X-Message-Number: 3115
Subject: CRYONICS:Risks, good and bad
From:  (Charles Platt)
Date: Sun, 11 Sep 94 22:14:35 EDT

Regarding "risk": There is a lot of potential for confusion 
here, because the word "risk" is being used by different 
people to mean different things. Let's break it down as 
simply as possible. 
 
Storage risk, we all agree, is bad risk. We want to be stored 
as safely as feasible, though we may disagree about how this 
should be done. 
 
Risks taken during standby/transport/perfusion are another 
matter. Here, there are two kinds of risk: good and bad. Bad 
risks may result from ignorance, haste, poor equipment, 
missing equipment, delays, inexperience, misunderstandings, 
and imperfect assessment of a situation. There are cases 
where patients have been subjected to some or all of these 
risks, despite the good intentions of all concerned. I will 
say however that BioPreservation has minimized these risks to 
such a degree, it currently has a better record than any 
other organization in the standby/transport/perfusion phase 
of cryopreservation. The records of BioP's two recent cases 
provide documentary proof of this. 
 
Now, let me turn to the concept of "good risks." These are 
the risks in standby/transport/perfusion which are taken *on 
behalf of the patient.* For example: a hospital may demand 
that the standby team should not administer any medications 
to the patient--even after legal death is declared--until the 
patient is off the premises. The hospital may even refuse to 
allow the patient to be packed in ice. The standby team may 
feel that this will result in so much damage to the patient 
(because of a long period of ischemia) that it is "worth the 
risk" to disobey hospital rules and administer the treatment 
that the patient needs. This, of course, is good from the 
patient's point of view, but it may get the standby team into 
some sort of trouble. 
 
If the standby team is employed by the same organization 
which also maintains patients in long-term storage, there is 
a problem. If the team "breaks the rules" of some instituion 
on behalf of a new patient, legal backlash can threaten the 
whole organization--including patients who are currently 
frozen. Thus, the "good risk" (from the new patient's point 
of view) turns into "bad risk" for the patients who are 
frozen. In the past, there has been a lot of argument about 
how best to balance out these conflicting considerations. 
 
The obvious answer (I think) is to have a standby team that 
does NOT work for the company that stores patients. Once this 
decoupling has occurred, the standby team can take any good 
risks it feels necessary on behalf of the new patient, while 
the patients that have already been frozen are protected by 
being under the control of an entirely separate company. 
 
This is the happy situation which we now have with 
BioPreservation, which provides "emergency cryonic care" 
before passing the patient to a separate company for long-
term storage.
 
>From the above, it seems obvious that the "risk debate" which 
caused a lot of discussion during Mike Darwin's tenure at 
Alcor is no longer relevant (except to Alcor's current 
suspension team, led by Tanya Jones, who probably has 
opinions of her own on this subject). Mike Darwin can risk 
his ass on behalf of CryoCare or ACS patients without any 
repercussions affecting patients who are frozen, because the 
frozen patients are elsewhere. 
 
The "risk debate" is, in fact, a tired old bogeyman which has 
been resurrected presumably for the sole purpose of making 
people nervous--a tactic which does not surprise me, but does 
sadden me, because it stands in contrast to the much higher 
level of discussion we have seen here recently. 
 
--Charles Platt, vice-president, CryoCare
(I believe the above statement represents a fair summary of
CryoCare's policy on this topic, which is why CryoCare 
currently contracts for the services of Mike Darwin and his
company, BioPreservation, for standby/transport/perfusion.)

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Charles Platt  /  1133 Broadway (room 1214)  /  New York  /  NY 10010 
               / phone  212 929 3983

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