Day two of the Alcor Conference. The day began with the “Human Cryopreservation and Critical Care Medicine Panel,” including Alcor’s Tanya Jones, critical care physician David Crippen and bioethicist Leslie Whetstine and moderated by Aschwin de Wolf.
The panelists discussed the various definitions death, including legal and biological, and the ethical issues of cryonics. A diagnosis of brain death is required for organ procurement as well as cryopreservation, but determining death is difficult. There are several steps within brain death and it is difficult to determine exactly what part of the process a brain may be in at any particular time. These difficulties and complexities require negotiation between hospital and Alcor personnel, and there are similarities and differences with organ donor requirements.
Alcor prefers the pronouncement of cardiac death over a pronouncement of brain death. Whetstine argued, however, that cardiac death is problematic. If the heart is dead, but the brain is not, and as technologies improve, then this could lead, according to Jones, to a time when the first steps of cryopreservation will transition from an after-death procedure to a medical procedure requiring trained medical personnel.
The inclusion of a bioethicist in the panel added some drama to the proceedings. Whetstine appeared to be arguing (and this is a vast oversimplification of her argument) that it is okay to declare someone dead if their heart stopped, but it is wrong if you then want to cryopreserve the patient.
So when is a patient dead? When is it okay to cryopreserve them? Right now, Alcor must work within a legal and cultural framework that does not view cryonics as feasible and where the definition of death is changing. Jones said she believes Alcor will need to go on the offensive based on positive results, instead of waiting to be attacked. Whetstine was argumentative, but I found her arguments unclear. She obviously finds cryogenics problematic, but she kept repeating things like “but then they are not really dead” and “that is not death.” She works on the definition of death and believes it needs to be changed.
Some Alcor members were concerned about how their own personal wishes would affect decisions made upon their death. Crippen felt that physicians generally honor their patients wishes, but Whetstine felt patients’ consent should not be part of a declaration of death. Crippen said Alcor members need to get over thinking of consent as something that trumps legal and cultural issues.
Both Jones and Crippen believe that the framework will need to change for cryonics to be more acceptable. Alcor, said Jones, must be open about their arrangements to ensure a more positive future for Alcor.