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Vaniver comments on Suspended Animation Inc. accused of incompetence - Less Wrong Discussion

38 Post author: CronoDAS 18 November 2010 12:20AM

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Comment author: Vaniver 06 December 2010 06:06:10PM 2 points [-]

Honestly, the fact that she's not signed up makes her far more credible in my eyes. Has no one here heard of consistency bias? Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works. For someone without a horse in the race to look at cryonics and have a low opinion of it does provide me information.

Comment author: bgwowk 06 December 2010 11:59:12PM *  3 points [-]

it provides me no information that he thinks cryonics works.

I don't think cryonics "works." I think it's worth doing. That's not the same thing. I've explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.

The purpose of cryonics is to prevent "information theoretic death," or erasure of the neurological information that encodes personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.

Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I've seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a "fatal" period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress during cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.

To be clear, this bad stuff is going to happen no matter who does the procedures. It's intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.

Getting back to the question of whether cryonics "works," it was actually Ms. Maxim who took exception to me saying that she didn't believe cryonics could work. She said:

I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work."

I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a "fairly pristine state," and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today's cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn't good enough to work for anyone.

Comment author: bgwowk 06 December 2010 10:53:02PM 3 points [-]

Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works.

I don't recall making any context-less statements that cryonics works. Obviously I think that cryonics is worth doing, but that's not same as thinking it "works."

I explicitly stated that the damage done by the best cryopreservation technology is severe by contemporary standards. It's not compatible with revival by any near-term technology, no matter who does it. Nobody should be under any illusions that human cryopreservation by available technology is easily reversible.

The goal of cryonics is to prevent "information theoretic death," or erasure of the neurological basis of human identity. Any criticism of cryonics procedures, and the extent to which procedures impact the prognosis of cryonics patients, must be with reference to that. That has been absent in any of the recent criticisms of cryonics related to qualifications of personnel. Recent criticisms of cryonics cases have been with reference to what would have happened to living medical patients had the same case problems occurred (i.e. they might have died). The criticisms have not been with reference to the biological impact on someone who's already suffered a "fatal" period of cardiac arrest before the hospital even let cryonics procedures begin, and who is going to be perfused with cryoprotectants for hours, dehydrated, and then cooled to a temperature that results in thermal stress fractures through all major organs of the body, likely including the brain. In such circumstances, ultimately getting cryoprotectants into tissue is enormously more important than how long cannulation for field blood washout takes, within reason.

Regarding what Ms. Maxim believes about cryonics working, it was Ms. Maxim who took exception to me saying that she believed cryonics won't work. She said:

I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work."

I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

There are two possible interpretations of this. Either she believes that cryonics today done by the right people could result in a sufficiently pristine state, in which case she believes that cryonics today could work. Or she believes that the cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures that are unavoidable with today's technology are not sufficiently pristine to permit revival. In that case, the entire debate of qualifications of personnel and procedural details are academic to whether cryonics today does anybody any good because the technology is intrinsically not good enough to work.

Comment author: lsparrish 06 December 2010 06:29:37PM *  0 points [-]

My objection is not so much that she isn't signed up but that she has no plans to sign up, even when her moral outrage issues are resolved. So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it's not simply a criticism of the cryonics industry, but of cryonics itself.

What makes it suspect to me is that she argues as though it is a criticism only of the current cryonics industry and yet makes no defense whatsoever of the general notion of cryonics (except a very vague version that sounds more like long-term hypothermic hibernation). Most critics seem to support some kind of future advancement suspended animation -- but that's a very different idea from cryonics from a service (and technological) perspective.

Comment author: Vaniver 06 December 2010 07:37:07PM 3 points [-]

So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it's not simply a criticism of the cryonics industry, but of cryonics itself.

So? Why is her opinion on the technical feasibility or personal desirability of cryonics at all relevant to her claims of organizational or technical incompetence on the part of current cryonics organizations?

Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim? (for example, "a vascular surgeon that takes 30 minutes to cannulate a femoral artery is unqualified to perform surgery", with all the technical word's accuracy limited by my memory and my time writing this post- I am not a doctor)

If so, then something is rotten in the state of Denmark, regardless of who pointed it out originally.

Comment author: David_Gerard 06 December 2010 08:23:58PM *  5 points [-]

Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim?

Yes. This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal ("it's just motivated cognition", "she has no plans to sign up") which really obviously dodges actually addressing the claims. Which are natural human reactions, but that doesn't make them good ideas.

Comment author: lsparrish 06 December 2010 09:00:16PM *  3 points [-]

Yes. This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal of the claims ("it's just motivated cognition", "she has no plans to sign up"). Which are natural human reactions, but that doesn't make them good ideas.

Is this reaction evidence against cryonics?

Comment author: David_Gerard 06 December 2010 09:03:29PM *  5 points [-]

Against the technology, no (I'd say obviously not). Against the organisational robustness of present-day cryonics? I'd say it could well be. I suspect Charles Platt would agree.

(voted up as good question)

Comment author: enoonsti 07 December 2010 08:05:20AM 2 points [-]

Upvoted. Did you check out the analysis by Freitas as well? Here's a link with some additional commentary by Dr. Wowk: http://www.imminst.org/forum/topic/45324-alcor-finances/

By the way, many of your posts are both enlightening and smile-inducing... and yet, I think I mocked you in the past (I think it was at Pharyngula). Since I suddenly feel guilty about this, I ask that you give me a downvote for atonement.

Comment author: David_Gerard 07 December 2010 11:03:34AM 3 points [-]

Upvoted to leave you beholden to me. BWAAAhahaha. I learnt that trick from Draco in HP:MOR.

Comment author: enoonsti 08 December 2010 06:58:24PM 0 points [-]
Comment author: Vaniver 07 December 2010 05:23:11AM 1 point [-]

Again, why does it have to be evidence against cryonics instead of, say, Alcor or SA or CI? She's not discussing the theoretical desirability or practicality of cryonics.

Comment author: lsparrish 07 December 2010 07:16:21AM *  2 points [-]

The theoretical desirability and practicality of cryonics is what matters at this point. It's what the real controversy is about. If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced. But, supposing that is necessary, we would need new people to replace them with. People who actually care about cryonics. Melody is not contributing to that cause, in my estimation. Rather she seems to be contributing to, and playing upon, the existing cocktail of mockery, misunderstanding, and marginalization that has plagued cryonics for years.

Comment author: enoonsti 07 December 2010 08:09:50AM 2 points [-]

The theoretical desirability and practicality of cryonics is what matters at this point. It's what the real controversy is about.

Upvoted. But I'll still talk about organizational matters below :)

The thing I like about Mike Darwin is that he offers technical criticisms of cryonics organizations without resorting to threats of strict regulation. Of course, I understand there are people who do not think highly of Darwin, and condescendingly claim we are being duped by this "dialysis technician" (who then conveniently leave out that he received additional training from Jerry Leaf). Perhaps those people should inform David Crippen MD that he has been duped by Mike. David is with the Department of Critical Care Medicine at the University of Pittsburgh Medical Center, and Mike must have lied about his credentials when submitting to his book "End-of-Life Communication in the ICU: A Global Perspective"

Mike also probably lied to get into this debate too: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414041/

;)

With that in mind, since I deeply care about useful external criticism (as opposed to mainstream medicine's silent apathy... because they are still stuck at the starting line by thinking that immortality is some separate magical state of being...), I want Melody to continue with her more technical critiques. However, I do want her to drop her threats of strict regulation, unless she can find many people who have gone through all of the paperwork of signing up and suddenly proclaiming, "Oh my god. You mean to tell me that Atul Gawande is not going to be at my bedside?" I understand the need in politics to sometimes play hardball, but this is different.

I encourage Less Wrong users to look at the language being employed here. Dr. Wowk is saying things like "Mayo clinic" from a life-saving perspective. Melody is saying things like "last wishes," and emphasizing licensed embalmers. I do not feel comfortable with such language being floated around regulation that its (potential) members don't want. At all. If any Less Wrong users do want such regulation without even having the intent of utilizing cryonics, then.... well.... shoo, go away.

Comment author: bgwowk 07 December 2010 02:31:59AM *  1 point [-]

This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal....

As I've tried to explain, the entire line of criticism is based on a false analogy of cryonics to hypothermic medicine.

OF COURSE, if cryonics were an elective procedure in which a patient were to be cooled to +18 degC and heart stopped for brain surgery, you wouldn't use paramedics, scientists, or contract cardiothoracic surgeons who may or may not able to show up to do the surgery. OF COURSE, you would use a Certified Clinical Perfusionist to work alongside the surgeon, no exceptions. OF COURSE, any less qualified people are bound to make mistakes, and have made mistakes, mistakes that could be fatal in a mainstream medical setting in which someone was expected to be warmed right back up from +18 degC and woken up at the end of the procedure. OF COURSE, anyone with common sense (no independent medical expert needed) would say that! But that's not what cryonics is, or could be with any near-term technology.

Cryonics doesn't stop at +18 degC. The hypothermic phase continues down to 0 degC, and then the cryothermic phase down to -196 degC, doing injuries far beyond reversbility by mainstream medicine. Cryonics is an information preservation excercise at liquid nitrogen temperature, not an attempt to recover people in real-time from minor cooling in clinical settings. The procedures during the hypothermic phase aren't even the same in many major respects, but I won't bother getting into that.

Isn't anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures?? What medical standards or established specialties exist for that?

Comment author: CronoDAS 07 December 2010 07:16:38AM *  1 point [-]

Isn't anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures??

No, why do you ask?

Comment author: enoonsti 07 December 2010 08:08:02AM 7 points [-]

Be honest. Was your one-liner typed with the full understanding of his points on hypothermic vs. cryothermic phases? Or were you just participating in the Less Wrong zombie ritual of linking to other posts? Whatever the case, bring me the down votes on a silver platter :)

Comment author: CronoDAS 07 December 2010 08:58:44AM 0 points [-]

Mostly the latter. I see someone use the absurdity heuristic, my conditioning kicks in, and I link to the post about it.

As for the "hypothermic vs cryothermic" criticism, well, no, I don't see the difference. The less the damage that's done to our decapitated, frozen, fractured heads between clinical death and freezing, the easier it will be to recover the person from the corpse. As far as I can tell, an extra 30 minutes of decay at room temperature really could end up making a significant difference.

Comment author: David_Gerard 07 December 2010 08:39:46AM 1 point [-]

Emergent! (waves garlic and cross)