Problems of cryonics

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Problems associated with cryonics

(and some possible solutions)

When you buy a house, the seller is legally obligated to reveal any known defect. When you review a company’s annual report, it informs you of all the problems that could affect the value of corporate actions. Since  arrangements for cryoconservation  can have a much greater impact on your life than the ownership of a home or investments in stocks, we feel an ethical obligation to reveal the problems that affect cryonics in general and Alcor in particular. We also believe that an organization that admits its problems is more likely to address them than an organization that pretends that it has none. Therefore, full disclosure should encourage, rather than discourage, consumer confidence.

Start status

As of 2016, Alcor is more than 40 years old. Our Patient Care Trust Fund has more than 9 million dollars and is responsible for the long-term care of more than 100 cryopresents. In almost every year, since its inception, Alcor has experienced positive member growth. We are the largest cryonics organization in the world, but in many ways we are still a new company. We have less than a dozen employees in Scottsdale, Arizona and approximately 20 part-time independent contractors in various parts of the US. UU., Dedicated mainly to the emergency waiting and rescue efforts. We serve more than 1,000 members and the protocols that help our search for the goal of reversible suspended animation continue to develop. Nowadays, The technology required to achieve our goal far exceeds the current technical capabilities. Cryonics will not be comparable to conventional medicine until our patients can be revived using contemporary technology, and we hope to wait decades for this vision to be fulfilled. However, we have made important advances in introducing brain vitrification to improve the preservation of the tissue structure of the patient.

Alcor shares some of the characteristics of the new companies. The organization does not have enough staff in some important areas and it lacks as much capitalization as would be desired to support maximum growth. The limited resources prevent the organization from hiring the amount of highly qualified and experienced personnel that is desired, and sometimes we have to postpone improvements in equipment and procedures.

Because Alcor must react quickly to circumstances, it can not always handle multiple tasks simultaneously. We feel a significant impact if, for example, several members experience legal death in rapid succession. A large number of cases generally means that administrative and even technical development work is postponed, while member emergencies take precedence.

On the other hand, Alcor staff believes strongly in the mission of the organization and is extremely dedicated. The Alcor transport team members are dedicated to saving lives through cryonics and behaving accordingly. Above all, everyone at Alcor is concerned about guaranteeing the safety of cryopreserved patients. The powerful sense of purpose of the organization is reinforced by the fact that all the directors of Alcor and most of the staff have made arrangements to be cryopreserved in the future.

Unlike most new companies, it is unlikely that Alcor will fail for financial reasons. Due to the legally independent status of Patient Care Trust of Alcor, patients can be maintained indefinitely through their portfolio of cash, investments, real estate and capital equipment. Some wealthy Alcor members have contributed donations and donations to help the organization move forward, and in the event of a financial crisis, many of the people who hope to finally be cryopreserved will likely provide assistance. In this sense, Alcor benefits from its small size, since it maintains an intimate relationship with many members, which would be more problematic if our membership were ten times larger.

Inability to verify results

When a conventional surgical procedure is successful, the patient usually recovers and heals. If the same surgical procedure is not successful or if a surgeon makes a serious mistake, the patient may die. These clear results provide a quick response for the people involved. A doctor may feel deeply satisfied if a life is saved, or he may be very worried (and may be sued for malpractice) if the mistakes cause a death that should have been avoided.

There is no clear answer of this kind in cryonics, because the result of our procedures will not be known definitively for decades or even a century. We have good reason to hope that future technologies capable of repairing cell damage in cryonic patients will be developed, but we have the same certainty that if a patient experiences very serious brain damage prior to cryopreservation, repairs may be delayed, incomplete or they can not The dividing line between positive and negative results may not be clear at this time.

Suppose a patient experiences 30 minutes of warm ischemia (lack of blood flow at an almost normal body temperature) after legal death occurs. Will this downtime create irreversible damage by any imaginable technology? Probably not. But what happens if the ischemic interval lasts an hour, two hours or a day? We just do not know where to draw the line between a patient who is potentially viable and another who is not.

Of course, we can refer to experimental work that has evaluated the injury that occurs when cells are deprived of essential nutrients. These studies provide guidance on the possible harm a patient may experience, but they still can not tell us with certainty whether future science can reverse that damage.

Another problem that affects chronic cases is that many uncontrolled variables prevent us from developing objective criteria to compare one case with another. Consider these two examples:

  • Patient A has received anticoagulants prescribed by a primary care physician, independent of Alcor, to treat a pre-existing condition. These drugs have the fortunate effect of helping to keep the circulatory system open after legal death is pronounced. Since the patient is in hospital that allows rapid access to transport equipment, postmortem cardiopulmonary cooling and cooling can begin immediately, and all medications are administered. The blood wash is carried out successfully in a local morgue, reducing the body temperature to 3 degrees centigrade. So far, all right: this is a case of textbook. However, because the patient is in a remote location and does not have enough funds to pay for a rental plane, transportation to Alcor must be made through scheduled airlines. The patient must wait overnight for the first flight in the morning. A lost connection causes an additional delay, and then all flights are grounded by an exceptionally bad weather. When the patient arrives in Alcor, he is still packed in ice, but he has experienced a total transport time of 36 hours.

  • Patient B experiences a cardiac arrest when he is alone at home and remains undiscovered for several hours. Since it is located very close to Alcor, the members of our team arrive quickly to administer anticoagulants and drugs to eliminate clots, supplemented with cardiopulmonary hand support. The patient is transferred to our operating room and receives cooling perfusion and cryoprotectant only two hours after the legal death was declared.

In the first case, will the long transport time override the advantage of a quick initial response and replacement of the blood with a cold storage solution? In the second case, will the initial hours of hot ischemia exceed the advantage of fast transport to Alcor? We can make educated guesses, but we can not answer these questions definitively. We do not have a sure way to know which case will work best, because we do not have proof, we do not have results.

We have some simple ways to determine if a patient’s circulatory system allows good perfusion with cryoprotectant. The staff in the operating room will notice if blood clots appear when the infusion begins. The surface of the brain, visible through the holes in the burrs that are created to allow observation, should be pearly white. The brain should shrink slightly as the water is replaced with cryoprotectant. When the perfusion is complete, the patient’s characteristics should have acquired a sallow color that indicates that the cryoprotectant has diffused through the tissues.

These simple observations are useful, but even so, people who work hard to minimize transport time and maximize cooling speed can never enjoy the satisfying satisfaction a doctor receives when one of their patients recovers and returns to a life normal and active. This lack of positive results can cause feelings of frustration and uselessness, which sometimes leads to disappointment and exhaustion.

Conversely, if a case goes wrong, team members will be protected from negative comments. A team leader can never tell one of the staff members: “Due to his mistake, the patient has no chance of recovery.”

The lack of a clear result also prevents us from refuting people who claim that future science will be able to undo almost  any  degree of harm. The danger of this extreme positive thinking is that it can lead to laziness. Why bother to make heroic efforts to minimize injuries, if nanotechnology solves everything?

The declared policy of Alcor firmly rejects this attitude. Team members are highly motivated to minimize injuries because we believe our members should not bet their lives on unknown abilities of future science. In general, Alcor presents a report after each case, encouraging all participants to share complaints, frustrations and suggestions for improvement. Ideally, each case should be a learning experience, and participants should accept criticism as an opportunity to identify weaknesses and overcome them in the future.

Even so, the lack of a clear result remains one of the greatest weaknesses of cryonics, since it encourages complacency and avoids accountability. The antidote to this problem is a better set of objective criteria to evaluate the cases, and Alcor is working in consultation with experts in cerebral ischemia to develop these criteria.

Voluntary help

During the 1960s, the first cryonics organizations were run entirely by volunteers. The field did not have enough reputation to attract qualified medical personnel and, anyway, no one could have paid professional help.

Today, cryonics is making a transition to professionalism, but financial constraints are prolonging the process. Some paramedics are associated with Alcor, and we expect more in the future. We have an MD medical director, access to three contracted surgeons, access to a palliative care nurse and assistance from an ischemia research laboratory in California, where the staff has extensive experience in relevant procedures, such as vascular cannulation and perfusion. Alcor also communicates with a cryobiology laboratory that has achieved the most important advances in the preservation of organs during the last decade. Even so,

In the future, as Alcor becomes more financially secure and can offer higher salaries, the organization will attract more medical professionals. At this time, the transition is incomplete.

Limited support of conventional science

In the 1960s, scientists in conventional laboratories investigated techniques to cryopreserve whole organs. By the end of the 1970s, most of this work was over, and the field of cryobiology emphatically separated from cryonics. The Society for Cryobiology has discouraged scientists from doing work that could promote cryonics, and has adopted a statute that threatens to expel any member who practices or promotes cryonics. Consequently, the few scientists who are willing to do research related to cryonics live with the fear of being excluded from the scientific specialty that is most relevant to their work.

The gap between cryonics and cryobiology may have been caused initially by fears among scientists of the current that cryonics had a taste of “tabloid journalism” incompatible with science. In addition, many scientists are dissatisfied with the idea of ​​applying procedures without a complete and complete understanding of their results. Generally, in medicine,   a technique is first studied, validated and perfected, and  then  applied clinically. Cryonics, of necessity, has made a final tour around this formal approach hastening to apply a technique based on theoretical arguments instead of validating clinical efficacy.

During the last decade, our knowledge and procedures have advanced far beyond the freezing methods imagined by most cryobiologists, and experts in molecular nanotechnology have expressed strong support. As more articles are published. Describing the technical advances, we hope that cryobiologists and other scientists review their negative evaluation of cryonics. In the future, we believe that the arbitrary barrier between cryonics and cryobiology will gradually dissolve, and research on cryonics will be recognized as a legitimate field specialty. However, at the moment, the dim view of cryology by most cryobiologists remains problematic,

Limited legal and governmental support

Cryonics is not explicitly recognized in the laws of any state in the United States (see The legal status of patients with Cryonics). This does not mean that cryonics is illegal or not regulated. In fact, Alcor must comply with state laws that control the transportation and disposal of human remains, and we make arrangements with authorized specialists to ensure that these requirements are met. Alcor also complies with federal regulations established by agencies such as OSHA and EPA.

Even so, the lack of specific enabling legislation for cryonics can cause problems. In the late 1980s, the California Department of Health Services (DHS) stated that because there was no legal procedure to become a cryonic organization, human remains could not be transmitted to a cryonic organization through the Uniform Law on Anatomical Donations (UAGA), and therefore it was illegal. Fortunately, the courts were not impressed by this argument. In 1992, the legality of cryonics and the legality of the use of UAGA for cryonics remained at the level of appeal.

In 1990, the Canadian province of British Columbia enacted a law that specifically prohibited the sale of cryonics services in that province. In 2002, the Attorney General (Canadian equivalent of a state Attorney General) issued a written clarification stating that the law only prohibited funerary homes from selling cryogenic agreements. Cryonics could still be carried out in the province, even with paid assistance from funeral homes, provided they were not involved in the direct sale of crionics. This position is affirmed by the Consumer Practices and Consumer Protection Authority of British Columbia. Despite these guarantees, concern for the law persists.

In 2004, the Arizona House of Representatives passed a bill to place cryonics and cryonics procedures under the regulation of the state funeral board. In its original form, this law would have prevented our use of the UAGA. The bill was finally withdrawn, but may be revived at a later date. During the debate on this bill, very hostile comments about cryonics were made. We can not guarantee that any future legislation will be cryonic friendly or allow chronicity to continue in Arizona.

Despite these uncertainties, the United States enjoys a strong cultural tradition to honor the wishes of terminally ill patients. We believe that the freedom to choose cryonics is constitutionally protected, and so far the courts have agreed. We hope that we can continue to perform cryonics without technical commitment, under state supervision where necessary, for an indefinite future.

Limited general medical support

Cryonics is not a “therapy” accepted or recognized in the general medical community. For the average medical professional, cryonics is, at best, an unusual anatomical donation. In the worst case, some doctors may see it as a fraud for their patient. Hospitals have sometimes deliberately delayed the pronouncement of legal death, delayed the release of patients to Alcor or have banned the use of chronic life support equipment or medications at their facilities. On one occasion, in 1988, Alcor had to obtain a court order to force a hospital to deliver a patient to Alcor immediately after the legal death and allow our stabilization procedures in their facilities.

Relations with hospitals and their staff are not always difficult. Usually, when nurses and doctors learn that cryonics is a sincere practice that is overseen by other medical professionals, they will be willing to satisfy a patient’s wishes, or at least not interfere with them. Sometimes, medical personnel will even help with cryonic procedures, such as administering medications and performing chest compressions if the Alcor staff is not present when a legal death occurs.

The lack of formal medical examination or support for cryonics generally means that cryonic patients removed from Alcor should be transferred to a morgue for blood replacement before transport to Alcor. Ideally, these preparatory procedures should be carried out within hospitals, not mortuaries. Hospitals currently allow organ procurement staff to remove organs from deceased patients (a fairly elaborate procedure) within their walls. We hope that similar privileges will spread to cryonics more often as the process becomes better understood and accepted, but we can not predict how quickly this change will occur.

High incidence of poor cases

In more than 50 percent of cryonic cases, legal death occurs before the Alcor wait staff can be deployed and is often followed by hours of warm ischemia. This downtime can cause serious cellular damage.

The threat of autopsy, in which the brain is dissected routinely, is an even greater danger. Anyone who suffers a legal death in unexpected circumstances, especially in accidents or foul play, can be autopsied. Alcor strongly recommends members living in California, Maryland, New Jersey, New York and Ohio to sign the Religious Objection forms at autopsy.

Sometimes the Crionists perish in circumstances that result in the complete destruction or disappearance of their remains. The critics have lost themselves in the sea, suffered misfortunes abroad or have even disappeared without a trace. Two members of cryonics organizations were lost in the collapse of the World Trade Center towers in 2001. One was a police officer performing rescue operations.

Cryonics is not a panacea or a “cure” for death. The cryonics ideal of immediate cooling and cardiopulmonary support after cardiac arrest can not be achieved in most cases. We have good reason to believe that the molecular records of memory persist in the brain even after hours of clinical death, but only future doctors who use medical technology that we do not yet have can finally determine if that person is really immobile. “there.”

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