X-Message-Number: 6781
From:  (Thomas Donaldson)
Subject: Re: Hope and Cryonics
Date: Wed, 21 Aug 1996 00:02:39 -0700 (PDT)

Hi!

1. The example of doctors keeping their patients on respirators is a very 
   inappropriate one for what I believe you want to say. It is exactly the fear
   of being put on a respirator indefinitely that makes many people support
   a right to assisted suicide. Not only that, but usually  what happens is
   that doctor's put someone on a respirator not out of hope but because there
   is no clear legal statement to the contrary by the patient or his/her
   relatives, and they don't wish to risk a lawsuit. That is fear rather than
   hope.

   Yes, it is true that some families want their member to be placed on a 
   respirator in the hope that they will awaken, despite everything their
   doctors say. The number of those who do this is not large. Furthermore, it's
   far from clear that they would accept suspension instead --- they want to
   have the person back with them again. The only families which would want
   suspension in such a case are those who have already arranged for suspension
   for themselves.

2. There are many different grades of hope. When I am vaccinated against 
   measles, I do so in the hope that the measles virus will not suddenly 
   mutate into a new and virulent strain which happily ignores my vaccination.
   That is not a hope which I think is very questionable at all. If I have 
   heart surgery, I hope that I can recover and be as well as I was before;
   that hope is more questionable, but it does happen, and I can point to 
   people to whom it has happened. But then if I choose to be suspended, I
   have no more support for my hope than a simple belief that I WILL remain
   in suspension for as long as it takes, and that someday human progress
   in medicine will give me a cure. Compared even to the hope of a heart
   surgery patient, these are not strong versions of hope at all.

3. Yes, it will be interesting to see just how things play out when we can
   reversibly suspend brains. The first point we should remember, however,
   is that we should not impute our own definition of death to others who
   are not cryonicists. (Yes, our definition is better, certainly, but 
   that's not what I said). I don't claim to know what will happen. However,
   short of full body suspended animation, we will be suspending our 
   patients ("alive" or "dead") in the hope that someday we can provide
   them with bodies --- again, compared to heart surgery, a pretty wild
   hope.

   As you know yourself, the line between "life" and "death" is drawn by
   a quasi-religious ceremony, the "Declaration of Death" and the completion
   of a "Death Certificate". And the current definition of death, for what
   it's worth (not very much, but again that's not the point here) is that
   the "dead" person has irreversibly ceased respiration and heartbeat. Yes,
   an isolated brain clearly cannot breathe or have a heartbeat. Perhaps we
   will see some people seriously rethinking those ideas --- I hope so ---
   but I suspect that a very high proportion will go on just as
   before. The real problem for us, and one which one or a few scientific
   discoveries won't answer, is that this quasi-religious ceremony has the
   force it has on the imaginations of those participating. And a serious
   rethinking of "death" does not mean automatically a choice of suspension
   in preference. 

   Not only that, but we must deal with a gray area while others decide
   to see only black and white. To say that medicine will advance isn't just
   to say that we will learn how to cure diseases among the "living". It
   means also that we will draw the line very differently. And reversible
   brain suspensions or not, we will still want to suspend people now 
   considered by most to be "dead". That is exactly what all the current 
   work on resuscitation medicine and repair of brain damage is about: to
   find ways to recover people from conditions once thought so hopeless as 
   to amount to "death". When we progress, we don't just learn how to solve
   the old problems, we see the problems in a completely new way. To fail
   to use suspension in such cases would condemn many who may someday 
   be revived. Maybe you would be among them -- or me.

   Part of cryonics consists exactly of this refusal to believe that our
   inability to see a way to cure someone means that no cure can exist. And
   our view of "death" goes with that.  

   I doubt very much that suspension will have much use in medicine ---
   until medicine itself absorbs cryonics. (Yes, that will someday happen).    
   Many doctors will ask what the REAL difference is between being suspended
   "alive" at the age of 85 with many of the diseases (cancer, heart disease,
   etc) that come with aging, or to be suspended "dead" at the same age? To
   choose to do that for yourself or your relatives takes an awareness of 
   our true situation (how little we really know) that most people have 
   already shown they lack completely. And they will think that to do so 
   is cruel, and imagine that 85-year-old lost in a future which still cannot
   help them. 

   And it is just such people for whom cryonics is meant. Most people now do
   not die young, of simple diseases or accidents. We do not expect to do 
   that either, and will someday become "hopeless cases". Even if doctors
   were somehow convinced of the merits of suspension (that someday some
   medical conditions would be curable that now are not) then most cases 
   including ourselves would still be seen as too hopeless for suspension. 
   Sure, they might use it suspend people with a condition for which most
   doctors felt a cure was imminent: but that is NOT a large number of people. 

4. Does what I am saying suggest that we should do nothing to improve our
   means of suspension? Not at all! The better they are IN OUR TERMS, the
   more reason WE will have for hope. But it remains important that we should
   not believe that all those others out there accept our own ideas. Even
   the idea that the state of our brains, rather than anything else, is 
   central to life will be hard to swallow. Not only that, but since suspension
   is always something with uncertain outcome, we will not KNOW that our
   own suspension will be successful. Sure, we'll have more evidence, but 
   evidence isn't proof. Even with fully perfect full body suspended animation,
   many things can go wrong. The uncertainty and hope will simply have been
   shifted to other questions. It's important that we understand this, that
   by its nature cryonics cannot have any guarantees, not even of awakening.
   
Brian, I will also say this: I do not believe that we will ever see any
sudden awakening to cryonics. What will happen is a slow wearing away of one
set of ideas and their replacement by another. Reversible brain suspensions
would certainly be part of that, but not the only part... simply because they
still would not answer many questions. If I were to try to convince anyone to
join, I would point out first that essential uncertainty, and then tell of how
much we have done to date, and what we hope to do in the future. Certainly
the Prometheus project will be part of that: for part of cryonics itself is
not just to accept that uncertainty but to chip away on it, as much as we can.
And eventually that will lead to someone's revival and cure --- someone, no
doubt, who was suspended in the same state of uncertainty as all of us.

			Long long life,

				Thomas Donaldson


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