I'd actually be encouraged to see donated organs cryopreserved, and used for transplant long after their unpreserved expiry.
When we are using cryopreserved organs, then preserving the brain becomes more obviously pragmatic.
I am guessing that cryopreserved human kidneys do not have uniform cooling, spoiling interior tissue. A rabbit kidney is much smaller, and wouldn't suffer as much from this problem.
Anyone who looks them up online can find this information easily. It is required to be public since they are a 501(c)(3) non-profit. Here are their current board of directors: https://www.alcor.org/library/alcor-board-of-directors/
> What if their interests become misaligned wrt customers?
Anything is possible but this seems extremely unlikely given their governing structure and requirements for being on the board of directors. Alcor has been criticized in the past because they fall very far in favor of protecting their existing patients in cryopreservation rather than making accommodations for prospective patients, leading to them turning away prospective patients for a variety of reasons.
> A fundamental rationale for selecting the self perpetuating Board structure was its ability to provide continuity of purpose over a long period of time. Existing Board members select those new Board members who they believe are best able to preserve Alcor’s core values and carry out its mission. All Board members are required by Alcor Bylaws to be Alcor members. While not required by the Bylaws, we also find that Alcor Board members are cryonicists of long standing and are well known within the cryonics community. By tradition, new Board members are usually sought from the ranks of Alcor Advisors, although the Board can and has selected Board Members who have not been Advisors. Board members have a strong incentive to choose carefully because the success of Alcor and the survival of our members — including our Board members — is heavily dependent on the abilities and character of future Boards of Directors.
BTW, I'm not a shill for Alcor. I think some aspects of their operations are worthy of criticism. But this is not one of them. If you disagree, feel free to state why, but I would recommend at least learning the basics about them before doing so.
I agree it looks like someone tried to handle the thorny cases, but without real force of law protecting the corpsicles (perhaps revive-able, perhaps not) then it makes me think of "greater fool" investments, except in this case it might be charitably amended to "greater altruist".
Every person buying in--or perhaps checking in--to the system needs to trust that there's another person coming after them who is equally-invested in the projects' success, and at least able to pay the power/maintenance bills.
Somewhat aside, the fiction book Cryoburn (a long way through the excellent Vorkosigan saga) does explore some of these issues in the background: The protagonist visits a planet where the frozen citizens have their voting-rights delegated to whichever corporations hold their storage/revival contracts. (In fact, some corporations are even trying to commoditize contracts so that they can be traded, in a likely allusion to CDOs during the 2008 property crash.)
One of the core problems of cryonics is the suite of technologies needed to revive a person from the frozen state and then fix whatever was wrong with them before freezing is indistinguishable from physical immortality. So once we can revive corpsicles, nobody will ever be frozen again! So there's no situation where you could actually get that tested body of law around corpsicle rights.
The cryonicsphile response is, of course, that the alternative is death. Even if there's a 1 in 100 chance of being thawed, even if you're legally enslaved to pay off the unfreezing debt or are returned as an uploaded brain in a computer, that's still better than rotting in the ground, right?
I agree there's a problem there, but I don't think it's quite that absolute, since people might be frozen for other reasons.
For example:
1. A patient with a rabies diagnosis, awaiting a future treatment.
2. Someone born with with muscular dystrophy, waiting for a retrogenic cure.
3. Someone who has simply run out of time to wait for a difficult to find donor organ.
4. The victim of gross physical trauma where there are too many. Holes to plug and things to sew and tubes to reconnect for it to be done safely in a warm state.
Any of those things could provide the necessary legal test cases without implying anything about whether we've cracked functional immortality or not.
>Anyone who looks them up online can find this information easily.
The specific concern is about who operates it _eventually_ (perhaps centuries from now.) I can look up who is on their current board and what their governance structure happens to be now but it isn't relevant to my hypothetical concern. Lots can happen in relatively short periods of time and the well-meaning intent behind their current governance structure can surely always be subverted by sufficiently incentivized and devious humans. I also don't mean this as a specific critique of Alcor. My concern is about the general concept of "freeze-now and wake-in-100s-of-years."
Freezer burn occurs when moisture escapes from frozen biospecimens due to slow freezing and temperature fluctuations. It's not an issue during storage in liquid nitrogen, which causes much faster freezing and has a much colder storage temperature level.
> And a few very wealthy people
Cryonics is not only accessible to the very wealthy. There are options available that are equal or less expensive than an average funeral.
> How do you keep a cryostasis business honest when you - the customer - are dead and there is no profitable reason to keep you from becoming like that loose frozen hamburger at the bottom of my freezer
1: The companies are non-profits so profit is irrelevant.
2: You look at their long-term reputation which is important for them to get new clients. This is why Alcor has been around for 50 years without thawing a single one of their patients.
> They still need to be able to keep the fridges on.
I believe they are usually set up to invest the money people paid in, then keep the lights on with returns on that. They're not using the money directly.
> Which means "without proving they can actually deliver what clients expect".
They're very clear that they can't promise anything. People are willing to take the chance anyhow.
Is there a fallacy or lie in the parent comment you'd like to expand on, or are you just assuming OP is a shill? Because these are basic facts that apply to any cryonics company so I'm confused as to where your accusation is coming from.
Do you know what else sounds like a recipe for killing people? Not allowing people to access therapeutics that might save their life because it hasn't yet gone through regulatory approval yet for whatever reason (delays, too expensive to submit), etc.
> There's very little that's approved by a non-US body and approved by the EU or non-OECD body that warrants clinical use, and if it is it gets reviewed quickly
LOL. What are you talking about. There are so many examples.
One of the most tragic is amisulpride. Amisulpride is an antipsychotic medication used to treat schizophrenia and other psychiatric conditions. Some key notes about its regulatory status:
- Amisulpride was first approved in France in the 1980s and is widely used in Europe.
- It was never approved by the FDA for use in the United States, and at this point there's not organization that can afford to go through the approval process because there's no patent.
- The reason often cited is that the manufacturer did not apply for approval with the FDA. It was likely not considered commercially viable for the US market at the time.
- Amisulpride is believed to have comparable efficacy to other second-generation antipsychotics like olanzapine and risperidone, but with a lower side effect burden according to some studies.
- In Europe, amisulpride is considered a first-line treatment option for schizophrenia, but American psychiatrists do not have access to it. According to some sources, it is literally recommended as the best antipsychotic in other countries.
> Do you know what else sounds like a recipe for killing people? Not allowing people to access therapeutics that might save their life because it hasn't yet gone through regulatory approval yet for whatever reason (delays, too expensive to submit), etc.
Should we at least demand more specific criteria than "X _might_ save their life", like threshold of suggestive evidence? There will always be lots of stuff that hasn't been closely studied, the effects of which we can only partially describe. You could isolate any new molecule from some previously unknown bacterium and say it "might" be a treatment for any disease, but that's just a statement of our own ignorance right?
If we say, "so long as it hasn't been conclusively shown to _not_ beneficial for the patient's disease, then it _might_ help them, so it should be fair game", then that seems to open the door to quacks selling snake oil to desperate dying people and their families. And of the unenumerable list of potential "it might work because we haven't yet shown that it doesn't" chemicals, why shouldn't unethical practices pick the most expensive options available?
"Of course you must understand there can be no guarantees with any treatment, and this may be a long shot, and precisely because of the lack of prior studies we cannot even give you any efficacy numbers. But we're at the cutting edge of medical science! Please make out a check for $500k and sign this waver and we can begin treatment as soon as possible."
> Should we at least demand more specific criteria than "X _might_ save their life", like threshold of suggestive evidence? There will always be lots of stuff that hasn't been closely studied, the effects of which we can only partially describe.
We do, it's part of the FDA process and is determined on a case-by-case basis considering alternative treatments, disease course and intervention safety amongst other variables.
It's how the vast majority of stroke and novel cancer therapies are currently being approved.
> Do you know what else sounds like a recipe for killing people? Not allowing people to access therapeutics that might save their life because it hasn't yet gone through regulatory approval yet for whatever reason (delays, too expensive to submit), etc.
You're assuming a therapeutic not tested in humans has a better chance of saving someone's life than something tested and available. Do you have any evidence to support this?
> One of the most tragic is amisulpride. Amisulpride is an antipsychotic medication used to treat schizophrenia and other psychiatric conditions. Some key notes about its regulatory status:
There is little randomised evidence comparing amisulpride with other second generation antipsychotic drugs. We could only find trials
comparing amisulpride with olanzapine, risperidone and ziprasidone. We found amisulpride may be somewhat more effective than
ziprasidone, and more tolerable in terms of weight gain and other associated problems than olanzapine and risperidone. These data,
however, are based on only ten short to medium term studies and therefore too limited to allow for firm conclusions.
This review compared the effects of amisulpride with those of other so called second generation (atypical) antipsychotic drugs. For half
of the possible comparisons not a single relevant study could be identified. Based on very limited data there was no difference in efficacy
comparing amisulpride with olanzapine and risperidone, but a certain advantage compared with ziprasidone. Amisulpride was associated
with less weight gain than risperidone and olanzapine.
What's so tragic about this? Equally efficacious antipsychotics are available. Once again the alternative to non-approved drug isn't nothing or inferior substance.
I will concede that legacy off-patent drugs are part of the "very limited" gap with the FDA, this doesn't hold for new drug discoveries as discussed in the article.
Even then, there is an ongoing US trial for amisulpride and the substance is approved for nausea/vomiting (granted not in oral form).
"A comprehensive meta-analysis published in 2019 in JAMA that compared 32 oral antipsychotics helped solidify the sentiments shared by Kahn and other investigators who have conducted clinical studies with amisulpride. That meta-analysis identified amisulpride as the second most effective antipsychotic at reducing overall symptoms in schizophrenia patients (behind clozapine) and the most effective in terms of reducing positive symptoms. The analysis also ranked amisulpride better than clozapine in terms of tolerability and side effects."
> Antipsychotics are incredibly important medications for a lot of people.
Agree.
> It really matters that amisulpride is not available.
Not sure about this, I'm not a psychiatric expert but my cursory lit review shows conflicting meta-analysis as to whether amisulpride is better than 2nd gen. Although your source is newer Cochrane is generally the gold-standard on SRs and the included studies in the 2019 JAMA article predate the Cochrane review, they detail the limitations of comparison.
Looking at Canada, amisulpride is limited to special access and is also not first line.
The UK pharmacotherapy guidelines are also waffly and cite limited evidence to guide firs-line decision making.
A systematic-review from China showed different side-effect profile for both, hard to say which is better. Amisulpride was cheaper.
In any case old drugs that were never approved are part of that "very little" I was referring to that fall through the cracks.
Not sure I'd call this one tragic though given that other countries also don't use it or limit access and there are good alternatives.
The problem with "there are similar efficacy rate alternatives" is that, for most psychiatric drugs, it's not necessarily the _same_ population that is helped by two different drugs at similar efficacy for the same issue, even if the total success rates are comparable.
A number of people have tried many different individual or combinations of treatments before finding something workable, or close enough to workable that you can paper over the cracks. I would strongly suggest against concluding the lack of access to something isn't an issue for some patients because they have alternatives, without very compelling evidence.
A story from my recent past - I've had, historically, no issues swapping between different generic manufacturers, or name brand and generic, if someone stopped making something I was taking, or I moved and the pharmacies stocked different versions, or whatever. So a little over a month ago, when I noticed my meds looked visibly different after getting them filled, I checked to be sure they hadn't given me the wrong thing, but no, same dose, different generic manufacturer, and I stopped worrying.
...until I started getting extremely nauseous to the point of being debilitating, for 6-8 hours every time, when I take this medication twice a day. So I went back and tried the third generic manufacturer the pharmacy had, after a few days of making sure it wasn't a fluke, and the third one had the same issue. We finally ended up switching to the extended release version of the med, which had still more different manufacturers, and did not have this issue, since the first manufacturer had a shortage for over a month and counting.
Medications are a lot less interchangeable than we might hope.
I apologize and wish I could have presented it better. I first compiled this in 2019 and had been planning to summarize it more. Alas, I recently realized that I wouldn't have the energy for that and that I should simply publish as is.
I'm surprised that people care at all, but perhaps I underestimate how many are as interested in the content as I am.
Regarding the formatting, I will try to update the background to something more readable using wordpress, although I obviously lack your skills in this area. In the meantime, you're free to copy it onto your website or elsewhere.
Very fair point. There are other examples that go beyond DHCA, though, and point clearly in the same direction. One example is that sometimes people suffer cardiac arrests and lose consciousness for minutes to hours 10.1016/j.resuscitation.2014.06.015. Coordinated electrical activity stops after a few minutes following cardiac arrest, but people can (rarely) be revived with their apparent memories and personality intact.
"It doesn’t do any good to use the most advanced techniques to get our members into cryopreservation unless we can keep them there, as well as build capital to eventually fund revival and reintegration."
Also, if the technology to do revival develops in the future, it is likely to be relatively cheap.
Analogy: in the 1910-1920s, people were interested in life extension via hormone replacement therapy (mostly misguided, but that's a separate topic). They were understandably worried that this would only be available to the rich, as it was relatively expensive to do at the time. One hundred years later, hormone replacement therapy is relatively cheap and widely available, at least in countries like the US.
There are many many problems with cryonics, but IMO this is not a major one.
Not sure how that helps. What is alcor’s incentive to bring me to life in the future? Remember, I’m dead, so I can’t post nasty comments on twitter when they leave me in the vat.
More generally, why would I trust a private company to bring me back to life? It is extremely rare for any company to last for hundreds of years. And pretty much inconceivable for one to last that long without going through periods of very short term thinking.
So if your point is a separate one, that Alcor et al might have to close, eg as a result of war or global financial collapse, then that is a very reasonable point and absolutely a potential cause of failure.
It is one of the things that Tim brings up as well: "The cryonics company goes bankrupt and doesn’t have the means, the will, or the organization to create a plan that will save the patients. I mentioned that this happened a few times with some of the earlier companies. The major companies today claim to have secure backup plans in place in case of the worst case scenario, and this security blanket is the main purpose of Alcor’s sizable trust."
No, I was just supporting my original point. I think that for the most part, people do things because they are incentivized to do them. What is Alcor's incentive to wake me up 500 years in the future?
Contractual obligation? I find it very unlikely that legal systems and national organizations will still be around 500 years from now to make it necessary for Alcor to honor it's agreement with me.
Market forces? I doubt it. Say Alcor is still in business - their business model will have to be very different, given the change in technology we can expect in 500 years. Since they will be selling something very different, will anyone care that they dumped those 500 year old bodies? Probably not. They will just announce on a Friday before labor day weekend that they had an anomaly and lost cooling, and by Monday everyone will have forgotten.
Familial connections? Why would my ancestors want to bring me back to life? Would you want to bring your 80 year old great great great great great aunt back to life right now, and give her antibiotics for the pneumonia she died of, and then care for her? Remember, she has never seen a telephone or a computer or a tanning salon, so it is going to take a lot of work on your part just to get her comfortable with living in the modern world. If you want to bring more people into the world, why not make or adopt a baby? Why pick an old person to bring into the world?
Moral obligation? Ha.
I just don't see any reason for me to be brought back to life. The only way I see it working is if I somehow created a financial reward for whoever brought me back to life. That seems almost impossible to pull off though.
I'm working towards a phd in genomics right now, primarily doing bioinformatics. Here are some thoughts:
1. You're almost certainly likely to make more money doing something else, like web development or finance. Scientists get paid very little money relative to their education and abilities, with the trade-off of interestingness. If you go into it, it shouldn't be for the money. So basically yes in re (2). So for you, doing bioinformatics would probably have to be a goal in your life that you're willing to make sacrifices for.
2. If you want to work on life saving drugs or curing cancer, you could learn how to make some contributions with a MS, but realistically would need a PhD to have more autonomy. Depends on what matters to you.
3. The main benefit would probably be working with a good mentor and helping to decide if you want to go for the PhD. Not sure about your prospects in industry with an MS however.
