I have a problem. Does the readers understand the subject line?

... that you want any and all measures taken to keep you alive until the cryonics team gets there, at which point you want it changed to "DNR" (Do Not Resuscitate) with the cessation of all measures to keep you alive.

What does yours say?

Presumably life support will be removed once Alcor arrives and Alcor will administer a stay-dead drug. Or-- if death is declared while Alcor is standing there, they'll administer a stay-dead drug THEN life support to maintain functions for transport? I've just never thought about the stay-dead drug... and that isn't covered in the will.

Perhaps, to satisfy a probably confused hospital staff, it would be better to spell out in detail what you are talking about. Unless such staff do indeed use that term for keeping circulation and respiration going after death, for other reasons - I don't know if they do or not, but I kinda doubt it.

You should also have in there that you wish all possible attempts to be made to keep you alive until the cryonics team arrives. That would probably give better results than chest compressions on a corpse.

FD

"post mortem life support". right? The brain is probably not alive but you keep HLR automatics going for circulatin-- even air. I don't understand the problem with the terminology.

They can TRY to keep me alive until Alcor gets to me-- but what if they can't? Then, declare me dead but keep me on the life support systems till Alcor gets there.

haparin. That would mean I'm not going to recover from the CPR... so what is the problem cryonics has with people waking up after being declared dead? If you cool the guy first, inject heparin-- at the same time you're doing CPR-- no problem right?

Reference
Charles Platt's Alcor Forum publication, #1, November 2001. P. 5.

"A bolus (single large dose) of potassium chloride is also administered to electrochemically prevent the heart from restarting so that "legal death" is maintained. Despite continued cardica arrest, breathing and circulation can be restored almost fully. The brain is therefore resuscitated, and anesthetic drugs are necessary to ensure that the "legally dead" patient remains unconcious".

I don't like the sounds of this. Does the reader? It's actually rather alarming. It seems to me we're on very thin ice here. Am I the only one reading danger into this?

Brian Wowk wrote...

The reality is that 90% of people die under circumstances in which they could be revived.

Terminal patients in hospitals and hospices are routinely deprived of nutritional and fluid support, and given "no code" status, which means that no attempts will be made to restart their heart when it stops. Even non-terminal patients (such as accident victims)could be resuscitated with emergency heart-lung bypass if their hearts cannot be restarted. But this just isn't done.

Let's say for the sake of argument that we take everyone who is dying and do everything possible to keep them alive. We'll give them I.V. support, parenteral nutrition, advanced cardiac life support protocols when their heart stops, and even heart-lung machine support to keep them alive when their heart stops. The result would be that intensive care units would be transformed into torture chambers in which everyone could enjoy a horrible, agonizing months-long death that would cost approximately $1 million a person. At the end there would be little brain left to preserve because of horrible sepsis and cerebrovascular pathology. The defining event for death would presumably become "brain death" (i.e. a completely fried brain) as it is for organ donors. Is this what you really want?

Cryonicists didn't invent the legal system, health care system, or ways that people die. These simply constitute the environment in which we must operate.

By the way, if you want to change the legal system so that only patients who are really dead can be frozen, move to France. The French government made such a change to thwart cryonicists a couple of decades ago, and now there isn't a cryonicist in France who wouldn't love to trade places with you in the U.S.
END QUOTE


My comment-- so how do we die? And how do cryonicists die? If I'm "pronounced" dead, and COULD be revived-- wouldn't I INDEED want to be revived even if it entailed lots of equipment? I would think so. The UNWILLINGNESS of the medical system to keep me alive-- is the problem it now appears to me.

Wowk says its costly... but maybe it's not that bad. Maybe we could have giant hospitals where thousands are kept on life support... with a few minutes of consciousness a day... which is better than nothing. A high productivity society wouldn't have any problem with that. The problem we have today... is not high cost of life support but low productivity.

Platt points to heart-stopping drugs and anesthetic so concioussness is intentionally suppressed. It sounds like cryonics "kills" you-- at least to me. I haven't thought this through after a few decades of being signed up. Signing up for cryonics might be submitting yourself to heart-stoppers and anesthetic. Maybe I don't want that. Maybe I'm on the wrong path altogether here... with cryonics. Maybe I've made an awful mistake. Maybe I'm actually interested in those giant hospital warehouses that keep me alive, no matter what, that Wowk ridicules.

Hmmmm.... food for thought.

[Wowk's point was that, for chronic cases of fatal or profoundly debilitating conditions, current technology can only delay the inevitable so long, allowing you to languish there for months only to die anyway. I don't think he's talking about cases where life support or CPR could lead to recovery. At any rate, it's possible that a living will or medical surrogate could specify the circumstances in which a patient would like cryonics procedures to begin. -CFMod]

I'm not sure I like THAT idea either. What if I'm not fully recoverable but somewhat recoverable.. with no hope of full recovery? The direction you're going makes it seem like I'm as good as dead, by the medical system's own standards. Eventually, we'll have something along the lines of the sci fi flick-- Logan's Run-- where everyone over 30 is killed because they cost too much.

But unfortunately it's an inherent weakness of the current system, and I'm talking about the medical system here, due to lack of funds, technology, and political will. If we had never ending resources, I suppose we could keep people alive on machines indefinitely, but judging by the health of people who are currently being kept alive in comas, I don't think they would fare very well being bedridden for years or months at a time. There's also the risk that they could suffer irreversible brain damage due to an unstable respiratory and cardiovascular system. After all, life support systems can't repair things like vascular degeneration. At least not yet.

Brain damage is more likely repairable from anything other than cryonics-- so years of life support in a coma is preferable to the frozen state. Lack of so called "funds" is never a problem is a high productivity civilization-- since "funds" is nothing more than "an agreement" when you define "funds" properly. You see the direction this is going. Even vascular degeneration is preferable to being frozen. In other words, ANYTHING and everything is preferable to being cryopreserved.

You do realize that vascular issues can lead to dementia, which means memory loss, which is synonymous with identity loss? I agree with you that there are times when extreme measures must be taken to support life, but I also think there are times when the damage done in order to preserve life can be worse than death. This is a very complicated topic with many nuances, details that should probably be worked out in a living will or discussed with a medical surrogate. But I don't think it's a reason to give up on either option entirely. Both "paths" have their time and place. And neither one is entirely guaranteed.

My position is that it's not complicated at all. Anyone saying it's complicated is hiding the fact that "cryonics kills"...and that Alcor "life extension foundation" requires you that they "make you dead" in order that you "may live again". Anything short of extreme efforts to keep every last neuron alive in the front lobe through whatever high tech means neccessary is euthenasia, in my updated view on this matter. Alcor is getting away with murder and so are hiospitals-- as Wowk points out. Just because everyone's doing murder these days, however, doesn't make it universally "right". As it turns out, in this regard, Wowk and everyone in cryonics are deathists after all. I might have to quit my membership in Alcor. I'm feeling pretty extreme about this new realization. I can't believe it myself, but there it is.

[Your so-called extreme life-support could, in some cases, such as the ones I mentioned in my post, only end up doing more harm than good. What good is survival without memories intact? It would be no better than the substandard care we are currently criticizing cryonics organizations for. You either need to work with the technology we currently have, which does not allow for healthy long-term life support in all cases, or work toward bettering the technology. It does you no good to compare cryonics to some fantasy, and then criticize it for falling short. -CFMod]

Let's think about the OPPOSITE of what Alcor and hospitals are inclined to do and consider a business where the person has paid us to keep him on EXTRME life support no matter what. That's what I would want. Affordabilty is a moot issue in this thought experiment-- for now.

The trouble is you could keep your body alive and kill your brain that way. Until we defeat the causes of neurodegeneration (alzheimer's, stroke, brain cancer, etc.) you are probably better off frozen than on life support in a vegetative state.

The good thing about staying on life support is that it might give you access to more advanced cryopreservation technology. The longer you last, presumably, the better it gets. Maybe you could benefit from an extra decade's technology that way.

The bad thing about it is that your brain might rot, and previously recoverable information might over time become unrecoverable. Think of a chalkboard that has just been erased -- you can still see the information, in the form of faint chalk outlines. But over time and use it will become less legible and finally disappears entirely.

If you shatter the chalkboard into a million pieces right after it has been erased, you could probably still get the information back if you carefully glued it back together and look closely at the chalk marks. But the longer you leave the chalkboard in use before that, the less of a chance there will be.

You're relating the position of cryonicists who are involved in keeping people dead once they're pronounced. I'm on the other side of that fence.

Do you seriously want to be kept alive without a brain? Would you honestly trade your shot at the future for a few more minutes of breathing?

Where exactly do you draw the line?

Cryonics isn't death anyway in my opinion, it is staying alive -- by the criteria that matters, which is whether the brain can be repaired with the same person inside. If you live by the "still breathing" criteria for a few more minutes or months it is not going to do you any good. Once today's medical technology has zero hope of restoring you to a sane healthy condition, it is time to freeze ASAP if you seriously want to survive.

...after EVERYTHING else fails. I don't see cryonics orgs exploring everything. There are plenty of cases in cryonics where the brain was NOT failing or deteriorating-- just a body part-- and YET- EXTREME life support measures were not taken. When Alcor calls itself "life extension foundation", and cryopreserves someone WITHOUT extreme life support FIRST-- that's not much a life extension program. Cryonics requires you to be dead-- that's why cryonics kids at Alcor have life suppressing drugs in them-- to PREVENT you from coming back to life on CPR after legal death pronouncement. I didn't like that idea a few years ago.

A real radical life extension org would put radical life support tech in their lab at least as an option-- for those whose brains are still good. By definition, Alcor should be a warehouse of people at normal body temp on extreme life support systems, a sort of hospice itself, where millionnaires who don't want to die, get to to on RADICAL high tech equipment beyond anything insurance will pay for. Cryonics should be there if ALL ELSE FAILS... but that's NOT what's going on these days in cryonics. Cryonics is taking short cuts, snuffing out good brains on bodies that fail.

My realization of this as a problem is hitting me very deeply right now.

Dying with high tech radical life support possibilites is unaccetable. Cryonics accepts is and promotes it. Something is clearly wrong with this picture... fundamentally wrong. I think I crossed a line a few days ago when I realized that I, myself, might be a victim one day-- of life suppression drugs in a cryonics kit. This is my Halloween nightmare now. I can't get past it. It might destroy my ability to remain a cryonics member.

There is a commercial need to unfreez food without freeze damage. Eventually some kind of device will be invented that can do this without destroying the cell membrane and also redissolve other components. For this reason CPR and standby teams are probably unnecessary.


Basie

You could logically come back to life on CPR without your brain being any good... Whereas cryopreservation means your resuscutation happens with the aid of advanced nanobots. You could be "alive" by cardiorespiratory standards but "dead" by neurological standards.

The whole point of cryonics is to try and preserve people while they are alive by neurological standards. Failing that, information-theoretic standards (which are a continuation of the same idea). In either case they don't want to risk all that information being erased and letting the individual simply die. Freezing a corpse or a mess of spare parts is not the plan.

...if instead a clinic, it becomes a high tech extreme life support radically expensive (for wealth who can afford it beyond any insurance)-- EXTREME life suport system clinic.

THAT way we cover that end of things-- for those whose brains are NOT deteriorating-- and even for those whose brains ARE if that's doable-- because brain deterioration can be thought of as a NEW problem-- to be solved-- say with more support neuron stem cells in the frontal lobe, frontal cortex support and sampling.. .etc... going wild and crazy with an science fiction theme you can think of.

If THAT fails, AND the millionnaires money ALL runs out-- and there simply is no way to continue-- THEN do cryonics. But ONLY after all of that. I think cryonics jumps the gun-- and doesnt' try hard enough to keep people alive.

FD's clinic idea then becomes viable-- with Maxim working there-- but in a slightlly modified form-- the RADICAL EXTREMEM LIFE SUPPORT CLINIC-- of which I think there is nothing along those lines publicly seen anywhere yet-- but which MUST exist-- in private somewhere.