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REVIEW ARTICLE
Year : 2017  |  Volume : 44  |  Issue : 2  |  Page : 63-66

Assessment of ethical aspects of cryonics: An emerging technology


Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India

Date of Web Publication11-Oct-2017

Correspondence Address:
Vagish Kumar L Shanbhag
Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, University Road, Mangalore - 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_19_17

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  Abstract 

Cryonics is a technology that is often looked upon with suspicion and as a science fiction. It is a life support technology that aims to revive a deanimated legally dead body on availability of suitable scientifically advanced technologies in the coming future. Thorough reasoning and analysis reveal that in fact cryonics is somewhat an extension of the current medical science and technology. The present article analyzes cryonics and attempts to discuss ethical aspects connected with it.

Keywords: Bioethics, cryonics, cryopreservation, deanimation


How to cite this article:
Shanbhag VL. Assessment of ethical aspects of cryonics: An emerging technology. J Sci Soc 2017;44:63-6

How to cite this URL:
Shanbhag VL. Assessment of ethical aspects of cryonics: An emerging technology. J Sci Soc [serial online] 2017 [cited 2017 Oct 22];44:63-6. Available from: http://www.jscisociety.com/text.asp?2017/44/2/63/216492


  Cryonics Top


Cryonics is preserving legally dead human (or animal) bodies or only its head part in extremely cold temperatures with the aim of reviving them in the future as and when appropriate scientific and medical advances become available.[1],[2] Cryonics is actually a type of conservative medicine.[3] Cryonics asserts that it provides long-term care for critically ill patients at lower temperatures, rather than its mere preservation.[4] In cryonics, death is noted as a series of process and not as an event.[5] Cryonics perceives a legally dead body to be in a state of dreamless sleep, which can be “awaken” through future advances in technology and science. Definition of death according to cryonics is based on information-theoretic death.[1],[6] According to cryonics, death occurs when the human brain cannot be repaired by the current technology and science and when the brain is damaged to such an extent that there is complete disruption in its cell structure and chemistry, resulting in complete loss of information contained in its structure such as memory, personality, and identity of a person. Cryonics aims to stop various body functions indefinitely and preserve the cell structure and chemistry of human body or head by cooling it to low temperatures, with an aim of using future science and technology to revive or resuscitate the person. Cryonicists are people who fulfill the procedures of cryonics and those who themselves want to undergo this procedures.[2] Cryonicists use the term deanimation instead of the term death.[2]

As science and technology advances, the definition of death should change accordingly. Around 100 years ago, it was believed that cardiac arrest was irreversible and the people were declared as dead. However, now, it is well known that cardiac arrest can be reversible through the current science and medicine such as cardiopulmonary resuscitation technology and cardiac defibrillation.[7] After 6 min of cardiac arrest, the brain tissue becomes ischemic and dies.[8] Hence, the aim of cryonics is to prevent the death of the brain tissue by preserving its structure and chemistry through cooling. Brain tissue has been successfully revived after 1 h of warm cardiac arrest, and vital brain cells have been recovered even after 8 h of clinical death at normal temperatures.[9] Cryonics uses very low temperatures of −196°C through liquid nitrogen.[3],[9] Cryopreservants such as glycerol are administered to replace water and body fluids from the body. Cryonics aims to replace not only blood in the bloodstream but also water from cells.[2] Cryopreservants prevent formation of ice crystals inside and in between the cells of the preserved body. Ice crystal formation is capable of causing fractural damage to the cells and tissues of the cooled body.[4],[10] Cryopreservants include ethylene glycol, propylene glycol, and dimethyl sulfoxide.[2] In modern day cryonics, brain structures can be preserved without this ice crystal damage through vitrification.[8],[10] This process of vitrification is performed in a computer-controlled cooling box.[2] A recent study described aldehyde-stabilized cryopreservation technique as a new brain banking technique which exhibits a characteristic ability to produce excellent anatomical resolution in long-term ice-free sample storage.[11] In this study, rabbit and pig brains were perfused with glutaraldehyde fixative. Then, increasing concentrations of ethylene glycol were perfused slowly over several hours till 65% w/v ethylene glycol was achieved. Furthermore, small quantities of sodium dodecyl sulfate and sodium azide were used to prevent brain shrinkage and mitochondrial swelling, respectively. Subsequently, the authors vitrified the brains at −135°C for indefinite long-term storage. The anatomic preservation of brain structure was excellent in both the species. The authors observed that this cryopreservation method has advantage of preserving anatomical brain structures over a long time without degradation and that the cryoprotectant can be removed by simple diffusion or reperfusion.[11] The authors concluded that aldehyde-stabilized cryopreservation method is superior to other methods for brain banking.

Cryonic procedures will ideally start from the moment when the patient is pronounced legally dead. It consists of stabilizing the legally dead patient through use of cardiopulmonary support and administration of protective medicines such as heparin to minimize or stop the coagulation, ischemic, and physical decaying process that frequently occurs after the death.[9],[12] New methods such as using cold saline solution, which is circulated through the entire body to stop the metabolic reactions and brain activity, are now being attempted to stabilize the body.[10] Although physical damage may occur to cadaver during preserving process due to extreme low temperature and toxic chemicals, cryonicists believe that future advances in the science and technology can nullify this adverse effect.[2] Through cryopreservation, a reversible and stable biological state can be achieved in animals and humans.[13]

Justification for cryonics is based on the following observations: (1) Even though low temperatures slows down or stop biochemical processes, human embryos are observed to remain functional and grow into healthy children even after preservation in low temperature for years. (2) Fully durable long-term functional mammalian kidney has been achieved after cryopreservation at −135°C. (3) Cooling the body at high temperature without the formation of ice crystals is possible by adding cryopreservants through vitrification. (4) Advances in the current and future nanotechnology, molecular biology, three-dimensional printing technology of biological materials and organs, and regenerative medicine may be in the future be capable of reviving each and every cell of the preserved body, in addition to restoring the patient's consciousness, personality, and identity. (5) Modern organ transplantation technology is already giving a new ray of hope to fight death. (6) Long-term memory is stored in brain cells, which do not need continuous brain activity for their survival and can be preserved by cryopreservation.[5],[6],[8],[10],[12],[13],[14]

The idea of neuropreservation or preserving the head of the legally dead patient is on the premise that the future technology such as regenerative medicine, stem cell technology, and nanomedicine, in addition to reviving the personhood, will be able to regenerate tissues of the body around the preserved head.[15] In neuropreservation, the skull is surgically separated at the area of sixth cervical vertebrae.[2] Cost of cryonics is high and is $200,000 for whole-body cryopreservation and $80,000 for neurocryopreservation in cryonic organization such as Alcor Foundation.[16]

An important ethical consideration of cryonicist is its moral thinking of attempting to save life of the legally dead bodies through cryopreservation. Cryonicists perceive that not recognizing cryonics means withholding the rights of a person opting to live. They believe that legal death is a condition where the current medical advances are not able to revive the dead. It asserts that by allowing cryopreservation of legally dead bodies, it provides the opportunity to the person opting for cryopreservation to get revived in the future when appropriate scientific and medical advances will be made available. Hence, cryonicists feel cryonics should be made legal, current definition of death based upon cardiopulmonary standard should be changed, more scientific research on this field should be supported, and it should be treated as a part of genuine medical science. Considering the fact that functions of humans can be restored to life even after up to 66 min of submerging in cold water, cryonics seems to be reasonably feasible.[5],[14],[17]

Arguments and ethical considerations against cryonics are that it is perceived just as a speculative science. However, it is better to keep hope and take the risk of it becoming a failure, rather than simply opting for burial or cremation which obviously is of no value in reviving to life. In addition, there may be significant advances in cryopreservation in the future such as to prevent damages that occur during thawing and reviving the cryopreserved body. In addition, existing cryonics system has arrangements to cryopreserve the body for as long as thousands of years to wait for the emergence of advanced technology to revive the cryopreserved body.[10],[18] The point is that there still may be some negligible hope of cryonics becoming successful in the future. Second argument is the doubt on whether the cryopreserved person revived in the future will retain the same amount of personhood and identity as before. As all the structures will be cryopreserved sufficiently till reanimation, it is likely that the personhood and identity will remain similar to as before. Third argument is that cryonics will contribute to overpopulation if cryonics will succeed. It should be remembered that population is already ever increasing every year even though cryonics is still in its infancy. Moreover, new technology in the future by itself may be capable to sustain the increasing population. Further, cryonicists could be taxed for contributing to the overburden just as taxing families who have more than two children. Fourth argument is that cryonics is expensive and cryonicists are selfish. In fact, cryonics is affordable through life insurance and may cost as low as a dollar per day.[10] In addition, opting for cryonics solely depends on the opting person's views, priority, his/her necessity, and an intense urge to survive. Just as it is unfair to call a person selfish if he/she opts to undergo an expensive bypass surgery to save his life, it is unfair to call cryonicists selfish for his/her longing to save his/her life in the future through cryopreservation. Fifth argument is that what should be the property and insurance status of the revived person if cryonics proves to be true. Cryonics views death as a process, so the person should be righteously offered his/her property rights, since now he is alive after a prolonged deanimation. The insurance view should be reconsidered as similar to the benefits given for a person with prolonged illness. Sixth argument is that when the person is revived after the “prolonged sleep,” he/she will have no friends and family and feel alone. It is possible that some of his/her family may also opt for cryonics or he/she may be able to find new friends or maybe he/she can be in contact with his/her family descendants.[18] Moreover, it is better to live than to die, whatsoever the reasons and be optimistic of life. Seventh argument is that the revived person may still find himself/herself with the same disease that killed him/her long before. However, it should be mentioned that cryonic organizations will not revive that person until technology is available to completely cure the person of the disease which killed him/her. Eighth argument is that cryonics is not environmental friendly since it requires a lot of resources to preserve bodies for a long time. However, it should be borne in mind that cryonics deals with preserving the body when compared to alternative options such as burial and cremation which are in contrarily just methods of disposal of the body. Ninth argument is that cryonics interferes with religious beliefs associated with death. However, it should be remembered that cryonics is similar to that of a medical intervention, which hopes to “cure” the person from “deep sleep.” Tenth argument is that cryonics may promote euthanasia. In the future, people may think that it is better to get cryopreserved their body before diseases such as cancer, dementia, and old age gets hold on their body. This argument seems considerable only when cryonics becomes successful. In such cases, this does not amount to assisted death as the cryopreserved body will eventually be restored to life. In addition, government can bring legislation or laws to disallow people to undergo cryonic preservation before legal death.[18]

The only three possible reasons for probable failure of cryonics may be that there may occur severe damage to the cryopreserved body during or before cryopreservation procedure so as to make it impossible to revive or recover the brain information or personhood or identity. Second, the future advances may never be able to advance sufficiently to revive the cryopreserved body. Third, the natural catastrophe such as earthquake or flood or bankruptcy of cryonic organization or sociopolitical conditions may create situations impossible to revive the person.


  Conclusion Top


Cryonics is nothing but a science based on extension of the current science and technology. Although it speculates and heavily depends on success of future science and medical advances, it does seem to have some value of benefit of continued living in the future. At present, the alternative to cryonics after death is burial or cremation, which obviously is useless. Cryonics should be considered, appreciated, and viewed as a form of life support to prolong life and fight death. More support and research opportunities should be offered to the field of cryonics to realize its full potential.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Jones G, Whitaker M, King M. Speculative ethics: Valid enterprise or tragic cul-de-sac? In: Rudnick A, editor. Bioethics in the 21st Century. 1st ed. Croatia: InTech Open Access Publisher; 2011. p. 139-58.  Back to cited text no. 1
    
2.
Monette M. Spending eternity in liquid nitrogen. CMAJ 2012;184:747-8.  Back to cited text no. 2
[PUBMED]    
3.
Monette M. The church of cryopreservation. CMAJ 2012;184:749-50.  Back to cited text no. 3
    
4.
Institute for Evidence-Based Cryonics. What is Cryonics? Available from: http://www.evidencebasedcryonics.org/what-is-cryonics/. [Last accessed on 2017 Jan 04].  Back to cited text no. 4
    
5.
Cohen C. Bioethicists must rethink the concept of death: The idea of brain death is not appropriate for cryopreservation. Clinics (Sao Paulo) 2012;67:93-4.  Back to cited text no. 5
    
6.
Whetstine L, Streat S, Darwin M, Crippen D. Pro/con ethics debate: When is dead really dead? Crit Care 2005;9:538-42.  Back to cited text no. 6
    
7.
Gorski D. Cold Reality Versus the Wishful Thinking of Cryonics. Science-Based Medicine; 2014. Available from: https://www.sciencebasedmedicine.org/cold-reality-versus-the-wishful-thinking-of-cryonics/. [Last accessed on 2017 Jan 04].  Back to cited text no. 7
    
8.
Alcor Life Extension Foundation. What is Cryonics? Available from: http://www.alcor.org/AboutCryonics/index.html. [Last accessed on 2017 Jan 02].  Back to cited text no. 8
    
9.
Alcor Life Extension Foundation. Alcor Procedures. Available from: http://www.alcor.org/procedures.html. [Last accessed 2015 Jul 04].  Back to cited text no. 9
    
10.
Moen OM. The case for cryonics. J Med Ethics 2015;41:677-81.  Back to cited text no. 10
    
11.
McIntyre RL, Fahy GM. Aldehyde-stabilized cryopreservation. Cryobiology 2015;71:448-58.  Back to cited text no. 11
    
12.
Cryonics Institute. Frequently Asked Questions. Available from: http://www.cryonics.org/about-us/faqs. [Last accessed on 2017 Jul 02].  Back to cited text no. 12
    
13.
Best BP. Scientific justification of cryonics practice. Rejuvenation Res 2008;11:493-503.  Back to cited text no. 13
    
14.
Crippen DW, Whetstine LM. Ethics review: Dark angels – The problem of death in intensive care. Crit Care 2007;11:202.  Back to cited text no. 14
    
15.
Alcor Life Extension Foundation. Cryonics Myths. Available from: http://www.alcor.org/cryomyths.html. [Last accessed on 2017 Jan 02].  Back to cited text no. 15
    
16.
Alcor Life Extension Foundation. Costs. Available from: http://www.alcor.org/BecomeMember/scheduleA.html. [Last accessed on 2017 Jan 02].  Back to cited text no. 16
    
17.
Bolte RG, Black PG, Bowers RS, Thorne JK, Corneli HM. The use of extracorporeal rewarming in a child submerged for 66 minutes. JAMA 1988;260:377-9.  Back to cited text no. 17
    
18.
Shaw D. Cryoethics: Seeking life after death. Bioethics 2009;23:515-21.  Back to cited text no. 18
    




 

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