The Bioethical Implications, Dilemmas And Questions Involved With Cryonic Suspension written May 31, 2003.
The concept of being resurrected from the dead is not a new one. The quest for human immortality has been demonstrated in many ways: resurrection; heaven; reincarnation; ghosts; leaving long-lasting imprints of ourselves and our work such as writing; Egyptian mummification; and even vampire stories. Immortality is a very ancient part of mythology. The Gilgamesh epic, 3rd millennium BC, is one of the oldest recorded stories of man's search for immortality. Gilgamesh is listed as an actual Sumerian king of c. 2700 BC but in the mythical epic is portrayed as a half-God, half-human who searches for answers to avoid death. He fails and dies because it is the wrong quest for a human1. Lucretius, ca. 98-55 BC, an Epicurean philosopher, did not believe in a potential state of immortality but did subscribe to an atomic theory of matter. Based on that he speculated that perhaps one could be rebuilt by reassembling the atomic structure of a human being2.
The Quest for Immortality
Nikolai Fedorov (1829-1903), a schoolteacher and librarian in Moscow, was one of the first to consider actually bringing back the dead by using science3. This is where it becomes a question of morality versus mortality. Fedorov, both scientific and a committed Christian, suggested that immortality could be obtained by means other than divine intervention, but maintained that it would be consistent with God's will and even morally mandated.
Actually, the idea of life extension through science well predates Fedorov. In 1773 Benjamin Franklin wrote an oft-quoted letter in response to Jacques Dubourg. "I wish it were possible …to invent a method of embalming drowned persons, in such a manner that they might be recalled to life at any period, however distant; for having a very ardent desire to see and observe the state of America a hundred years hence, I should prefer to an ordinary death, being immersed with a few friends in a cask of Madeira, until that time, then to be recalled to life by the solar warmth of my dear country! But…in all probability, we live in a century too little advanced, and too near the infancy of science, to see such an art brought in our time to its perfection"4.
Humans have a natural tendency, through the mental apparatus, to strive for immortality, as exemplified by the Egyptian and Sumerian rituals and religious thought. The desire to be immortal is an extension of the will to self-preservation, which humans share with other animate creatures, as part of the Darwinian imperative of survival of the fittest. When we are placed in critical situations, our body responds chemically with an adrenaline rush, and we choose to fight or flee in an unconscious attempt to preserve our lives. Expanding on this basic response, we take medication so that we may be healthier or to treat a disease. The health market is a major industry and everyone knows that being well means living longer. Many people stop smoking in hopes that it will add a few years to their lives. As we advance in medicine and technology there are more options available to extend our lives. Along with these advances, however, we encounter those who feel there is a point at which we have too much technological aid. I will return to this topic in connection with the controversy over cryonics.
As early as the seventeenth century the English scientist Robert Boyle reported reviving small fish and frogs after brief exposure to subfreezing temperatures5. In my own life I experienced this natural wonder. My grandparents had property in Termo, California, where I spent my summers as a child. There was a windmill that connected to a water trough and conveyed water into a manmade pond. In the trough my grandmother kept some large goldfish. In the winter the water would solidify and the fish quite still and also look frozen. One summer, on returning to the property, I saw the fish swimming about and asked my grandmother if she had put new ones in. She said "no, they're the same fish". So I marked the fish and waited for winter and another season of summer. The fish were swimming, and my marks were on them. I should have known not to doubt Grandmother: they were the same all right. I thought, "I wish, I wish I was like a fish."
Some major advances affecting the way we think about death occurred in the twentieth century. In 1946 Jean Rostand found that glycerol was a protectant for animal tissue, greatly improving survival rates for cells which had been cooled to low, subfreezing temperature and then rewarmed6. Then in 1965 Isamu Suda at Kobe University in Japan removed a cat's brain from its body, perfused it with glycerol, and froze it for six months. After the brain had been restored to body temperature, it demonstrated electrical activity7. Traditional medicine was also making great strides, and people were revived from hypothermic states of respiratory and cardiac arrest-what was previously thought to be death.
In 1967 James Bedford, a 73-year-old retired psychology professor in Glendale, California, died of renal cancer and became the first person to be frozen under controlled conditions with the goal of eventual reanimation. With the Bedford freezing a new practice known as cryonics was established.8 (Frozen by the Cryonics Society of California, Bedford was eventually transferred Alcor Life Extension Foundation's facility in Scottsdale, Arizona,9 where his cryopreservation continues.) Presently several companies in the U. S. offer cryopreservation, more than one hundred people are currently preserved, and almost a thousand are signed up for the procedure, which will be performed at their legal death10. Compared to conventional funerary arrangements (burial or cremation) the service is expensive, costing anywhere from about $30,000 to more than $120,000 depending on the type of arrangement and protocols used. The most common way to arrange for payment is through a life insurance policy which makes the cryonics company the beneficiary. Clients receive a bracelet and/or necklace that tells EMT's or hospital staff to call a number and what to do and not do to the patient in their care. In a typical arrangement the staff of the cryonics company will then fly out to obtain the body, cool it with ice, and bring it back to their facility. Once there the body is treated with a cryoprotective agent, a kind of antifreeze, to reduce or eliminate damaging ice crystals as the temperature is lowered. Finally the body will be cooled and put in an insulated container or dewar under liquid nitrogen, at a temperature of 196°C (-320°F). (A variant on this is the "neuro" or head-only option, in which only the head is preserved, the rationale being that technology capable of reanimating the patient can also recreate the rest of the body, through procedures at least distantly related to cloning. Neuros are cheaper and easier to handle and maintain.)
As might be expected, no one has yet been reanimated. To reasonably do so would require repairing what killed the person and reversing the effects of aging as well as undoing any tissue damage that occurred during cryopreservation. A person who signs up for cryonic suspension hopes that future technology will be able to accomplish all these things. And indeed, the emerging science of nanotechnology11 is a good candidate to someday develop this capability. In 1994 Charles Platt, vice president of the cryonics company Cryocare, commented on Engines of Creation, a 1986 book by Eric Drexler. "Drexler proposed the concept of nanotechnology-machines on the molecular scale, theoretically capable of repairing individual cells. At last, cryonics advocates were able to describe exactly how they hoped future science could undo the freezing damage that still tended to occur even when cryoprotectants were used"12. With technology advanced so far that people could be reanimated from cryopreservation, there is also the possibility that the means would exist to maintain them indefinitely in a state of youthful health.
Cryonics has had to brave some legal challenges. When 83-year-old Dora Kent was gravely ill with pneumonia in 1987, her son had her transferred to Alcor's facility, then in Riverside, California. There she died and was cryopreserved (as a neuro). Through an oversight no physician was present to sign the death certificate, and it led to a coroner's investigation. The headless body was autopsied and the cryopreserved head was demanded too but could not be found. Metabolites found in the body left the impression that Mrs. Kent was still alive when the cryopreservation procedure was started, and the death was ruled a homicide.13 (Patients to be cryopreserved, however, are given metabolic support, including oxygenation, to reduce tissue damage prior to deep cooling, which could account for the metabolites.) Eventually the courts ruled in favor of Alcor. Kent remained in suspension and no charges were filed. In 1988 Thomas Donaldson, a mathematician, was diagnosed with a virulent form of brain tumor with a low survival rate. Fearing the tumor would severely damage his brain before it killed him, Donaldson appealed to the California courts for the right to be cryopreserved before legal death. His request was denied,14though fortunately and against the odds, the tumor has stayed in remission. A third legal battle erupted in July 2002, when baseball star Ted Williams died and his three children had a very publicized debate over his personal wishes to be cryopreserved15. Currently the conflict has calmed down and Ted is reportedly preserved at the Alcor facility. (Alcor officials themselves have not confirmed this, citing reasons of confidentiality.) But the Ted Williams case brought cryonics and an associated ethical debate to major broadcast media and American living rooms.
Why is cryonics such a controversial topic? Some reasons can be conjectured. Since the dawn of humanity people have been conditioned to expect inevitable death. So far, everyone who has ever lived has died, putatively excluding the gods. Perhaps this alone suggests why talk of scientifically defeating death seems blasphemous to many and tends to mire its advocates in controversy. Gilgamesh, at the end of his quest for immortality, is told that his humanity requires him to accept death, that death is necessary, right, and proper. So we ask, what makes something "right," or at least, seem right in the minds of many? A partial answer, at least in some important cases, must be its sheer lack of novelty, its being "traditional." If a certain thing, on the other hand, has never been done before it may appear unsettling and even frightening, to the point that it simply seems wrong. In any case we are conditioned to accept our demise, and have cultivated a vast array of beliefs to alleviate our fears. If we are good in life, for example, it is said we will be compensated with an immensely rewarding, heavenly afterlife, where no pain or sorrow exists. This and other afterworld beliefs engender a hope of escaping the otherwise final nonexistence. We have, in essence, created an alternate immortality to the scientific prospect that is offered by cryonics.
This in turn is "unnatural," say opponents. But how substantial is this claim? In particular, we may ask, how desirable is it for something to be "natural" anyway? It seems clear that "natural" should not be simply equated with "good." Diseases such as the common cold or tuberculosis occur naturally, and we recognize that death may happen through natural causes but don't generally applaud when our loved ones perish this way. The unnatural in turn is not necessarily bad. Consider the world we live in. We find a plethora of examples of the unnatural, even in methods used to extend our lives: computers, hospitals with electronic equipment, drugs that interfere with viruses and other sources of disease, prosthetics, contact lenses, warm clothes, heaters, gym equipment, processed vitamin supplements, hearing aids, pacemakers, and even synthetic organs. This is evidence that our technological progress has reached the point of enhancing our own humanity. Arguably too, many of these devices are endorsed on grounds of basic medical ethics, which posits that it is good to provide good health and, along with it, as much life as possible. This is what cryonics seeks to provide as well, yet mainstream medicine often disparages cryonics as quackery, due to its unproven nature. Cryonicists, however, are not out to deceive anyone, but provide honest information for the prospective patient, so that they may choose through informed consent if they are willing to take this gamble. Many of the greatest advances in medicine were based on experiments in which the results were previously unknown. In contrast to the medical ethics of good health, opponents of cryonics suggest that we should not have all of the health and life we want, but that it should be limited.
Bill McKibben in his book, Enough16, says: "Without mortality, no time. All moments would be equal; the deep sad, human wisdom of Ecclesiastes would vanish. If for everything there is an endless season, then there is also no right season. No time to be born, nor to mourn, nor rejoice, nor die. 'Anytime' is not the same as time that matters. The future stretches before you, endlessly flat." But I think McKibben's concerns are not hard to address. Why should it make any difference in cherishing time, if it is endless? Time would still exist, it would just be in greater abundance. Let's think about our natural life span. I am young enough that I can expect to live another 60 years, a rather long time. Does my assumption that I have years of life to live cause this moment in time to be "flat"? I do not find this season of life any less valuable, or meaningless altogether, simply because I expect future seasons. I cherish every season. Today is as meaningful to me as tomorrow is and will be. McKibben's statement also underscores the sentiment that living indefinitely would be too long, and too banal. True, with today's limited life expectancy there are days or moments in which people can get bored. But, I ask, must this always provoke the response, "I'm bored, I don't even know why I'm alive, I want to die"? Certainly not. It is a particular situation that is boring, not life. With all the time in the world, you could read every book you ever wanted to read, and master many subjects. Intellect could perhaps become greatly expanded. It is this last point that also creates a fear, a dread of the superhuman.
Many people fear that these advanced options would further widen the gap between those who excel and who do not, in an already highly competitive society. These fears inhibit interest in the idea returning to consciousness after decades or centuries of sleep, as might happen with cryonics patients. But, as with McKibben, I think the concerns can be reasonably addressed. In the first place, of course, we have to acknowledge that the worriers have a point. Things would have to be pretty far along to be able to reanimate people in cryopreservation and offer them the prospect of indefinite, youthful health. Moreover, we can assume that advanced technology would be available for everyone so that all could go as far as they were willing. Many then must have progressed very far indeed, yet this outcome need not overwhelm the traveler from the past. Though the world might have inconceivable technological marvels, cryonic resuscitees would still be a valuable, direct link to our ancestral culture. Future denizens could carry on their superhuman life as usual, but would have an added benefit deserving their respect and appreciation. By comparison we can imagine the interest that would be shown if someone from a remote historical time, or even a not-yet-human from far more distant past, could live again and, in one way or another, transmit experiences from that bygone era.
In the case of Ted Williams the media aired and debated the cryonics issue, often showing lack of appreciation. On the CBS news the estranged daughter, Bobby Joe Ferrell, said, "my dad is in a metal tube, on his head. So frozen that if I touched him, it would crack him because of the warmth from my fingertip"17. A talk show radio WEEI 850am disc jockey said about the Ted Williams case, "It's macabre, the whole thing is macabre"18. In other ways cryonics all too often is presented and perceived as bizarre or gruesome, relative to more conventional means of "disposal of the dead." This of course is silly, given the real purpose of cryonics and the scientific premises on which it is based. We are talking about someone who is already dead, by conventional standards. The more typical funerary options do not have much to offer by way of comparison. When one is buried in the ground, soil organisms and other destructive mechanisms make short shrift of what remains. Cremation does an even more thorough job: DNA does not even survive. Nasty stuff, we might say. Cryonic suspension by comparison is far less damaging, thus less macabre, with the added benefit that it is not certain the "deceased" is really dead. In fact, it is death itself that is more deserving of the epithet macabre than is a potential second chance at life.
Hope for the Future
If cryopreservation does not work, nothing is lost; the dead will simply stay dead. Those who sign up willingly accept this risk. And if cryonics does work, they ultimately have everything to gain. The issue, of course, is far from settled and probably will remain so for some time. Yet there have been hopeful signs, of which the following are a few highlights. The cat brain experiments of Suda have been noted. In the mid-1980s a beagle named Miles had his blood replaced with "base perfusate," a preliminary to cryoprotection and deep cooling. During the operation, directed by UC Berkeley's Dr. Paul Segall at the Trans Time cryonics facility in Emeryville, California, Miles was cooled to near the freezing point (not below it), and his heart and breathing stopped. The dog was then rewarmed, his blood was replaced, and he returned to consciousness and tail-wagging good health, making guest appearances on the Phil Donahue show and in People Magazine19. Scientists have also now frozen and successfully revived embryos, sperm, and corneas20.
Perhaps one day humans will reawaken from death and make a giant leap for all humanity in the process. With continued research in understanding the brain, along with future technological advances, the dream could be realized of fully restoring the cryopatient's memories and self. Legal issues could be crucial here. The best possible cryopreservation may not be consistent with existing laws, as was the case for Thomas Donaldson. But, important as it is, the right to do as one wishes with one's body (including a premortem cryopreservation) is not the only factor in the prospects for human life extension. In a recent article at Reason Online, Ronald Bailey writes "…the President's Council on Bioethics is now considering whether or not it is ethical to pursue biomedical research aimed at extending human life spans. Last month the Council met to discuss the staff working paper 'Age-Retardation: Scientific Possibilities and Moral Challenges'…the paper worries…age retardation might undermine 'the meaning of the life cycle' so that we would not be able 'to make sense of what time, age, and change should mean to us'…Longer lives could also slow down 'innovation and change' since 'innovation is often the function of a new generation of leaders.'"21 I suggest the paper in question is actively participating in age discrimination. The document suggests that those who live extended lives will demonstrate a lack of innovation and change. This is most ironic since this is exactly what it is protesting, innovation and change. The article considers life extension which is the aim of cryopreservation (though it could happen by other means too). It appears as though the powers that be are deciding if it's good for us to live longer! The suggestion, in fact, is that maybe it isn't, which is disheartening, especially since it reflects the opinion people with sizable political influence.
The vision of the reanimated cryonics patient is a symbol of hope. Hope for what the world may one day become, a world without disease, right here on earth. Cryopreservation, nanotechnology, and immortality are all hyperlinked and all highly controversial. If Bill McKibben had his way, we would not progress as a society but stagnate, perhaps even regress. Let's imagine this on a personal level. What if you or I never evolved and never learned new things but remained the same, out of simple fear? Fear of change is often the culprit preventing progress. Yet without change, we would not grow and that is the true joy in life. We have the capability to grow in knowledge, grow in relationships, advance our skills, and change and develop into better human beings. The same holds true for us as a society. Growth will happen. As we evolve and advance, we will encounter problems, certainly, but we must not stop or turn back. Progress is our best hope of desired outcomes.