December 6th, 2012

happytoast power lines

reposted for @ciphergoth

Source: https://www.quora.com/Cryonics/How-soon-will-we-be-able-to-cryonically-suspend-and-reanimate-people-clinically-and-safely/answer/Matt-Harbowy

How soon will we be able to cryonically suspend and reanimate people clinically and safely?

There are a few people being cryonically suspended already, however current methods cause substantial damage to many organs including the brain. Thus it is reserved for patients who are already clinically dead, which is itself a traumatic and unpredictable process that tends to inflict additional damage.

However at the opposite end of the spectrum is the theoretical ideal of cryopreserving patients without any damage -- as is usually portrayed in science fiction -- which means a person can be reanimated without requiring extreme repairs.

That is a harder goal than current-day cryonics, of course. And yet, once the goal is achieved, it could be practiced routinely on living patients without harming them -- it would instead add many years to their lives. A technology such as this could transport sick people forward through time until whatever treatments they are waiting for have made it through clinical trials.

People with viral infections could go into stasis while awaiting the production of vaccines, for example. Even cures for very long term and highly complex conditions like the diseases and causes of aging are most likely possible if you can buy enough decades of time to test and develop them.

Is this a realistic possibility for humans currently living? Is there likely to be a safe, clinically reversible cryonics technology within our lifetimes?



Answer updated based upon reinterpretation of intent of anon OP.


The intent of the OP is whether or not cryonics will become a viable alternative in the field of emergency rescue. There are significant ethical and financial problems with indefinite cryopreservation that I will address after the use case of temporary or time-bound cryopreservation. 

First, this assumes that cryopreservation is not being undertaken by otherwise healthy people. Even if there was reliable animal experiments which proved that a whole animal could be revived after cryogenic freezing with no apparent defects (which is not a technology I expect to see in the next 100 years), there would have to be a first patient, and as far as i know, you can't just sign your life away in exchange to be that first human subject.

The original question suggests that there is some technique that could slow metabolic rates on a whole body in order to preserve it for a time. There are two example use cases given- that the body is preserved until a cure can go through clinical trials (presumably the original intent of http://en.wikipedia.org/wiki/Dick_Clair ) or that the body is preserved until an organ transplant is available. I am going to suggest a simpler use case- in the event of an emergency evacuation due to trauma, so that the person can be transported (still alive) but with the body's mechanisms put on pause, so that a surgeon can be made available to provide the correct treatment. Let's call this the CryoAmbulance scenario.

But first, let me critique organ transplant. The article from the journal "Transplantation" (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&term=%22Transplantation%22%5Bjour%5D) which documents a recent change in protocol from performing a randomized lottery for organ transplant versus transplanting those rated to die "soon" on a priority basis http://www.ncbi.nlm.nih.gov/pubmed/22531492 seem to bode poorly for survival rates from the priority group. This highlights a point I would like to make about transplants and surgery in general: the more dramatic a rescue, the more likely the higher cost (human and financial) of the procedure. This is not to say that given an infinite amount of resources, so called "post-scarcity", that everyone shouldn't be given the chance at life. I don't believe that you can put a price on life, and I am not arguing for terminating the poor. However, we don't have infinite money nor an adequate source of donor organs nor exactly the technology we need today to meet all unmet medical needs. The allocation of scarce resources, no matter how it is done, is not done scientifically. Rather, it is done with satisficing, trial and error at the cost of patients lives, and I don't feel that people take a good hard look at what they give to future society when they insist on revival at any cost without ability to pay. When ethically sourced transplant operations might cost up to $800k (http://en.wikipedia.org/wiki/Organ_transplantation) the debt you incur from said surgery goes somewhere, and people cease to think rationally.

The better approach will be for organ transplant based upon organs that are manufactured on demand. We are able to currently construct scaffolding for some autologous organ regeneration, but the technology is not quite there yet. I expect that the ability to regrow human organs will be advanced sufficiently to replace a major organ (heart, liver, lungs, amputation) within the next 50-60 years. There's a problem, though, with the brain and the immune system, which I like to call the "Theseus' ship" problem. http://www.productiveflourishing.com/the-ship-of-theseus-and-personal-identity/

The brain is often thought of as a blank slate, a kind of "neural network" which is simulated by computational neural networks. Disregarding the possibility that the analogy is incorrect (at which point I might just believe in an incorporeal soul), we make our decisions based upon however our experiences have molded themselves inside our head. Frequently, we would make different decisions "knowing what we know know" but disregard that having done it that way gave us the experience to believe that. I have argued elsewhere that non-invasive or non-destructive techniques will never have the image resolution to take a living person and snapshot them in time to make a backup Radiology: Will MRI technology ever reach the resolution to image individual neurons?. Because it is a limitation at a quantum level to create a sufficient copy at great enough detail through any possible frequency transmission bandwidth less that that of cosmic high-energy radiation beams, I don't believe brain transplants, in the sense of giving you a new brain engineered from your own dna and put back into your otherwise healthy body (head trauma use case) will ever be viable without serious loss of memory and experience. These limits will also take place for more localized surgeries- it becomes increasingly difficult to accurately "stitch" a repair the more extensive the stitch needs to be. It may be possible to parallelize this in future remote surgical techniques in the next 20 years. Problem is, if one doctor botches things, how do you find out who to sue?

The single question, though, that advocates of cryonics should consider, is whether or not they believe that a computer is an adequate model for the brain. If so, are they not concerned that as soon as the power is off, the memory and any semblance of what makes you "you" will be wiped? You might be convinced that neurons, because the axon fibers can grow and reconnect, is something like flash memory. However, isn't it more likely that those are reserved for biological instincts, like breathing and "flight or fight" and the general OS of muscle movement, with the higher order functions of memory and philosophy is more like reflection? http://en.wikipedia.org/wiki/Reflection_(computer_programming)

CryoAmbulance use case

(coincidentally to writing this response, Cracked does a great post on the subject of the real cost of ambulances: http://www.cracked.com/article_19798_5-terrifying-secrets-about-riding-in-ambulance.html?utm_source=facebook&utm_medium=fanpage&utm_campaign=new+article&wa_ibsrc=fanpage When you think of the ways people abuse ambulance care today, imagine the cost of cryoambulances, relative to my argument that people don't think rationally about cost when faced with infinite penalties such as death. Even if it is hallucinatory.)

In order to determine the technology to take a living patient and transport them effectively from where they happen to be to where they can get the best care, we have to understand what is state of the art technology. 

If we are strictly talking about reducing body temperature to slow metabolic rate, we are talking about some form of hypothermia http://en.wikipedia.org/wiki/Hypothermia and it depends on what part of the body. The damage from hypothermia can be different depending on the particular organ, and on the body's ability to repair itself. With individual organs or severed limbs, the state of the art is about 12-24 hours, and tissues can be biobanked for up to five years. But the surgery for trauma is life altering, and the changes in a person's personality due to recovery from extreme hypothermia cannot be underestimated. When you elect for a procedure, you risk not only the ongoing pain from imperfect or needed excision, but the fact that cell death produces toxic materials and can make you much more susceptible to infection. Once infection sets in, it is extremely difficult to reverse. 

Whole body hypothermia is typically restricted to about an hour without some alteration in the innate metabolism of the cells. As such, I don't forsee hypothermic or cryogenic preservation to ever be viable solely in terms of some combination of mechanical and thermal methods.

In essence, I would like to distinguish cryopreservation (icing or freezing to stop metabolism without some other change) with hibernation. Specific cases where this has been achieved do not necessarily require hypothermia- http://en.wikipedia.org/wiki/Induced_coma comes to mind. Hibernation http://en.wikipedia.org/wiki/Hibernation either by lowering metabolism with a drug in combination with mild hypothermia or by supplementing fluids with antifreezes to replicate the long-time freezing and revival of e.g. goldfish raises severe questions: to take a computer analogy too far, how much of the brain contents is "hardware", and how much "software"? The brain is in constant activity, and we don't know to what extent completely freezing out the electrochemical activity causes irreversible wiping of memory or knowledge. A goldfish doesn't have to keep a lot of memories to survive- just a set of basic survival instincts which might be pre-patterned in. Before undertaking such a procedure, you might have to sign a waiver that says not all of you might be still there when you wake up after the cryoambulance ride. If you happen to remember nothing of your life prior to the incident, philosophically speaking, why spend the extra money on preserving "you" as opposed to, say, growing an entirely new clone or just letting a newborn child take your place in carbon consumption.

Pre-indefinite summary:

I am not optimistic for many of the expected outcomes of emergency preservation. One can think of technologies like, for example, Star-Trek like stasis fields, or even Clarkeian hibernation a la 2001. The electrochemical instantaneous makeup of a person is definitely impacted by sleep, but we are definitely not conserving metabolic resources when we sleep. We may need fewer calories to survive, but even in sleep we consume at a finite rate. It may be that we are ideally dreaming beings who have to periodically wake up in order to prepare for sleeping, but that is a separate metaphysical question. 

The analogy with Clarke is apt: Clarke has been widely hailed as having "forseen" the satellite, http://lakdiva.org/clarke/1945ww/ but his predictions for what space travel would be like in the future have not come to pass on his timeline. It's easy to prognosticate about the future when you have no skin in the game. 

As for "stasis", think about what that means. This is a classic problem with "transporter" mechanics: the amount of bandwidth required to transmit exact physical characteristics of a person and move them to another location is the same with keeping them in the same physical state indefinitely in the same location. 

The body is an extremely efficient copying machine. Many of the cells of the body are completely replaced every 20 years, many more frequently, and yet we still age and die.  I have argued against the shoddy science of much of the "life extension" program of some, such as SENS, in http://www.quora.com/TheExomeExperience/Telomerase-and-aging-part-2 The real question would be, if you were like a record on 78 and had the option of living like you were on 33 1/3 (?: http://en.wikipedia.org/wiki/Gramophone_record for you kids) would you do it? What do you gain for living the same amount of life except on slow? there are real unanswered emotional and psychological impacts to longer term hibernation, and until people can demonstrate that a barbituate coma or some other sort of procedure allows me to live a substantially longer period of time on "slow" compared with a reasonable control, I seriously doubt our ability to devise a means of slowing us down that doesn't have unintended, life-shortening side effects. 

Indefinite preservation:

Longitudinal studies are notoriously difficult. There's very few of them, they are immensely expensive to conduct. Yet, long term observation of the outcomes of various "preservation" techniques have yet to demonstrate any clear results on humans beyond the 90-110 year life span. If it could be done "naturally", why has it never been documented? If it is done through some mechanical or chemical means, why would we not necessarily be robbing peter to pay paul? The psychological effects of long term hibernation are well-argued in a novel by, of all people, L. Ron Hubbard: http://en.wikipedia.org/wiki/To_the_Stars_(novel) Here, he uses time dilation as the mechanism for indefinite hibernation, something we can think of as "possible using current known technology", despite cost.

I would argue that economically, we don't have the will or the means to conduct the scale of experimentation necessary, and that Terrence Reed might have a good point about the ethical conundrums.

I would say that his answer evokes the charlatainery of current "cryonic" methods, freezing people in liquid nitrogen. The idea that we currently have the technology to suspend indefinitely and reanimate someone, which relies on a distant future where the cause of death (and any subsequent injury from freezing) can be reversed, is impossible because all accounting of such a procedure is unsupportably reduced to an economically free scenario by most current implementation schemes. They can fund you frozen, but there will be no funds left to pay for your revival.

(to part 2...)
happytoast power lines

reposted for @ciphergoth, part 2

We will never engineer the ability to suspend indefinitely, and subsequently reanimate people.

In order to justify such a pessimistic view of the future, a genuine analysis of the challenges involved must be performed to find criteria under which it might be possible. First, though, let's do a use case analysis on indefinite preservation or "reanimation".

Ben Franklin Use Case

For purely personal reasons, let's say we wished to store and reanimate Ben Franklin. The historical reasons for such an activity seem clear: each subsequent generation will have new questions, new historical perspectives that would benefit from a first hand witness. But a human being has to have more purpose than to be chained up like an EPCOT Audio-Animatron.

At best, Ben would have about a high-school's worth of education, if that, relative to our era. Ben was a hacker, and would probably enjoy the social and intellectual environment of current hackerspaces. Therefore, he would need at least 5-10 years at full learning ability just to learn the things needed to be an effective statesman and inventor again in today's age. He would also have to unlearn some habits and customs which have aged out. 

Presumably, Ben would desire an unbroken chain of experience from his death until his resurrection, which would require filling the gap, and then having the insight to process what he learned in a way that would bring him some additional profit. More likely, however, he would just see the future for what the future happened to be at the time of his revival. He believed in a form of government that would end tyranny forever: the pain of finding out the number of times his founded State had become tyrant instead might be crippling to the optimist who wanted the national seal to read "Rebellion to tyrants is Obedience to God" in 1776. 


Ben quested after the same form of immortality that Ettinger sought- "By working hard and saving my money, I intend to become an immortal superman." http://www.cryonics.org/preface.html Transhumanism, singulatarianism, and SENS all share the same Moore's law conceit- that exponential growth can lead to some immense future profit, but in order for those profits to be realized, they need to be cashed, and cashing that check has always been a problem. Franklin set aside a small amount of money which he expected to grow without limit for fantastic projects- he might find living in the Franklin Institute less than ideal, and less fantastical than his imagination, for his second turn. Or he might find it very cool, because it is a pretty cool museum, but I don't think he envisioned a museum. I expect that when he is reanimated he would expect his small investment to have created flying cars, moon colonies, and genetically enhanced sex robots on his borrowed dime, that he also owned by virtue of making the donation.

What future do we seek?

Most cryogenic life extension foundations are created with the intent of supporting, indefinitely, your frozen corpse. You are not Ben Franklin, so you hope that in this future time the value of the foundation would have appreciated beyond mere cryopreservation but somehow to own (free of other's patents) the rights to reanimate you. Why? Because unless your memories are of pure, historical value, and your internet drivel not so driveltastic that futuristic atomic supermen decide it's not worth it to reanimate you, you don't have an exit strategy.

Ben was "best of the best": what hope do you have in overcoming his use cases' challenges? Do you think it is worth it to me, your future reanimator, to reanimate a human 1.0 when I can clone up some greater being that has my own genetics and whatever incremental improvements have baked into our chromosomes by then? After the novelty of reanimating Ben and chatting with him for a while, what do you expect him to contribute to society beyond keeping me entertained for a few weeks? It is this future that is completely absent in most people's ideation of the result of cryonics. The benefit of reanimating archaic humans will always be far less than the benefit of creating a new one from scratch.

Few people contribute continuously over their lifespan, and there's a couple causes for this. First, you begin to slow down, age, degenerate, and that's the easy part, the part "future science" will cure. But second, your thought processes become more entrenched. If your brain is in fact well-modelled by computational neural networks, they become very good at solving a minimal set of problems and pretty much useless at solving new problems as their nets begin to lock out and specialize. How much of you would be offended by whatever mores the future holds? There's a reason Young Ben wrote his epitaph differently from Old Ben:

youngThe Body of B. Franklin Printer; Like the Cover of an old Book, Its Contents torn out, And stript of its Lettering and Gilding, Lies here, Food for Worms. But the Work shall not be wholly lost: For it will, as he believ'd, appear once more, In a new & more perfect Edition, Corrected and Amended By the Author.

oldBenjamin and Deborah Franklin.

Old Ben realized just what death meant- the end. You can believe in an afterlife, but you should probably bet against it until you meet someone arisen from it. Christians, by and large, think they already have done so in Jesus, so I can't see cryopreservation as a very good strategy for christians.

People save old home movies, tapes, CD's, etc, and i don't intend with this response to minimize the entertainment and informative content of such things in the context of heavy curation. I just don't expect my curated value to exceed zero. If you wish to say we will ever have this ability, you have to come up with the how and why of universal post-scarcity economics and prove to me that your personal worth to other people is non-zero over extremely long periods of time. People want to be Cleopatra, not third whore from the left, talents notwithstanding. How is the average person that's been cryopreserved worth more than a newborn? Ettinger isn't, and if as future curator of the stack of corpses in a cryobank i were forced to unfreeze one experimentally, I'd bank on his as wastable for science.

Think about it: do you really expect that you will be immortal, or the last person to be unsuccessfully unfrozen before they perfect the technique? And in terms of an answer for you, as a singular person, doesn't the latter seem much much more likely? Great, they reanimated your corpse but you're mostly multiply disabled. Or they reanimate your brain in a body with green skin and a tail because that's what humans have evolved to- how do you like that? It might appeal to some, but to most, you would begin to question what else they didn't get right. Why are you not better than everyone else in this new world? Aren't you no more useful than a delivery boy? Why?

The main problem is, that this question can be answered statistically, which is absolutely meaningless without knowing about how many reanimations have to go wrong before they get the experiment exactly right as you envision it in your head. There are about 200 corpses in line ahead of you, Walt Disney included- how do you really feel about being test case subject #201? What contractual obligation do you think they have to you, Mr Philip J Fry? Even if the statistical answer was 200 years, would you still be enthusiastic if they expect to need about 1000 human test subjects before they expect to get it right?

A living person can consent to tradeoffs of a medical procedure. If there's a 10% chance I'll die or become a vegetable for some finite cure, i can decide whether it's worth it. But the future risks of an undeveloped procedure isn't something I can ever reasonably give consent for.

The OP argues that my repeated evocation that your lack of ability to pay for being immortal is, perhaps, unkind. It is not my intent to objectify humans, but to bend to the ultimate reality that (barring, as I say, post-scarcity from fusion power, replicator, and warp drive, which I place squarely forever in the realm of "science fiction" due to fairly reliable understanding of the physics involved) someone has to pay. You might as well argue that "perpetual motion machines" are possible because I can write science fiction in a way that makes them possible. Wishing does not make it so.

The intent on my post is not to discourage. I would like to be proven wrong! but I am trying not to cause you to give up, but begin to see the real barriers to progress, so you can begin to break the problem down into tractable problems that we can achieve in our lifetimes. Don't ask for immortality. Ask for things you can do- to better understand how the genes and RNA and proteins work to keep you alive. You cannot understand what you cannot build, so be open to creating life forms of all kinds. Most of all, accept that the people from this era are cavemen, neanderthals, to be put in museums 200 years from now. Envision the Franklin Institute of your 200 years from now, The "Anon OP Institute". http://www2.fi.edu/- what are you going to exhibit there? I've provided tons of links and references I have used to support and inform my views. Curate me a museum, and I will grant you have immortality.

In 800 years, the DNA which made you up and you might have passed to g-g-g-g-grandchildren will have passed away from every human alive, and any genetic contribution you specifically made will be almost certainly gone from humanity unless you are super special. Accept this. http://hbergeronx.livejournal.com/309847.html

Metaphysically, after death, you're on your own. I have accepted mine, and still found reason to learn. It's not what you can do for yourself, to extend your lifespan, that matters- it's that you have an open enough mind to accept your obsolescence when it comes.

updated based upon http://blog.ciphergoth.org/blog/2010/02/14/an-open-letter-to-scientific-critics-of-cryonics/

It is reasonable to assert that criticizing cryonics based upon the fact that one has not successfully done it, is disingenuous. Therefore, let me criticize the idea that one can add a cryopreservative to create a reversibly preserved specimen. This is something which I have some experience with, in an analogous sense.

I've done a number of experiments where i use various solvents to perform extraction of substances which have a highly polar, hydrophilic nature. Subsequent to extraction, I seek to isolate these components in a dried form that allows their future use and reconstitution in an unaltered chemical state. What I have found is that if you choose a solvent which has a higher boiling point than water, such as glycerol, DMSO, butanol, or the like, it is extremely difficult to get it back out unless extracting it with a lower-boiling solvent to remove it from the aqueous solution. The problem for tissues is that most of these lower boiling substances are going to either be toxic or damaging, swelling the matrix due to changes in density and hydrophobicity.

Even more so, with techniques like sugar. Although a high concentration of sugar or other poly-alcohol antifreezes may be less inherently toxic than glycerol or ethylene glycol, the simplest members of the class, the removal of these substances is extremely difficult for many of the same reasons as butanol or other high-boiling alcohols- the energy needed to reverse the reaction, displacement of polyalcohols with water, is far greater than the energy needed to diffuse them in, and often causes very slight micro-damage which can clearly be visualized in model systems as Maillard browning. Put a pure, white amino acid in solution with a pure, white sugar, and freeze dry it in large trays, and you will see slight hints of color no matter how carefully you perform the freeze drying. The energy you add back to such a mix is nearly impossible to perform uniformly over more than a milliliter or so of volume.

You might argue, that freeze drying is nothing like reanimating vitrified samples, except that the principle is the same- you need to remove the preservative at the same time as readding liquid water. This is trivial with thin slices of tissue- either in freeze drying or reanimation, but nearly impossible with larger structures. In freeze drying, you are bursting the water out into the gas phase and replacing the hollow with voids. In vitrified tissue, you are reperfusing water in exchange for the preservative. if the process is energetically favorable going in, it is going to be unfavorable going out. On one side or the other, you need to add energy, and without the means to conduct it uniformly through the sample you will get browning- and damage. 

In this sense, cryonics is attempting to sell a perpetual motion machine- they believe that in the future, we will find a way to reperfuse downhill both ways. And if the suggestion is made that slices of the brain could be taken to perform this more evenly, I refer you to David Gerard's analogy of putting a CD through a paper shredder http://blog.ciphergoth.org/blog/2010/02/14/an-open-letter-to-scientific-critics-of-cryonics/#c42 - if you are arguing that the fine microstructure is where the memories are stored, exactly which memories are you willing to sacrifice in return for reanimation? Do you think a computational neural network with 1% of its connections erased, or even fewer than that, still performs?