A 14-year-old British girl recently made headlines for winning a court case after her death. However, considering the verdict, she may live on as more than just a new story. The teen won the right to have her corpse cryogenically preserved after dying of a rare terminal cancer in October. She was inspired by the possibility that bioengineering could eventually progress to a point at which bodies preserved in ‘freezing’ conditions can could be revived and healed, resulting in an extended lifespan. As the Telegraph reported, she told a relative, “I’m dying, but I’m going to come back again in 200 years.”
There are a myriad of ethical issues rooted in the feasibility of cryonics, but before delving into the nitty-gritty details of “should we do it,” it needs to be determined whether this procedure is even remotely possible. While the process of cryonics sounds like a Frankensteinian experiment that would intrigue leagues of scientists, it remains a largely unexplored field. Many young scientists shy away from studying cryonics because of the stigma associated with something seen as a “sci-fi” waste of time. Cryonics continues to exist as a taboo field, under the radar of mainstream science, and studied by very few. However, from the opposite perspective, cryonicists are baffled as to why fellow scientists are pushing away a potentially life-saving technology. Whether you fall into the category of believer or critic, now that this procedure is making headlines worldwide, it is time to examine what cryonics really entails, and why some believe that it is an alternative to death.
Cryonics has its roots in a widely-accepted and relatively common surgical tool: therapeutic hypothermia. By cooling the brain and body during surgery, metabolism can be slowed, reducing the need for oxygen in various tissues. Thus, a lack of oxygen during surgery does not cause long-term tissue damage. Cryonicists have decided to exploit this mechanism to reduce metabolic needs indefinitely, which may allow for patient revival and treatment should biotechnology advance sufficiently in the future. However, in practice, cryonics is a lot more complicated. The cryonics procedure actually begins before death. Patients must make arrangements ahead of time with cryonics agencies to ensure funding, meaning a hefty minimum of $28,000 USD. As a pretreatment, patients are generally instructed to increase doses of certain compounds, such as forms of Vitamin E and fish oils, that can help prevent neurological damage and lipid peroxidation after death.
The actual process of preservation can only begin at the point of clinical death – generally considered to be the point at which the heart stops beating – and this begins the incredibly time-sensitive procedure of ‘freezing’ the body. First, patients are injected with a cocktail of medications that nourish their tissues and ensure that they will live on without a heartbeat. Cells can remain living as long as they are supplied with adequate oxygen and nutrients via the blood stream so as long as cryonicists can maintain blood flow, they don’t need an active heartbeat. They do this with active compression-decompression equipment while submersing the body in an ice-water bath to cool the tissue just under 10 degrees Celsius. At this point, they perfuse the corpse with agents to prevent ice formation and store the body in liquid nitrogen tanks at -196 degrees Celsius. Theoretically, when a cure for cancer is discovered, the aforementioned 14-year-old patient could then be revived from her ‘frozen state’ and treated.
Another key argument brought up by cryonicists is that if the physical connections of the brain that are responsible for storing memory (synapses) are preserved by pausing metabolism, then a patient’s identity and memories are also preserved should they ‘wake up’ in the future. This would allow for a patient to be revived and healed, while retaining a complete memory of their former life. If, upon revival, the patient was ‘brain-dead’ due to the deterioration of brain cells or lacked memories from their past life, the process of cryonics would be pointless. It wouldn’t be worth it to “live on” as a body alone knowing that your former identity would be lost forever. That is why brain preservation is critical in the process of cryonics.
For the sake of argument, we shall assume that cryonics will, one day, rise to its full potential. There remains a major divide separating those who support cryonics from its critics stemming from an important ethical point of contention: the definition of death. For the average person, death refers to the end of life – the point at which one’s heart stops beating, what we call a clinical death. However, supporters of cryonics posit that death and clinical death do not have to be one and the same. For supporters, the distinction can be drawn where clinical death refers to the commencement of the process which the body undergoes after the heart stops beating, while true death refers to the actual loss of crucial brain structures due to cell death in the minutes to days following clinical death. Cryonicists believe that as long as brain networks are still structurally sound, a person has not completely died because should they ‘wake up’, they would retain their capacity for memories, emotions and beliefs. Since the cryonics process is completed as quickly as possible before these brain structures undergo cell death, a person is considered still technically ‘alive’ (or at least, not completely dead) at the time of preservation and upon an eventual revival, it would merely be viewed as an extension of their life span.
If you consider cryonics to be an extension of life as opposed to a revival from death, it is easier to understand why cryonicists are so confused when their work is denounced as morally-corrupt science fiction. From their point of view, cryonics should be categorized with other medical discoveries like vaccines, antibiotics and soap in terms of their effects on increasing life-expectancy. Whether or not cryonics is morally wrong is overshadowed by the overarching issue of whether any life-expectancy-enhancing technology is inherently ‘bad’. We, as a society, have justified past breakthroughs in increasing lifespan so one should ask, what is all this uproar about cryonics?
It is easy to say that technologies like vaccines and soap are simply not comparable to cryonics because they are used prior to clinical death as preventative measures, while cryonics is a process strictly limited to post-mortem patients. However, how does this argument hold when we consider cardiopulmonary resuscitation (CPR)? CPR is commonly used as a way to revive someone after a clinical death. This technique is so universally accepted that it is taught to school children in case of emergency. Where do you draw the line between this and cryonics? Is it temporally-based, such that it’s only considered ‘ok’ if revival is within a few minutes of a stopped heart? Is it based on the cause of death so it’s ‘ok’ to bring someone back if they died of cardiac arrest but not of cancer?
These are delicate but pressing questions that need to be considered as cryonics continues to become a trendier topic of debate. As of 2016, cryonics has yet to produce a successfully revived patient. This leaves us with many unknowns and many practical considerations. Despite careful preservation work, brain damage is not out of the question. Vitrification agents could have unintended consequences. There may be obstacles in the revival process that just cannot be imagined at the present. We simply don’t know if it could work at all, let alone the ethical considerations if it were to be successful in the future. However, the crux of the matter is simple: people are choosing to preserve their bodies indefinitely instead of accepting a clinical death and if this is becoming a social issue, it is worth exploring this as more than science fiction.