of importance, and only with much of this will the continuum idea become satisfyingly tangible to those who will embrace it as a principle on which to base their actions.
Future Factors Which Might Influence Procedures.
With enactment of "Humane and Dignified Death" legislation in state after state, it will become easier to avoid ischemic delay in all levels of procedures. One can envision a day when, in the case of a comatose parent, the children might be able to provide for a "non-membership" suspension which would dovetail with the administration of a lethal (non brain damaging) injection, a type of suspension not representing significant compromise.
Affordability factors, per Figures 5 and 6, will lead to a spectrum of cost vs. quality tradeoffs in both initial procedures and storage modality. The profile of Figure 6 is probably more realistic, a skewing of the distribution toward the lower cost areas, since a majority of those electing cryonic suspension will be under cost constraints and will take lower priced options.
In Figure 7, the diagonal line (the vertical scale can be regarded as logarithmic, perhaps) would indicate the number of suspensions of Lifepact Members. Here we are assuming that a substantial number of these members (in the early days) will be those who were not members of cryonic societies at the time of initial suspension, but were "enrolled" after the fact in both Lifepact and in the suspension organizations concerned, by family members who made commitments to be responsible for them.
We might expect to see a somewhat even mix of those whose suspensions would lead to dependency vs. independency on reentry, at first, and then later a falloff of the dependent group, as suspension procedures became more sophisticated, as more of the group had prearrangements, and so forth. With time, referred to periods when reanimations were feasible, it would be reasonable to expect that by far the majority of those reentering would do so above the Lifepact Threshold, in a fully independent state.
Who will provide for those who reenter in "dependency"? It is projected that it will be those who manage to come back in an independent state, who will assume responsibility for them! This obligation will have been made before they were suspended, and for good reason. It will not be possible for any cryonicist to predict with surety what sort of circumstances might lead to a loss of life, or what compromises might be entailed. Therefore every cryonicist, no matter what organization he or she may be with, will need to provide for the contingency that he or she may suffer a compromised suspension.
The agreement to be responsible for those who emerge in a dependent state, in addition to being responsible for oneself, could come to be known as a "Lifepact Threshold Agreement" (as distinguished from a more ordinary "Lifepact Agreement". It would establish a commitment that if one were fortunate enough to reenter in an independent state, one would share in the effort of reanimation and rehabilitation of those not so fortunate. On the other hand, if one were to suffer a compromised suspension, one would then benefit as the recipient of such support.
It is not expected that this will be much of a load. We are not talking about people emerging as infants, needing to learn to walk and talk. These will be adults with hazy memories, some sense of identity to regain, otherwise little worse off for the experience. Once they have acclimated to the society of the day, in which people take responsibility for their lives, it is to be expected that they will affirm their acceptance of a Lifepact type obligation and move immediately to a state of independence.
III. NON-MEMBERSHIP SUSPENSIONS
To this point, non-membership suspensions have been discussed as if they were an accomplished fact. They are not... far from it. [11] There are arguments against the idea, sound ones, and many problems to be solved before non-membership suspensions of a practical kind are a reality. To begin with, what are the reasons such a program would be valuable to cryonics? Are there benefits to be obtained if we spend time and effort developing a program of this kind?
Why Provide For Non-Membership Suspensions In Any Way?
"Why provide for them at all?" some might say, who oppose non-membership suspensions. "They represent only liabilities and problems we should be avoiding. Sooner or later, the world will come to understand that those who want to be frozen must plan ahead. It's too bad people will be lost in the process, but that's unavoidable. Why should we, who have devoted our lives to developing our organizations, risk what we have built to save those who wake up to the problem of mortality at the last moment?"
(No one has actually used these particular words to oppose non-membership suspensions, but they fit the tones with which some cryonicists have responded to this idea, saying, "We've got enough problems already!")
Cryonics organizations, the well established ones making news, do not need an image of being elitist groups which care nothing for outsiders. Is there a risk of this? If there is a policy of closing doors on those who arrive at the last moment, the result may be anger and resentment. The rejected latecomers may hold an enduring grudge against the cryonics organizations which turned them away. If they truly grasp the cryonics concept, they may feel their loved ones were condemned to death for not having filled out the papers years before.
There are countless stories about the 'callousness' of emergency wards where all the forms must be completed before a doctor will check to see if you're having a heart attack. The same types of accusations could be leveled, in a far more deadly way, at cryonics societies, if no ways are sought to provide suspensions without prearrangements.
An even more disconcerting thought is that someone, even if totally unqualified, will offer non-membership suspensions as soon as sufficient demand exists for them. If competent cryonics groups do not develop routes for non-membership suspensions, fly-by-night organizations will spring up to fill the gap. Then there very well might be exploitation, fraud, and litigation filling the newspapers of communities everywhere. Broad public backlash could develop, striking well-established, competent cryonics organizations as well as shoddy ones in the process.
If cryonics organizations take on the task of developing systems for non-membership suspensions, this can be a public outreach with many rewards. The building of a more positive image will be only one of them. In the end, net liabilities and public image damages can be more contained and limited than if the issue were ignored. The world needs to know, as the Venturists keep insisting, that cryonicists do not want to merely "keep it for themselves". A program for providing non-membership suspensions would be a positive step in that direction.
The organization(s) fostering non-membership suspension availability may be able to grow more rapidly than if this sort of program were not developed. The growth will result from a more positive public image, from a larger number of suspendees under care, and from an influx of living members. Surviving family members who become interested in cryonics via the route of non-membership suspensions will, perhaps more than others, appreciate the necessity of such a program and contribute to efforts to make it sound.
To properly appreciate the potential for organizational development, we can compare cryonics organizations with other groups which unite people in the search for meaning and fulfillment. Venturism, in its inception, focused on the example of churches (where many hundreds of millions of people join in a common concern with personal destiny). A compelling contrast is the infinitesimal participation in cryonics. Almost all of cryonics' development lies ahead. Non-membership suspensions may be a critically important element of that growth.
How would the tapestry of cryonics appear if there were a thousand persons in suspension? Ten thousand? A hundred thousand? A million? Would all these people have been suspended as a result of prearrangements, as members in the sense we think of them today? Probably not! It is possible a substantial fraction of those who are eventually suspended will have been frozen without prearrangements, and those organizations which enable this may gain, as members, the family survivors of such suspendees. Organizations which remain aloof from this development may fail to grow at the same rate, and may become relatively small in proportion to the others. This topic is of such importance it deserves to be explored separately.
To date, many of those involved in cryonics have been loners and individualists, adventurers, technically inclined persons who thirst for the future, and those whose alienation with the present has inclined them to escape it for a new and better world fifty to a hundred (or more) years away. This is to be expected, in keeping with the pioneering nature of cryonics. At the heels of these explorer-pioneers, though, will come 'settlers' of the future, people with more in the way of conventional visions and expectations, lots of them.
Most people who die are aged. Scanning the obituary columns will give a feeling for this, but there is another aspect. Aged people tend to die in controlled circumstances, where they are under care and observation. Accordingly, it would seem these people would be the most likely candidates for suspension, except for one thing... they are unlikely to seek out cryonic suspension, or even be receptive to it. By the time they reach the end, most of them are reconciled to death as their destiny, and accept it.
But their children may feel otherwise. If, in wanting to return the gift of life they received from their parents, children want to have them suspended, the situation of lack of prearrangements will rear its head again and again. The children may see cryonic suspension as a way of saving lives, even though the medical community may dispute this.
[The medical community may dispute the worth of compromised freezings even after it is proven that suspended animation works in the context of proper clinical entry. It may dispute the worth of more compromised freezings even after less compromised freezings have proven reversible. Will the medical community ever accept the cryonics idea in a basic way? Possibly, by which time it may be concerned with opposing direct uploading [12], holding that no reanimations should be done on a basis other than strict biological reconstruction.]
Cryonics societies will be unwilling to sign up parents on a third person basis, children making the arrangements. Particularly if a parent says, "I don't want this done," no cryonic society will want to be involved. Even if a parent says, "I don't really care, one way or another," some cryonic societies will be in a quandary. If, at the last moment, some parent says, "Do what you want with me", how many cryonics societies would respond to a request (by the children) for a suspension? (Appendix C provides a brief discussion of the ethics of such situations.)
If there is no way for this to be done, in grief, many such children may go back to the business of life, resigned not only to their parents' deaths but in subtle ways to their own, in ways they could not explain to anyone but which may weaken interests in cryonics which might have flowered, had they been able to suspend their parents. Conversely, if suspensions of parents by their children are possible through a non-membership program, involvement of a greater group of new people may be the outcome, people who are intimately aware of the compromises entailed in lack of prearrangements, people far more likely to make arrangements for themselves which were lacking for their parents.
These new people, these families, could be fundamentally a new dimension for cryonics in terms of growth. To repeat a previous point, these are the settlers of the future, not necessarily the explorers. They will follow their parents into the future, in a curiously inverted way. They will have been the ones to take the initiative to save their parents, but then they may view the future as a more nurturing place, because they anticipate their parents' presence there, not necessarily to protect them or financially provide for them, but to enrich their lives by continuing a relationship they value in a way they would be hard put to describe.
Why Can't People See The Necessity For Prearrangements?
Providing for non-membership suspensions is one approach to a solution, one might argue, but why not simply embark on a program of public education concerning needs for prearrangements? Isn't this a more reasonable approach? Like it or not, reason will not rule, in issues of life and death, in a culture conditioned to accept death. Procrastination rules, in seemingly endless ways. Here are some of them:
People will worry they will be taken advantage of. Only when a doctor predicts death in the short term will they bring themselves to look into suspension arrangements. Even then, ignorance of options, reluctance to face reality and fears of being defrauded may forestall action until none is possible. Those who could most easily pay for suspensions may miss out on them for this reason.
Most people avoid actions of any kind which admit death is a possibility. It is hard for them to be persuaded to so much as make a simple will. Death, on final approach, tends to give little notice; concerns focus on possibilities of a cure, while even more time slips away. By the time the great majority of people admit that death is upon them, it is close to the end. Then come desperate calls for cryonic suspension without prearrangements, situations which require a solution and seem to offer nothing but problems and liabilities.
(4) Financial Conflicts of Interest.
Relatives (heirs) may attempt to persuade older family members that cryonics is futile. It is not merely that the heirs want to save the funds required for suspension, which may be a small portion of the total, but there will be fear that much of the rest might be donated for research or into research endowments, later (potentially) to be recovered upon reanimation.
Heirs will, thus, have strong incentives to argue that prearrangements should be postponed, regardless of how likely it might seem that cryonics will 'work'. Why might those same heirs' attitudes shift at the last minute? Change of heart? New information which makes cryonics so convincingly plausible that they would feel foolish objecting to it? A conviction that they themselves (the heirs) might want to be frozen someday? Guilt, fear they would feel unworthy if they argued against cryonics and sent others to graves rather than to cryogenic storage facilities? Who knows?
(5) Reluctance To Be Part of a Minority.
Cryonicists with prearrangements are presently less than one hundred thousandth of one percent of the population of the world. This makes them conspicuously a minority. In any issue as fundamental as life and death, there are tendencies to avoid joining such a small fraction of humanity. Only in the face of death may the will to survive prevail over habits of conformity. There is a scene in the "Poseidon Adventure" (a movie) where most of those trapped in an overturned ship ignore the plan of a small group to climb to the underside of the ship (above the surface of the sea), until water rushes in and threatens to drown them. Then they scramble quickly to follow the same people they scorned moments before.
Whatever the reasons, with time there will be more and more people who reach the end without prearrangements for suspension, knowledgeable enough of cryonics to want it. There will be no way for cryonics societies to satisfactorily verify familiarity with cryonics or interest in it, on the part of the prospective suspendees or their families, yet there will be financial means and intense desires for it. How is an outlet to be created for this demand, as it grows?
(figure scanned from original publication)
How to Get from Point A to Point B.
Let us take the premise, as indicated in Figure 8, that lack of prearrangements and calls for last minute suspension will be a continuing problem; that we want to get from point (A) where non-membership suspensions are not feasible, to point (B) where such are available.
This will not be a single, simple step, but a more complex matter, as indicated in Figure 9. A detailed proposal or comprehensive plan of action should be prepared and refined (through appropriate revision and review procedures) in terms of strengths and goals of a sponsor organization. This, together with studies on how to limit the liabilities, would precede other development. There would be a period of preparation in-house, including further reviews of the program, followed by more development work on the outside, before the desired state would be reached.
(figure scanned from original publication)
It would be an important, underlying principle that there would be intermediate goals and benefits, even if the final objective (non-membership suspension availability) were never achieved. Thus, there would be no thought of effort being wasted, if non-membership suspensions could not be provided for due to liabilities or lack of benefits. In a similar fashion, Voyager (having now completed flyby of four planets) started as a two-planet mission (MJS, Mariner Jupiter-Saturn). It was later expanded to include Uranus and Neptune per the original "Grand Tour" concept, but only after exhaustive reviews of reliability criteria and funding requirements.
Fundamentals of a Non-Membership Suspension Program.
The basic approach to a non-membership suspension program, as proposed earlier [1], is for funeral directors to contract with (the relatives of) those lacking prearrangements, independently. After initial procedures are performed, it still remains for the cryonics organizations to accept suspendees as members, in effect converting the suspendees' status from "deceased; cryogenically preserved" to "suspendees with full arrangements as members".
The most plausible way to develop a program of this kind is to initially increase the involvement of funeral directors in suspensions of members, and then move on to suspensions for non-members after further evaluation. Can such an increase in the involvement of funeral directors come about? The answer is almost certainly "yes", and a detailed approach to bringing about such involvement is presented in Appendix D. On that basis, let us go on to consider the elements of a non-membership suspension program. (Assume that funeral directors can see a strong role for themselves in cryonics and desire to be active participants in its development.)
If a funeral director independently contracts to perform procedures after the death of a non-member, such procedures would necessarily be of a different category than those applied in the case of members (of a suspension organization). The procedures might be identical, but would need to be legally distinguished from membership "cryonic suspensions" in a number of ways:
The term "cryonic suspension" denotes both a procedure to place a person into a state of preservation and the state of preservation itself, in which the suspendee might remain for a very long period of time, awaiting the development of repair methods. This term should almost certainly be used only in conjunction with membership suspensions and in cases where a cryonics society elects to take on, as a member, a suspendee frozen outside and prior to that context.
Procedures carried out by funeral directors, contracted for by family members (or even by a dying person) might be termed "cryostabilization" or even "cryo-embalming". The key consideration is the way the term is defined.
Usually, a cryonic suspension organization's paperwork will state that the procedure is experimental and unproven. The exact nature of the procedure is left undefined, but the goal is stated as preservation of biological viability and structural integrity of the tissues suspended.
In a procedure to be performed for a "non-member", the safest approach might be to specify the procedure to consist of certain steps, without reference to a goal of preserving biological viability or structural integrity of tissues. The procedures which a funeral director carries out in connection with his standard licensing relate only to the "disposal of remains", and for him to represent them to be anything else would take him outside that domain.
It would be appropriate for the funeral director to show the prospective client specifications of his procedures, and for the client to review these with a prospective suspension organization (with which the suspendee's relative might hope to arrange a permanent suspension after initial procedures were performed). Notwithstanding such review, the funeral director would only contract to perform a specified procedure and provide temporary storage, as in the case of conventional situations where the purpose is postponement of a funeral, to be followed by burial or cremation.
Disclosures and Releases of Responsibility and Liability.
In contracting for non-membership procedures, funeral directors would make disclosures and obtain releases of liability. It would be recognized that there might be negotiations (in which the funeral director would have no part) with cryonics societies for long term maintenance, and the funeral director would have no way of guaranteeing the outcome of such. Details and acknowledgements concerning these and other problems could be included here.
The relatives would be advised to make (if time allowed, before any procedures were performed) contingent long term arrangements with a cryonics society, so that uncertainty of final disposition would be reduced. The sponsor organization (or perhaps others) would negotiate with such persons, being sure to use similar disclosures/releases, spelling out all of the conditions to be satisfied before it became involved with caring for the (prospective) suspendee in a permanent way.
If, as to the relationship between the relative and the suspension organization, there were ethical considerations in connection with the consent of the suspendee (see Appendix C), it would be appropriate for these to be acknowledged at the beginning. All financial requirements and other constraints concerning a final suspension arrangement would need to be defined, so if a procedure were performed on the basis of a contingent arrangement, there would be no hidden obstacles to consummating a permanent suspension.
Distinction of Membership and Non-Membership Suspensions.
In what ways, then, would a non-membership suspension differ from a membership suspension? Briefly restated:
(1) In a membership suspension, the arrangements are between prospective suspendee and suspension organization. In a non-membership suspension, they are between a relative of the prospective suspendee and a funeral director, on the basis of a "right to dispose of remains" vesting with the relative.
(2) In a membership suspension, the procedure is the responsibility of a suspension organization, unspecified except as to its unproven and experimental nature. In the procedure to be performed in a non-membership suspension, a protocol would be specified, one well within the capability of the funeral director with whom the contract was made, with many additional caveats for various contingencies which could interfere (lack of notification of death, any intervention of authorities requiring autopsy, and so forth).
(3) In a membership suspension, financial arrangements for long term suspension are completed ahead of time, while in a non-membership suspension, they could be specified in advance but would not necessarily be consummated. A relative who contracts for an initial procedure may have to pay prior to the service being rendered, agreeing that in event of a failure to provide for permanent suspension, there would be a conventional interment.
Some funeral directors may require a contingent contract on the part a cryonics organization prior to a non-membership suspension. There are many possibilities to be explored, and only after they have been compared and evaluated will it be clear which is best. Only after such evaluation will it be known if any of them are acceptable at all.
Preliminary Nature of Concept.
The concept a non-membership suspension program is still in its earliest development. The earlier proposal [1] was lacking in many respects, particularly with regard to the analysis of potential problems. Even as to ideas like those suggested above (for example, that procedures be 'specified' to eliminate need for defining objectives for the procedure), there may be flaws, or better alternatives.
In what follows, emphasis is on a development program rather than on implementation details. Also, a premise is implicit that benefits may be outweighed by disadvantages, in which case implementation should be postponed until the balance shifts. If it is recognized that any decision to proceed requires satisfying concerns that are raised as part of the development process, there should be few objections to a study of the possibilities.
Elements of a Non-Membership Suspension Program.
As Figure 10 indicates, a non-membership suspension program depends on: (1) satisfactory completion of liability containment studies, (2) readiness of a sponsor organization to negotiate conversion of non-membership suspensions to long term suspensions, (3) qualification of funeral directors to perform non-membership suspension procedures independently, and (4) revisions of literature being distributed by funeral directors in general.
(figure scanned from original publication)
All these elements build on an earlier program in which funeral directors gradually become more and more involved in cryonics, as proposed in Appendix D. There would have been earlier liability studies as to possible problems in closer relationships with funeral directors. It is likely that the yellow pages advertising of funeral directors will have come to include notices of availability of information concerning cryonics, and it is part of such a program to provide for leasing space from funeral directors, hiring them to assist in suspensions of members, and training them in the same way as (many of them would be) primary suspension team members.
A non-membership program for suspensions, then, requires the following:
(1) Liability Containment Studies.
Additional liability studies would be conducted on the offering of non-membership suspensions. These would address all literature scheduled for distribution, documentation and interview techniques funeral directors would use to describe procedures and secure releases from prospective clients, and documents and negotiating principles to be used by sponsor suspension organizations in conversion of the non-membership suspensions to standard suspensions. The issue of informed consent would be central to these studies (see Appendix E for further discussion.)
The participation of a design team and a review board would be appropriate, at conceptual, preliminary, detailed and preimplementation levels (thus following procedures by which sophisticated hardware/software systems are brought to final development and accepted). While this might seem quite cumbersome and time consuming, concerns voiced by all of the suspension organizations making initial input on this concept suggest this approach is both appropriate and acceptable.
(2) Sponsor Organization Go-Ahead.
A decision that the non-membership program is of value would have to be made by the sponsor organization, completely aside from liability containment questions. This would take into account the time to be spent negotiating with families of non-membership suspendees, pros and cons of image aspects of the program, advantages of increased family participation which might result from such involvement weighed against the liabilities, and so forth. Interviews with near-misses (who tried to arrange a suspension but failed) could be part of a program for reaching this decision. [10]
Again, as with liability containment reviews, it would be appropriate for there to be a design team and a review board, with formal, multi-step development of the program on an overall basis. This is not the sort of decision making that lends itself to simple discussion followed by approval or non-approval. The mechanics of this type process, while somewhat intricate, have a large payoff downstream.
(3) Qualification of Funeral Directors.
Funeral directors would have to be qualified to perform suspensions independently. The candidates would be funeral directors trained by the sponsor organization in suspension techniques, who understood the liability problems and still wanted to be part of a non-membership program. Additional training would be provided to such funeral directors, by the sponsor organization(s), in interview strategies and specific disclosure techniques designed to eliminate liabilities.
(4) Modification of Publicly Distributed Information.
If all other elements were 'go', information distributed by the wider group of funeral directors would be modified to reflect availability of non-membership suspensions. The idea would not be to promote them, but make them known to people seeking them. All such literature would be designed to point out obstacles, uncertainties and problems which are involved with suspensions in the absence of prearrangements, laying groundwork for reduction of liabilities.
Non-Membership Suspensions; A Summary.
A non-membership suspension program may be possible through closer involvement of funeral directors in cryonics, together with careful planning to avoid pitfalls. If people cannot be induced to make prearrangements for suspension, perhaps at least they can be educated about what is involved, so they do not seek at the last minute to have themselves or their relatives placed into cryonic suspension with no forewarning of the difficulties. A key element of such education will be conservative information about cryonics distributed by funeral directors.
IV. RESEARCH AND EDUCATION
It has always been a premise that cryonics would involve a great deal of research devoted to the realization of suspended animation, and that it would be part of the picture to educate the public as to the prospects of life extension and what they might expect if they were to emerge into the future.
In the context of the identity continuum idea, it becomes evident that a comparable degree of research (perhaps this will be the greatest area of effort, in the long run) must be devoted to recovery of maximal identity/memory where losses occur. The public education effort must address these matters as well. In addition to educating the public as to the general promise of life extension and the future, it will be important to convey the idea that identity is more than just a black and white matter. There are gradations.
Each person is a dynamic process of identity transformation which can survive great damage, dislocation and content loss without total obliteration. We have tended to see ourselves as entities rather than "composites", yet we can begin to see that a monolithic view of identity is flawed [5]. We are different than we have been led to believe. These issues are of critical importance when it comes to reentry for those who suffer losses of memory and identity in the suspension process.
These ideas will perhaps be even more strongly fought than the idea of life extension itself. Yet without them, the means by which we must rebuild ourselves in repairing damage at the other end cannot be reconciled with our self concepts. It is not sufficient to say we will forget about these problems and solve them at the other end, for there may be individual preferences to be dealt with and options to be chosen.
For example (and this is a tip of an enormous iceberg), would it not be reasonable to suggest that we specify, from among those persons we know, those from whom we would be willing to "borrow" selected brain patterns if it were impossible for our own to be uniquely reconstructed (in areas where identity would be strongly affected)? How can we address a question like this if we are not aware of its existence? How can those who might serve as donors of brain patterns agree to be named for such or serve in this way if they do not comprehend the idea? Such would be far a more intimate matter than a heart and kidney transplant, yet we could be suspended in blind oblivion to this possibility.
firm reality, and with that must come the education of all who might be suspended, as to the implications of such research. We have barely peeked at the first page of the first chapter of this story.
Research, while one can envision many interesting avenues to explore, will gradually help us relate suspension procedures to the limitations we will face in the restoration of memory and identity. Three key questions or "transfer function" areas are:
(1) How do suspension procedures relate to structural preservation of neurons? [13]
(2) How does the structural preservation of neurons relate to their repairability? [14]
(3) How does the repairability of neurons relate to the restoration of memory and identity? [9]
By breaking the problem into subsets, some of which may be more "studyable" than others at various points in the development of technology, we can begin to acquire more of an understanding of what is important, at an earlier point.
As suggested earlier, it is in the repair of strokes and other brain damage that we will begin to get the best indications of what is possible and what is not. Also, as brain damage comes to be "treatable" by the replacement of parts which are damaged with "prosthetics" (with reconstructions derived from the brain patterns of others), the idea of repairing brains of suspendees in this manner will become acceptable in the minds of everyone (except the suspendees, unless they have faced such concepts as these in advance and have acknowledged this so repair teams can accommodate the options they have chosen).
(figure scanned from original publication)
Figure 11 illustrates the three above mentioned research areas as they would fit into the Procedure/Identity Domain, replacing the arrows used in earlier scenarios.
It will be beneficial if suspension organizations and groups like Lifepact and the Reanimation Foundation pursue coordinated programs of public education. These would not be attempts to persuade the world as to the value of cryonics, but rather to caution people not to expect trouble free access to suspensions without prearrangements at the last moment. While it is futile to hope most people will make prearrangements, at least they can be informed as to the limited options they will encounter.
With time, within limitations of which they have been warned, people without suspension arrangements will find pathways growing through which they may be suspended with scant notice. At the same time the importance of prearrangements becomes more widely recognized, procrastinators may become a more and more prominent portion of the cryonics "marketplace". We might wish that human nature were otherwise, but we are well advised not to attempt to change it too radically to fit our ideals.
Most importantly, we can hope that with time people will at least complete "contingency" paperwork of an inexpensive sort, so some of the initial steps will have been taken, informed consent problems are lessened, and options (such as the specification of brain pattern donors and execution of Lifepact agreements) will have been taken care of. Even if procrastinators have not filled out forms with a particular cryonics organization, perhaps they can be induced to obtain insurance (payable to their estates) so that funding problems will not stand in the way at the last moment. While these might seem like modest goals, they are steps in the right direction.
Long Range Outlook – Cryonics Organizations Assume Primary Role.
(figure scanned from original publication)
Figure 12 indicates that as a final step, once non-membership suspensions have reached a point where entry liabilities are no longer a problem, major suspension organizations would assume a primary role, dealing directly with non-members. By that time, the involvement of funeral directors would be firmly established; they would continue as in the past, except as representatives of cryonics groups rather than as independent contractors mediating relationships between clients and suspension organizations.
Providing for non-membership suspensions and the elaboration and spread of a continuum identity concept for cryonics go hand in hand. These could be major factors in the growth of cryonics. This article provides suggestions which may be helpful.
Hopefully, cryonics organizations will join, cooperatively, in bringing about increased involvement of funeral directors in cryonics, in making non-membership suspensions a reality, and in conducting research and education addressing prospects of memory and identity losses (and strategies for dealing with them).
These directions of development could benefit all cryonicists (and the rest
of humanity). Let's talk about how to pursue them! I'd be
interested in your thoughts, and in keeping you advised of how you could
help bring these things about. My address is: Earlier address (inactive After 1991)
************************************************************* "Non-Membership Program" design team (tentative):
FRC
(Names deleted; to be discussed in committee later, as to later applications.)
[Note: No action was ever taken to pursue this development, owing to strong opposition from groups advocating that only high-viability approaches be given priority. It remains to be seen, from the standpoint of future science, which point of view was most correct.]
POST MORTEM SUSPENSIONS By Fred Chamberlain (See Reference 1)
In Longevity Report #13, page 13.11-13.12, John de Rivaz comments on people who "wake up" to the possibility of cryonic suspension at the time a family member dies, who have made no prior suspension arrangements and then find no one will take on the job of performing a suspension.
He cites the arguments of Mike Darwin in the December 1988 issue of Cryonics, concerning (1) difficulty of obtaining valid informed consent from those under emotional stress, (2) financial logistics, (3) legal authority for dealing with remains, and (4) priority conflicts where taking risks saving non-members could, in a number of different ways, jeopardize members.
John proposes solutions involving (1) limiting liability by use of separate companies, (2) short term credit, and (3) legal procedures to resolve disposition of remains. He concludes by pointing out that as cryonics develops, refusing to deal with those lacking prior arrangements could bring about a "vacuum" in the market place which would be filled perhaps by larger firms of an entrepreneurial kind, eclipsing cryonics organizations of the sort we have today.
It is apparent this is an area of serious concern; it is not wise to ignore it. Another possibility John does not mention, perhaps more likely and more dangerous than large entrepreneurial concerns, is the emergence of shoddy cryonics organizations which will do anything, without regard for accuracy of presentation or the long term. The misrepresentations and predatory behavior of such organizations could catastrophically injure promotion and development of cryonics by the existing, legitimate organizations which have been around virtually "since the beginning".
Is there a solution? I think there is. Here, in essence, is an argument for helping morticians establish "half way houses" to help those who find too late that, instead of merely "talking up the idea" with friends and family, they should have been filling out paperwork and buying insurance.
What Do We Mean By "Cryonic Suspension"?
If you ask most persons who have been involved in cryonics for awhile, you will find a good deal of concern with (1) holding down the amount of time before procedures are begun and (2) some kind of "cryoprotection" to reduce cell dehydration and other adverse effects of exposure to low temperatures. As one goes on to examine other things that could be important, one finds a lot of attention given to preventing autolysis by combating effects of oxygen deprivation, pH shifts, etc. After all, if one goes into suspension from a state of maximum viability, there is a much better "head start" on repair (or so we hypothesize). As an ideal, of course, we would like to be suspended in a vitreous state from which there is a proven exit of reanimation at any time such is appropriate, and then we have "suspended animation", which is what we were always after in the first place.
But suppose we are not so lucky as to die in a clinical setting, and there are some hours of room temperature ischemia? Does that mean we do not wish to be frozen, then? Of course not! Until it is firmly established that so much damage has occurred that identity recovery is fundamentally impossible, we would like to have done whatever is possible under the circumstances. What if there is an autopsy? Do we then just discard the remains? Many of us say that we would prefer, still, to have frozen what can be, even though the chances may be vanishingly remote, or even (to many) laughable. Are such procedures cryonics? If not, then are we to search out a new name for what is done if things do not go quite right? No! It's cryonics, still, and most of us would far prefer to be "straight frozen" quickly and take our chances that way than to be autopsied.
So What Does It Take To "Do A Cryonic Suspension?"
Does it take a "suspension team"? Well, yes, it does, if you're talking about someone who has advance arrangements, and the circumstances are favorable. But what if the circumstances are not favorable, and you're in a little town three hundred miles from the nearest airport, under hold for a possible autopsy and no assistance can be flown in for over twelve hours? Then does a mortician with an insulated box and some basic knowledge look inviting? You bet! In the end, if you managed just to be straight frozen by that mortician instead of being autopsied by the local coroner, you (or rather your relatives and all of your fellow cryonicists) would heave a monumental sigh of relief and be happy such a mortician was available.
So while we fully signed up cryonicists would hope for a much better send off than a mortician and an insulated box, we could do worse, in some situations. What does this mean, in terms of a half way house? That's the next topic on the agenda.
Suppose? Just suppose?
Suppose a mortician has an insulated box and a basic notion of how to cool someone, either to water ice temperature or dry ice temperature, and he's contacted one night by a desperate relative who says, "I've called these cryonics organizations and none of them will help me. Your yellow pages ad says 'limited cryo assistance'! What does that mean?" ('Cryo' may not be the right word - there needs to be a term which indicates use of low temperatures but clearly is not "cryonics")
The mortician explains that he has the capability of holding remains at low temperatures, down to dry ice levels, and that he does this as an alternative to other "disposition of remains".
The mortician is careful to explain he does not have any "medical capability", and does this strictly as a mortician, but he has cryonics literature available for purchase, and there may be some way to move on to cryonics storage. This, he explains, he does not arrange for directly. That's up to the relatives, after they have thought over the various options carefully.
The cost for this "entry level" cooling would, naturally, be nominal, so at the outset, the financial obligation is small and there is no representation a "cryonic suspension" has been done.
Would a relative then elect to move up from straight freezing on a temporary basis to long term suspension? Who knows? The first steps have been taken, and at least the possibility exists. The mortician should, as mentioned above, supply literature for the relative(s) to review, which would (over a period of a day or two) clarify the limitations in what had already been done, and give an idea of what the road onward might be like.
Observe that: (1) no cryonics organization has to take any liability or (2) obtain a financial commitment, (3) the mortician merely follows the instructions of someone with legal custody of the body, and (4) there is no problem of compromising a cryonics organization's commitment to its regular members... yet a person is "suspended", at least to a level acceptable to a cryonicist if circumstances permitted nothing better.
What About The Mortician's Literature? His Technology?
The mortician's literature and technology could be supplied to him by any existing cryonics organization, and the literature should be extremely conservative, of course. At the outset, the relative(s) should read and sign a disclosure statement which specifies no procedure of a medical kind is being performed.
There should be brief discussion, in the initial paperwork used by the mortician, of the difference between water ice and dry ice levels. Transfer from water ice to dry ice can come later, but cryoprotection is infeasible if one goes directly to dry ice in the beginning (because perfusion is impossible). Some choices by the relative(s) are thus required, but in other ways there is "time to think", talk with cryonics organizations, decide if it is appropriate to go on to cryonic suspension or proceed with a conventional burial.
How Does This Benefit Existing Cryonics Organizations?
(1) It fills a "market gap" which would otherwise develop and later be occupied by those with far less qualifications.
(2) It makes an option immediately available to those who have not thought ahead, who otherwise would have to settle for no procedure at all, when in fact an option which (under some circumstances) would have been acceptable to a fully signed up cryonicist is possible to achieve.
(3) By a larger number of people being in cryonic suspension, the existing organizations (who then perform the storage) are strengthened.
(4) [This is most important of all] Existing cryonics groups have a cooperating "mortician network" across the nation, which can assist them if they need help in remote locations.
Is There A Reasonable Starting Point?
Anything is better than nothing. This can be coordinated or completely uncoordinated. ACS, Alcor, CI, Cryovita, CSC, Mizar, Trans Time, and even The Venturists all could contact morticians independently, get them "set up" for this sort of thing and then refer to them people who call in the middle of the night with no arrangements, helping them with transitions to cryonic suspension in those cases where the relatives in specific cases so choose.
Alternatively, there could be a "League" among the existing groups establishing a literature base and jointly promoting the idea to morticians, with "directory" information to all member cryonics groups. This latter approach would have the strength and credibility of unity... the mortician would not have to worry about being tied down to one group or another, and it would make the mortician accessible to all groups in the event of need for emergency assistance. As to commercial equipment (such as low temperature containers), the League could "sanction" certain products (like "UL Laboratories") if they met certain minimums; these could then be supplied by anyone meeting the standards.
This sort of development will come, whether we want it or not, and the choice is to welcome it and control it, having the benefits of it, or to fear it and wait for it to be set up by others who may or may not know what they are doing. Unless such proves impossible, I urge this development be a project of a League of some kind, perhaps CEL (Citizens for an Extended Lifespan) or some other coordination group with representation from all major organizations.
FICTITIOUS JOURNEY TO NEBRASKA
By Cameron Rockwell (Fred Chamberlain)
Come with me to the flattest part of Nebraska, to a place where the horizon is so even that the idea of a spherical earth seems laughable. On the front porch of an ancient house, in a cool autumn breeze, Ezekial Brommer moves gently back and forth in his rocking chair.
It's so quiet you can hear the San Andreas fault creaking some two thousand miles to the West, much fainter than the sound of Ezekial's rocking chair, but of a similar sort. Suddenly, Ezekial tumbles forward from his rocking chair onto the worn boards of the porch. There is a stirring from within the house, and Ezekial's relatives rush out.
The first to arrive is Ezekial's son, Jeremiah. Some eighty years old, but still in excellent health, he stoops quickly to feel for a pulse. Nothing! Slowly, he rises to his feet, and says to the others, "Well, shucks! Maybe we oughta freeze him!"
Jeremiah's sister, Mildred, some ten years Jeremiah's senior and as wiry and strong as a steel bullwhip, retorts, "But he's not signed up!"
Jeremiah sighs. "I know that," he replies. "If he'd been signed up, I'd have said 'We gotta freeze him!' But what I said was, 'We oughta freeze him!'"
Mildred scowls. "It may not work!" she mutters. "But it might work!" Jeremiah hurls back. "Suppose it doesn't!" "Suppose it does!"
And the argument, which is similar to those Mildred and Jeremiah have had, incessantly, for nearly eighty years, goes on until Ezekial's wife Matilda, some twenty years older than Mildred and of a stony constitution which says she might live forever, stops them with, "Shut up! It'll work, all right. The only question is, how good will it work?"
For a moment, thoughtful silence prevails. Then Jeremiah says, "Well, it won't work very good if we don't get some ice and cool him down, will it?" and hastens into the house, headed for a freezer Matilda has kept packed with crushed ice ever since old Ezekial said he thought "it might be a good idea to get frozen if he died."
Did they then live happily ever after? That is beyond this story since, after all, it is a very short story, almost as short as Ezekial's life would have been had he not been frozen.
ETHICAL QUESTIONS CONCERNING NON-MEMBERSHIP SUSPENSIONS OF PARENTS BY THEIR CHILDREN
One of the issues facing cryonics societies as to acceptance of non-membership suspendees will be motivation. Did the persons clearly wanted to be suspended? If only timing, logistics, or difficulties in verifying financial provisions stood in the way, then no ethical problems may exist, but what of parents who never made verifiable statements to the effect of wanting suspensions? Would cryonics societies be concerned that the parents might have stated to others that suspension was against their wishes, and were nonetheless suspended by their children pursuant to rights to 'dispose of the remains'?
Will cryonics societies feel a necessity to verify that a positive motivation was held on the part of the suspendee, to satisfy its own ethical standards? If there is no evidence one way or the other, will the organization decline taking on the suspendee as a member? Will there be a hidden liability for it if long term arrangements are consummated? These are not merely hypothetical questions. They will arise as a non-membership program develops. Suppose relatives appear some time after a suspension has been performed and swear, "Old Mary-Jane told me she never wanted to be suspended!" Issues such as this are sure to spring up. How will cryonics societies deal with them?
The issues are deeper than might be apparent. It is one thing to argue a person's right to say how his or her 'remains' are disposed of. It is quite another to define the handling of one's 'identity'. For truly that is what it comes to. If we believe someone is 'dead and gone', disposing of the biological remains is a relatively mundane matter. But if we entertain the possibility that the person will 'wake up again' in the future, as a result of preservation of those biological remains, then we have to ask the question, "How will the person feel about that?"
If persons have an expectation of awakening in a 'heaven', and instead awaken in a hospital of the future, have their lives been saved or have their hopes of a religious hereafter been dashed? (Or both?) If refusing to be frozen is tantamount to suicide, do we have a right to prevent it (by freezing them). One could argue suicide is 'illegal', therefore we have every right to prevent it (by freezing the remains). If a person can never be reanimated, we have done no harm. If the person can someday be reanimated, we have thwarted his or her suicide and so have done something quite proper under the law.
This appendix doesn't answer these questions; it only raises them. The debate will rage on in the future as to the rightness or wrongness of freezing people "against their wills".
While you think of it, why not add your comments below? If you'd be willing, then, to send a copy to me (Earlier Address: No substantial input on this subject or others in this paper was ever received.)
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INCREASED INVOLVEMENT OF FUNERAL DIRECTORS IN CRYONICS
Increasing the involvement of funeral directors in cryonics is part of one approach to achieving a non-membership suspension program. In what follows, let's look at things which could bring about a higher level of activity on the part of funeral directors in cryonics without a non-membership suspension program.
Articles in Funeral Director Related Publications.
Articles concerning cryonics could be written for many of the publications read by funeral directors. Such periodicals have published articles on cryonics from its very beginnings, almost always positive in tone. In the Centennial Edition of "Casket and Sunnyside" (Vol 101, No. 13, Page 84 - October 1971) there was an article entitled "Can Death Be Evaded Via Cryonics – And If So, How Will This Affect The Funeral Director". It was quite supportive in content, reporting much positive evidence for the cryonics concept, even though it was not possible (as one can see by reading the article) to tell how funeral directors would fit into the picture.
If one scans recent issues of The American Funeral Director and the UK's Funeral Service Journal, one finds continuing coverage of cryonics as relevant news. An article [1] on "Post Mortem Suspensions" was reprinted in the British publication (Funeral Service Journal, July 1989, Page 55) from Longevity Report, where it appeared earlier. It is reasonable to assume that more articles, concerning the general involvement of funeral directors in cryonics as well in non-membership suspensions, would be welcomed in periodicals like these. In the August 1989 issue of American Funeral Director (under "Turning the Clock Back 25 Years"), The Prospect of Immortality is recalled as follows:
"IN A BOOK titled The Prospect of Immortality, Robert C. W. Ettinger, a college physics instructor, described a program under which human bodies would be frozen either upon death or when subject to a currently incurable illness. In the latter instance, they would be maintained in a state of suspended animation until medical science discovered a way to restore them to health. 'No matter what kills us,' wrote the optimistic Mr. Ettinger, 'whether old age or disease...sooner or later our friends of the future should be equal to the task of reviving and curing us...'"
Direct Mailings to Funeral Directors.
Beyond this, closer involvement of funeral directors in cryonics could be developed by mailing information to them directly, offering relationships which could be mutually beneficial in: (1) yellow pages advertising, (2) lease of preparation room space, (3) hiring the assistance of funeral directors in initial stages of cryonic suspensions, and (4) training for those who wished to become qualified to participate more fully in or even take responsibility for performing cryonic suspension procedures.
(1) Yellow Pages Advertising.
This is an extraordinarily simple idea. All funeral directors advertise in the yellow pages already. It is one of their primary means of visibility to their surrounding communities. If they were to alter their artwork to indicate that cryonics information was available, such would attract inquiries from those interested. Funeral directors would simply invite inquirers to stop by and pick up information. When this happened, the funeral directors would have an opportunity to meet the prospective clients and increase the probabilities that they would be called upon if needs for non-cryonics mortuary services came about.
But, some cryonicists have asked, wouldn't this take business away from the funeral director? Not in the least. The information would be quite conservative, as would be appropriate. It would point out the many things one would reasonably have to consider about cryonics before deciding on it, including: the cost, the experimental and unproven nature of cryonics, the damage done by freezing, and the speculative nature of future repair.
The literature would not be designed to "sell" cryonics, but rather to make sure the recipients knew the negatives in advance. For those people predisposed to choose cryonics, the literature would not be a deterrent, but rather, by its realistic nature, would better convey that a well thought out program existed. (In most literature about cryonics, there is an emphasis on the 'upside', in terms of 'living forever', the glories of the future, and so forth. Practical minded people, who have learned to shade every outlook with a degree of pessimism, may find this tone indicative of fanaticism or euphoric blindness, and may attribute to cryonicists a degree of unrealistic optimism most of them do not deserve.)
It would be appropriate to convey something of this conservative approach to funeral directors, to arouse their interests and allay fears of being drawn into something of a radically militant kind. Phraseology which might accomplish this (to be included in the initial bulk mailings to funeral directors) might be as follows:
"By far the majority, once they are conversant with the details, would be expected to choose conventional funerals and interment over cryonic suspension, and would likely engage your services for this. For those few who, after understanding the limitations, still wished to make cryonics arrangements, Cryofutures's literature would prove helpful." (The name "Cryofutures" is fictitious, for the purpose of illustration.)
The form letter would point out that they (the funeral directors) would be providing their communities with a public service by providing literature which treats cryonics from a realistic, non-hype, down to earth viewpoint:
"In light of growing public interest in cryonics, Cryofutures regards the distribution of conservative information about the limitations of cryonics as being more of a public service than promotion, and solicits your aid to the end that overexpectations on the part of the public regarding cryonics are moderated."
By offering a program like this, a sponsor (suspension) organization would be able to locate those in the funeral director industry who were receptive and supportive in regard to cryonics, who might be interested in being more closely allied with it.
Lease of Facility Space, Hiring of Assistance and Training.
Continuing in the same way as with the idea concerning yellow pages advertising, the form letter from 'Cryofutures' could address the question of closer involvement in the following way:
(as to leasing space)
"Cryofutures owns and operates suspension and storage centers in (wherever Cryofutures has such property) and contracts for the use of additional facilities in (here listing other existing arrangements). Even with these capabilities, however, the logistics and circumstances of suspensions frequently make it desirable for Cryofutures to lease short term use of preparation rooms in mortuaries, in which initial phases of suspensions are performed. For complete information on rates and terms, simply check the 'facilities use' box on the enclosed coupon and return it to us." (A sample of such a coupon has already been prepared and ways of using it would be elaborated in the proposal previously mentioned).
(and as to hiring assistance and training)
"In some circumstances, Cryofutures uses the assistance of funeral directors in its initial procedures, particularly where it leases space on a temporary basis. Even morticians lacking specialized training in cryonic suspension are able to participate, at contract rates considerably above the industry average for conventional embalming. Cryofutures also offers additional training on an affordable basis for licensed morticians who wish to become qualified in cryonic suspension, and pays (when such personnel are hired to participate in suspensions) even higher rates. For full details on these programs, check the appropriate boxes on the enclosed coupon and mail it."
As to the training program, it would be based on the sponsor organization's protocols and procedures. If the organization is capable of carrying out a given procedure, it should be able to train additional teams to perform it. Funeral directors would be excellent candidates for training, since their surgical skills are highly relevant to cryonic suspension procedures.
It might be well to require current EMT certification, as part of a suspension organization's training of funeral directors (assuming the suspension organization has such a requirement for its own personnel). It is worth mentioning that shortly before inauguration of paramedic programs, over fifty percent of the ambulances in the United States were owned/operated by funeral directors. The role of rescuer is not one to which this industry is unfamiliar.
Summary.
Increased involvement of funeral directors in cryonics seems to be an achievable objective, which might be of great value even if it were never found practical to implement a non-membership suspension program. It is considered more likely that programs for offering non-membership suspensions will be found feasible and of great importance in the development of cryonics, and that funeral directors will play a key role in this.
THE INFORMED CONSENT DILEMMA
Problems exist if a suspension is performed by a cryonics society on the basis of last minute arrangements. In such a case, there is a higher risk that the suspension will later be aborted (or attempts will be made to abort it), perhaps on the basis that the action was taken under the stress of impending death without sufficient awareness of cryonics' limitations.
If full funding is not provided, such may not be forthcoming. 'Pay as you go' suspensions bring with them risks of desuspension or reliance on donations to continue the suspension.
An even more serious possibility is that of claims, however unfounded, that dying patients and their relatives were led on by the cryonics organization; that some sort of fraud was committed. It seems a characteristic of human nature to seek a scapegoat, someone to blame, when one is unhappy, and relatives who decide upon cryonic suspension at the last minute are prime candidates for this reaction if they become disenchanted with the potential of cryonics.
Lifepact Membership – Part of the Solution?
Members of Lifepact may be lesser risks in terms of informed consent, because of the documentation they have completed. While such will not eliminate liabilities, some organizations may take Lifepact membership into account, in deciding whether or not to accept non-member suspendees. Prospective suspendees and their families may find that the first logical step (in attempting to provide for a non-membership suspension) is to join Lifepact, so as to better document their understanding of the uncertainties of reanimation and various other difficulties of cryonics.
(1) Lifepact Agreement.
The basic Lifepact Agreement, in which a wide range of preferences and acknowledgements concerning reanimation and rehabilitation are included, will itself be evidence that careful thought was given to the unknowns and difficulties of cryonic suspension.
(2) Declaration of Intent.
There can also be a "Declaration of Intent", in which the signer sets forth intentions to arrange to be suspended, however little time there might be to do so, if a terminal illness is discovered. Accidental death cannot be included, since such would likely take place with so little notice that a declaration of intent would be meaningless.
In the declaration, it could be acknowledged that the failure to make advance arrangements represents a high risk, in that financial provisions would have to be taken care of quickly and there would be no certainty that arrangements for suspension could be made at all. Possible compromises could be spelled out, including "non membership suspension", with no assurance of permanent suspension.
For a prospective non-membership suspendee, of course, (who already is presumed to have a terminal illness) any declaration of this kind comes so late as to be marginal in value. Nevertheless, such a declaration might help reduce concerns on the part of a suspension organization as to the non-existence of informed consent.
(3) Question and Answer Interview Form.
An interview form can be completed in handwriting by the person concerned, where answers to questions show how long the person has been interested in cryonics, what extent of reading has been done, and so forth. This documentation will further support informed consent and might make it easier for a cryonics organization to accept a terminal patient on short notice, particularly if other family members of the patient's have filled out similar forms.
A holographic will, however crude, is powerful because it is "in the handwriting of the person who made it" (who therefore must have been aware of its contents). So, also, a Q&A Interview Form as described here would have considerable credibility, in the same respect, for the same reasons.
Other Non-Membership Suspension Documentation.
Irrespective of whether or not the prospective non-membership suspendee and family are Lifepact members, there will have to be extensive documentation completed by them in conjunction with both their contracts with a funeral director and their provisions for conversions of the non-membership suspension to a membership suspension. Arbitration clauses are almost certain to be of use. Acknowledgments and disclaimers should be of an all-encompassing kind. Lifepact documentation may be of help as a starting point, but extensive legal review will be appropriate.
1. "Post Mortem Suspensions", by Fred Chamberlain, Longevity Report, 1989 (#14), pp 18-21. Reprinted in Funeral Service Journal (UK publication), July 1989, page 55. Also reprinted as Appendix A of this paper.
2. "Introduction to Lifepact", by Linda Chamberlain, available free of charge from the Lake Tahoe Life Extension Festival, P.O. Box 18698, South Lake Tahoe, CA 95706. One of the basic ideas underlying Lifepact is that a contingent agreement is made as to responsibility of the suspendee for repaying the cost of reentry (reanimation, rehabilitation and reeducation) if such is not provided for by the member's suspension organization.
3. "Molecular Repair of the Brain", by Ralph Merkle (unpublished manuscript). A detailed projection of ways in which neurons may be mapped and reconstructed. Baseline calculations are made; the paper is thoroughly referenced.
4. "Will Cryonics Work? Examining the Possibilities" by Steven B. Harris, Cryonics, Vol 10, May 1989, pp 36-48. Here a wide range of uncertainties are brought together; the identity issue is treated by assigning a criterion of "success" to a case where there is "access to at least 50% of the memories" and where the reanimated person "feels him/herself, at least initially, to have the same identity". Following this, on pages 48-53, Mike Perry reexamines the odds in "Further thoughts on the Probability that Cryonics Will Succeed".
5. "The Society of Mind", by Marvin Minsky, Simon & Schuster, 1985. "Agents" and "agencies", as functional subsets of neurons, are explored by Minsky, applying decades of work in artificial intelligence to questions of human consciousness and identity.
6. "Engines of Creation", by K. Eric Drexler, Anchor Press /Doubleday, 1986. Reconstruction of biological tissues by use of molecular scale systems is only a small part of what is to be found in this book, which is "required reading" if one is to grasp the potential of technologies that are almost certain to be developed within the next century.
7. "GABAergetic Neurons", by David I. Gottlieb, Scientific American, Vol 258, Feb 1988, pp 82-89. Overview of inhibitory neurons and how they function in the cerebellum.
8. "Fundamental Neuroanatomy", by Walle J. H. Nauta and Michael Feirtag, W. H. Freeman and Co., 1986. See pages 280-288 for a detailed discussion of the cerebellar cortex, elaborating on the example given. Book is an excellent starting point for general study of the human nervous system.
9. "The Anatomy of Memory", by Mortimer Mishkin and Tim Appenzeller, Scientific American, vol 256, June 1987, pp 80-89. As this article points out, loss of memory is a clinical reality and an area of detailed research already. The primary circuitry of the brain involved with memory formation is outlined here.
10. "Lessons From a Near Suspension", by Jim Yount, American Cryonics, Vol 8, April 1989, pp 5-8. Chronicle of a case in which a cryonics organization did not choose to become involved, despite which various members of the group attempted to provide for a non-membership suspension (without ultimately succeeding).
11. "Post Mortem Suspensions", (commentary on reference no. 1), The Immortalist, Vol 20, May 1989, p 16. It was noted that: "The Cryonics Institute, American Cryonics Society, and Alcor all have firm policies against accepting such cases. Unless the patient is already a member, with a contract in place, there is too much chance of a hassle afterward, with the relatives claiming they had not made a truly informed choice or had acted out of temporary emotional stress. Trans Time may have a more flexible policy, but offers only year to year contracts."
12. "Matter and Consciousness", Ralph Merkle, The Immortalist, Vol 20, Jan 1989, pp 5-8. The issue of "relocating an identity" into a non-biological form has stirred great controversy, and is addressed in a fundamental way here (see also "Uploading and Interfacing", Fred Chamberlain, The Immortalist, Vol 20, Mar 1989, pp 25-30).
14. "Memory Storage and Neural Systems", by Daniel L. Alkon, Scientific American, Vol 261, July 1989, pp 42-50. The processes by which synapse behavior is modified and synapse structures are altered in the formation of memory is discussed, giving insights into what might be involved with "repairability".
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