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Tuesday, December 7, 2010

Brian Wowk explains cryonics' predicament.

From Less Wrong:

Except for the very small number of people who choose to sign up for it, practically no one values or cares about cryonics. No one takes the time to learn its premises, its history, the technologies it's predicated upon, or what technical elements will ultimately determine its success or failure. There are no schools or generally-recognized standards. No one cares. This includes mainstream medicine and mortuary science. . .

Against this backdrop, it's not credible that there is a conspiracy among cryonics companies-- companies run by people who want cryonics for themselves --to suppress a tide of experts who could easily step in and do cryonics better. There is no corps of knowledgeable physicians or morticians ready and able to deliver cryonics services that is being displaced by incompetent lay people.

So what do cryonics organizations do? They train lay people and Emergency Medical Technicians to do tasks suited to those levels of expertise. They use morticians to help with some aspects of cases, including vascular cannulation. They contract with sympathetic medical professionals who help with expertise-intensive aspects of cryonics cases when they can, ideally multiple professionals for redundancy. They hire full-time medical professionals for certain roles when they can afford to do so, and when candidates can be found. Or they allow their members to contract with companies, like SA, who do the above.

This mixture of people is then cast into world where they must perform these unscheduled procedures at short notice anywhere within the country, and sometimes beyond. Where they must lug hundreds of pounds of equipment and perfusate to do it. Where sometimes they have to wait weeks at bedside, only for the patient to recover. And where there is no mainstream infrastructure, support, or understanding of what they do. And, recently, where they are bitterly criticized when cryonics cases fail to meet the same standards as scheduled mainstream medical procedures with entire hospitals, universities, and industries that support them.

There have been claims that cryonics has not progressed in 40 years. Leaving aside the enormous improvements in the cryopreservation process itself, it would be instructive to critique reports of past cryonics cases performed only by morticians without today's bedside teams. What was the E-HIT (equivalent homeothermic ischemic time) when the mortician was called after someone legally died, then packed them in unstirred ice with no cardiopulmonary support? What anticoagulants or ischemia-protective medications were administered? What perfusate did the mortician have, and what happened when it was perfused by an unsterile high pressure embalming pump?

With great irony, it is actually a sign of progress in cryonics that cryonics procedures are now being held to the standards of mainstream medicine. Twenty five years ago, there were raging debates about whether the kind of mortician response I describe above was completely sufficient for cryonics. Really.




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