Cryonics, June 1988
by Brian Wowk
(This classic paper has been revised and updated to bring it into compliance with modern usage, e.g., “cryopreserved” instead of “suspended”, etc.)
“cry on'ics, n. the practice of freezing the body of a person who has just died in order to preserve it for possible resuscitation in the future, as when a cure for the disease that caused death has been found.”
— Webster’s New Twentieth Century Dictionary
“CRUEL, CRAZY, 6£ A MONTH TO COME BACK FROM THE DEAD”
— front page headline from the British tabloid, SUNDAY MIRROR.
This article is about a problem in cryonics. Perhaps the problem in cryonics. It is a problem which has dogged cryonics since its inception, and which has caused incalculable grief since then.
Unlike so many of the problems which confront cryonicists, I believe that it is a problem for which cryonicists have only themselves to blame.
The problem to which I refer is the perception of cryonics as the freezing of dead people, and all the corollaries that perception implies. How often have cryonicists struggled with impressions (be they conscious or unconscious) that cryonics is a sacrilegious, ghoulish, or Frankenstein-like practice when they try to explain the concept? How often have cryonicists had the impossible task of trying to overcome the notion that cryonics entails supernatural resurrection when they try to explain its scientific foundations? Problems of this sort (arguably the most serious public relations problems of cryonics) can all be traced back the fundamental problem of cryonics being perceived as the freezing and storing of dead people.
In this article a strategy is proposed for attacking this problem at its root. The strategy outlined does not require any scientific breakthroughs, political lobbying, new laws, or the breaking of existing laws. And it does not require any change in cryonics practice at all. What it does require is a fundamental change in the way cryonicists think about cryonics, and especially in the way cryonicists attempt to communicate it to others.
At first glance it may not seem that there is a solvable problem here at all. If cryonics patients must be legally dead before they are cryopreserved, and if once cryopreserved all metabolism has irreversibly (for the present) ceased, then are not cryopreserved patients, at least in some limited sense, dead? The answer is no.
A large share of public relations problems are directly attributable to cryonicists’ own confusion about this issue. This article is an attempt to solve this problem by first thoroughly examining the concept of death, and then proposing some consistent standards for dealing with death in a cryonics context.
Words evolve to describe particular realities. When reality reveals itself to be something other than expected (as it often does), communication can become difficult. Problems of this sort can be remedied in two ways: the meaning of old words can be modified to suit new realities, and/or new words can be coined.
The word/reality synchronization problem cryonics faces today concerns the meaning of the word death. "Death" seems to have two broad meanings in people's minds. First: the cessation of brain function. Second: the irreversible loss of life. Historically, our medical limitations have been such that these two definitions were equivalent. This of course is not the case today (and it will be less so tomorrow), and so begins many a tale of cryonics PR woe.
Clearly the meaning of the word “death” must be better defined. In fact, there is no doubt that it will be better defined as advancing resuscitation technologies obsolete old meanings in ever more minds. Notwithstanding, it is to the advantage of cryonicists to expedite this change as rapidly as possible.
The meaning of the word “death” can be brought back into sync with reality in one of two ways. cryonicists can either retain death as meaning the loss of brain function, and accept that death can be reversed. Or cryonicists can reject death as meaning loss of brain function, and retain death as meaning the irreversible loss of life. It is the proposition of this article that the second strategy is far superior to the first.
It is true that in most minds death is still strongly associated with the loss of brain function. However, death is more correctly identified with the irreversible loss of life. In other words, if the meaning of death must be clarified (and it must), it will be far easier to drop the association of death with loss of brain function than to introduce the idea that death itself can be reversed (with all the complex qualifications that statement entails).
I therefore propose the following firm definition of death.
Death: the absolute and irreversible loss of life, which occurs in human beings when their brain structure is destroyed.
Thus, no one is ever dead until their brain structure is gone. (Of course, death will not be quite so clear cut for future medicine; exactly how "much" a person dies will depend on how much brain structure is lost during injury. Nevertheless, retaining death as a “black and white” idea is fine as a first-order approximation.)
The value of defining death in this way is that it is completely independent of any particular level of medical technology. With this definition, dead is dead, now or ever.
Having better defined the criteria for death, it is necessary to introduce some new terms to fill the vacuum in the lexicon that has been created in the process. In particular, medical terms are needed to describe the vast expanse of time between cessation of heartbeat and breathing (the classic signs of death) and real death.
Conventional medicine currently uses the terms “clinical death” and “biological death” to fill this void.
However, I believe something more descriptive is necessary for cryonics purposes. For one thing, it’s necessary to adopt a terminology that does not in any way suggest an element of death (and all the emotional and intellectual baggage such an association will invoke) when discussing conditions other than real death. Also, cryonicists need a terminology that will be applicable to conditions far beyond what physicians today would ordinarily consider as clinical death (such as biostasis, or protracted ischemia).
The traditional workhorse for this task in cryonics has been “deanimation.” “Deanimation,” however, has always struck me as vague, crude, contrived, and in fact like just another name for death. I would like to suggest some more precise alternatives. In particular, I would like to borrow some possible terms from the medical lexicon of the 22nd century.
With mature cell repair technology, future medicine will be able to recover anyone whose critical brain structure (brain structure encoding basic identity information) remains intact. Whether their heart has stopped, their brain function ceased, or indeed whether they are frozen solid will not matter. As long as critical brain structure is intact, patients will always be recoverable. In fact, it is likely that future medicine will adopt a rather innocuous, almost casual jargon to refer to many conditions we still equate with death today. Below is a table of some of these conditions in their various grammatical forms.
Condition or Event
clinical death or biological death
death, legal death
ametabolic coma, or biostatic coma (when in biostasis)
What is the purpose of these definitions and redefinitions? Quite simply: the elimination of misunderstanding. Since cryopreserved patients are being transported to distant future medicine, cryonics simply cannot be understood without viewing its patients and their conditions from the perspective of future medicine. And from such a perspective, cryopreserved patients are not dead. There is therefore no reason ever to refer to cryopreserved patients as dead (and bring upon ourselves all the suspicion, confusion, and metaphysical baggage that that word invokes).
Should cryonicists be saying, then, that cryonics patients are alive? No. I believe this would be unwise because “alive” is most often taken to mean the presence of integrated metabolism. Instead, it is perhaps best to say that cryopreserved patients are in an ametabolic or biostatic coma (and as such deserve the same regard and care as any patient who is alive (i.e., metabolizing) but who is comatose and facing an uncertain prognosis.
Some may say that cryonicists are not justified in stating the status of cryonics patients so confidently because cryonics is not yet proven. I disagree. It is a convention of present medical practice that whenever the status of a comatose patient is in doubt, we treat them as viable patients until it becomes certain that recovery is impossible. Why should cryonics patients not enjoy the same benefit of the doubt?
Thus, by honestly and consistently characterizing the condition of cryopreserved patients in the proper medical terms — the future’s — it is possible to significantly ameliorate one of the greatest perception problems facing cryonics.
There remains one serious impediment to implementing this strategy. Nowhere have I ever seen cryonics defined as anything other than the preservation of clinically, legally, or otherwise dead people — even by cryonicists themselves. This is despite the fact that defining cryonics as freezing dead people (even people dead only by present standards) is inherently absurd.
Why? Because to define cryonics as freezing legally dead people means that cryonics — the very idea of cryonics — is to freeze people after legal death. Defining cryonics in this way means that even given the legal opportunity to do otherwise, cryonicists are people who believe in waiting for an arbitrary, deleterious physical event (cardiac arrest and ensuing ischemia) before even considering freezing someone. Clearly this is not what cryonics is all about.
Sooner or later (probably later) there will come a time when cryopreservation (even by imperfect means) will be performed as an elective medical procedure for terminal patients. Will this no longer be cryonics? On the contrary, it would be ideal cryonics — exactly the idea that cryonicists had in mind all along. Indeed, cryonics (now or ever) is not about preserving dead patients, but about preserving terminal patients. The fact that cryonicists currently must wait until cardiac arrest occurs naturally is merely an artifact of our present legal system, not an inherent component of the idea of cryonics.
Thus the final step to eliminating death as an element in cryonics is to correctly define cryonics as cryopreservation of terminal patients. This leaves a pure, untainted vision of what cryonics is really all about; a vision of a technology not for “handling,” or “dealing” with death, but for avoiding death. A technology for living people who want to stay alive.
Successfully communicating this vision will require overhauling many old ideas and habits cryonicists have when discussing cryonics. Listed below are just a few of the most important guidelines that will have to be followed to rid cryonics of its death-related imagery.
A typical presentation of cryonics today will begin by defining cryonics as the freezing of dead people (perhaps with “clinical” or “legal” qualification) and then, of necessity, engage in long explanation of why “dead is not dead.” This approach is highly inefficient, suspicion-arousing, and most importantly misses the most important idea of cryonics.
Understanding contemporary cryonics practice requires appreciating two basic ideas. First, that freezing with present methods is probably not fatal (assuming access to future medicine). Second, that “death is a gradual process,” or, more properly put, ischemic injury following cardiac arrest is a gradual process that probably does not kill patients for at least several hours (assuming access to future medicine). Of these two, the first is by far the most important.
If cryonicists can credibly argue that a living, functioning person might be able to survive freezing with present technology, and thawing with the future’s, then a complete case will have been made for cryonics. After making this case, it can be examined how to implement cryonics to save today's terminal patients, and note the present legal problems of performing this procedure on a legally living patient. It can then be explained that this isn’t a major concern because the legal declaration of death seldom means a person is dead from the perspective of future medicine (or even today’s), so let's go ahead and do this procedure even after cardiac arrest.
The most important point here is that the second idea is only relevant to our present legal environment, and is not intrinsic to cryonics. Ischemic injury (so-called death) is only a certain class of injury that patients may or may not have when they are cryopreserved.
Thus the reversibility of advanced clinical death (read: ischemic injury) is simply not the big cryonics issue it is usually made out to be. Ischemic injury is not inherent in the basic idea of cryonics. If anyone says to you, for example, that they don't think cryonics will work because legally dead people cannot be revived (as arbitrary as that belief is), then just turn the argument around and ask them why they aren't aggressively seeking legislation so that it won’t be necessary to wait until legal death to cryopreserve dying patients.
Of course, some readers may say this is all moot because as long as cryopreservation looks like death, and cannot be implemented until after legal death, its identification with death is going to be prominent in people's minds. That may very well be the case, but it is not the point. The point is to not concede to anyone’s irrational premises, and suffer the long-term consequences of doing so. For cryonics this means that cryonicists should not be arguing that “dead is not dead,” death is reversible, etc., but instead be arguing unflinchingly that cryopreservation patients are not dead, period.
How successful this strategy will be remains to be seen. Yet I believe it rests on a truism: one that says that people who disagree on the definition of death are inherently less crazy than people who claim they are going to bring the dead back to life. If this is indeed the case, cryonicists may be able to do away with some major communication problems.