Articles Tagged ‘cryonics’ - LessWrong

More Cryonics Probability Estimates

Tue, 18 Dec 2012 07:59:49 +1100

Submitted by jkaufman • 20 votes • 89 comments

There are a lot of steps that all need to go correctly for cryonics to work. People who had gone through the potential problems, assigning probabilities, had come up with odds of success between 1:4 and 1:435. About a year ago I went through and collected estimates, finding other people's and making my own. I've been maintaining these in a googledoc.

Yesterday, on the bus back from the NYC mega-meetup with a group of people from the Cambridge LessWrong meetup, I got more people to give estimates for these probabilities. We started with my potential problems, I explained the model and how independence works in it [1]. For each question everyone decided on their own answer and then we went around and shared our answers (to reduce anchoring). Because there's still going to be some people adjusting to others based on their answers I tried to randomize the order in which I asked people their estimates. My notes are here. [2]

The questions were:

You die suddenly or in a circumstance where you would not be able to be frozen in time.
You die of something where the brain is degraded at death.
You die in a hospital that refuses access to you by the cryonics people.
After death your relatives reject your wishes and don't let the cryonics people freeze you.
Some law is passed that prohibits cryonics before you die.
The cryonics people make a mistake in freezing you.
Not all of what makes you you is encoded in the physical state of the brain (or whatever you would have preserved).
The current cryonics process is insufficient to preserve everything (even when perfectly executed).
All people die (existential risks).
Society falls apart (global catastrophic non-existential risks).
Some time after you die cryonics is outlawed.
All cryonics companies go out of business.
The cryonics company you chose goes out of business.
Your cryonics company screws something up and you are defrosted.
It is impossible to extract all the information preserved in the frozen brain.
The technology is never developed to extract the information.
No one is interested in your brain's information.
It is too expensive to extract your brain's information.
Reviving people in simulation is impossible.
The technology is never developed to run people in simulation.
Running people in simulation is outlawed.
No one is interested running you in simulation.
It is too expensive to run you in simulation.
Other.

To see people's detailed responses have a look at the googledoc, but bottom line numbers were:

person	chance of failure	odds of success
Kelly	35%	1:2
Jim	80%	1:5
Mick	89%	1:9
Julia	96%	1:23
Ben	98%	1:44
Jeff	100%	1:1500

(These are all rounded, but one of the two should have enough resolution for each person.)

The most significant way my estimate differs from others turned out to be for "the current cryonics process is insufficient to preserve everything". On that question alone we have:

person	chance of failure
Kelly	0%
Jim	35%
Mick	15%
Julia	60%
Ben	33%
Jeff	95%

My estimate for this used to be more positive, but it was significantly brought down by reading this lesswrong comment:

Let me give you a fuller view: I am a neuroscientist, and I specialize in the biochemistry/biophysics of the synapse (and interactions with ER and mitochondria there). I also work on membranes and the effect on lipid composition in the opposing leaflets for all the organelles involved.
Looking at what happens during cryonics, I do not see any physically possible way this damage could ever be repaired. Reading the structure and "downloading it" is impossible, since many aspects of synaptic strength and connectivity are irretrievably lost as soon as the synaptic membrane gets distorted. You can't simply replace unfolded proteins, since their relative position and concentration (and modification, and current status in several different signalling pathways) determines what happens to the signals that go through that synapse; you would have to replace them manually, which is a) impossible to do without destroying surrounding membrane, and b) would take thousands of years at best, even if you assume maximally efficient robots doing it (during which period molecular drift would undo the previous work).

Etc, etc. I can't even begin to cover complications I see as soon as I look at what's happening here. I'm all for life extension, I just don't think cryonics is a viable way to accomplish it.

In the responses to their comment they go into more detail.

Should I be giving this information this much weight? "many aspects of synaptic strength and connectivity are irretrievably lost as soon as the synaptic membrane gets distorted" seems critical.

Other questions on which I was substantially more pessimistic than others were "all cryonics companies go out of business", "the technology is never developed to extract the information", "no one is interested in your brain's information", and "it is too expensive to extract your brain's information".

I also posted this on my blog

[1] Specifically, each question is asking you "the chance that X happens and this keeps you from being revived, assuming that all of the previous steps all succeeded". So if both A and B would keep you from being successfully revived, and I ask them in that order, but you think they're basically the same question, then A basically only A gets a probability while B gets 0 or close to it (because B is technically "B given not-A")./p>

[2] For some reason I was writing ".000000001" when people said "impossible". For the purposes of this model '0' is fine, and that's what I put on the googledoc.

89 comments

How to get cryocrastinators to actually sign up for cryonics

Sun, 19 Aug 2012 03:57:19 +1000

Submitted by JGWeissman • 19 votes • 89 comments

At the end of CFAR's July Rationality Minicamp, we had a party with people from the LW/SIAI/CFAR community in the San Francisco Bay area. During this party, I had a conversation with the girlfriend of a participant in a previous minicamp, who was not signed up for cryonics (her boyfriend was). The conversation went like this:

me: So, you know what cryonics is?

her: Yes

me: And you think it's a good idea?

her: Yes

me: And you are not signed up yet?

her: Yes

me: And you would like to be?

her: Yes

me: Wait a minute while I get my laptop.

And I got my laptop, pointed my browser at Rudi Hoffman's quote request form¹, and said, "Here, fill out this form". And she did.

The hard part of all that was identifying a cryocrastinator, by which I mean someone who believes they should be signed up for cryonics, but for whatever reason, hasn't actually signed up. Once I know that I am talking to such a person, just giving them an actionable first step to do right now gets them to do that step.

Previously to the party, I had held an "unconference" seminar for cryocrastinating minicampers in which I did a scaled up version of the same thing. For this I told everyone in advance to bring their own laptops, and I gave them the URL. (There was some confusion about the target audience of this seminar, and some people who were not yet convinced it was a good idea for them came expecting more of a discussion. They had no trouble expressing this, and were not required to fill out the form.) At the party, I did this for one other person².

What I have observed to work so far is that people will take the first step of filling out the quote request form when I make it easy for them. I am counting on Rudi to get them through the rest of the process, so they end up actually signed up. Rudi has agreed to track success rates of these people getting through the whole process, and I plan to check in with him in early December, and report back.

I was planning to write this up when I had the full results, but seeing this story of a young woman with brain cancer forced to beg to raise funds at the last minute reminded me that cryocrastinators are running out of time (even though getting brain cancer young is rare, there are cryocrastinators of all ages who aren't aware of when life insurance will become unaffordable). So I thought it would be good to let people know now how easy it is to get that cryocrastinator you know to get started signing up.

Again, all you have to do is establish that they want to be signed up for cryonics but aren't, and put this form in front of them and tell them that filling it out is the first step. Rudi will take them through the rest of it. And if you yourself are cryocrastinating, take a few minutes for your first step in signing up by filling out the form.

(If you do not already think cryonics is a good idea, I do not expect you to follow any of the advice in this article. I wrote this for the benefit of all the people who do think cryonics is a good idea, but are having trouble actually signing up. You may be interested in trying to generalize the technique for other forms of procrastination, however.)

1. Yes, Rudi Hoffman will make some money off of this. He should, as he is putting in professional hours to provide a valuable service. But the motivation behind this article is to get people to sign up for cryonics. Other paths with other first steps are welcome, as is any advice for people outside the United States.

2. I am not naming the other people involved. They can opt in to identifying themselves if they want.

89 comments

Plastination is maturing and needs funding, says Hanson

Thu, 21 Jun 2012 06:00:25 +1000

Submitted by Eliezer_Yudkowsky • 68 votes • 46 comments

http://www.overcomingbias.com/2012/06/plastination-is-near.html

Though cryonics has been practiced for forty years, its techniques have improved only slowly; its few customers can only induce a tiny research effort. The much larger brain research community, in contrast, has been rapidly improving their ways to do fast cheap detailed 3D brain scans, and to prepare samples for such scans. You see, brain researchers need ways to stop brain samples from changing, and to be strong against scanning disruptions, just so they can study brain samples at their leisure.

These brain research techniques have now reached two key milestones:

They’ve found new ways to “fix” brain samples by filling them with plastic, ways that seem impressively reliable, resilient, and long lasting, and which work on large brain volumes (e.g., here). Such plastination techniques seem close to being able to save enough info in entire brains for centuries, without needing continual care. Just dumping a plastic brain in a box in a closet might work fine.

Today, for a few tens of thousands of dollars, less than the price charged for one cryonics customer, it is feasible to have independent lab(s) take random samples from whole mouse or human brains preserved via either cryonics or plastination, and do high (5nm) resolution 3D scans to map out thousands of neighboring cells, their connections, and connection strengths, to test if either of these approaches clearly preserve such key brain info.

An anonymous donor has actually funded a $100K Brain Preservation Prize, paid to the first team(s) to pass this test on a human brain, with a quarter of the prize going to those that first pass the test on a mouse brain. Cryonics and plastination teams have already submitted whole mouse brains to be tested. The only hitch is that the prize organization needs money (~25-50K$) to actually do the tests!

Comments? If superior brain preservation can be demonstrated under a 5nm-resolution 3D scan, plastination wins over vitrification hands-down. Is Robin missing anything here, or is this indeed as important as he says?

46 comments

Brain Preservation

Wed, 28 Mar 2012 23:56:42 +1100

Submitted by jkaufman • 22 votes • 108 comments

Most people, given the option to halt aging and continue in good heath for centuries, would. Anti-aging research is popular, but medicine is only minimally increasing lifespan for healthy adults. You, I, and everyone we know have bodies that are incredibly unlikely to make it past 120. They're just not built to last.

But what are you, really? Your personality, your memories, they don't leave you when you lose a leg. Lose most parts of your body and you're still you. Lose your brain and that's it. [1] You are a pattern, instantiated in the neurons of your brain. That pattern is sustained by your body, growing and changing as you learn and experience the world. Your body supports you for years, but it deteriorates and eventually isn't up to the task any more. Is that 'game over'?

Perhaps we could scan people's brains at extremely high detail so we could run them in some sort of human emulator. This requires a thorough understanding of the brain, huge amounts of storage, unbelievably fast computers, and very detailed scanning. If it's even possible, it may be several hundred years away.

Our bodies aren't going to last that long, but what if we could figure out how to preserve our brains so that the information didn't decay? Then, if the future turned out to be one in which we had advanced brain emulation and scanning technology, we could be revived. I don't know if people in the future would want to spend the time or money to revive us, but in a future with technology this advanced, reviving a preserved brain as a computer simulation could be really cheap.

The most advanced technology for long-term tissue preservation today [2] is cryonics: freezing with vitrification. You add something to the blood that keeps ice crystals from forming and then freeze it. This is pretty much the same thing frogs do, hibernating frozen through the winter. The biggest organs that have been successfully brought back to working order after vitrification are rabbit kidneys, and the brain is a lot bigger and much more complex. While there are people applying this technique to human brains after death, it's very much a one way street; we can't revive them with current technology.

How much should it worry us that we can't reverse this freezing process? If we're already talking about revival via high-detail scanning and emulation, which is only practical after hundreds of years of technological development, does it matter that we can't currently reverse it? The real question in determining whether vitrification is sufficient is whether we're preserving all the information in your brain. If something critical is missing, or if something about our current freezing process loses information, the brains we think are properly preserved might be damaged or deteriorated beyond repair. Without a round trip test where we freeze and then revive a brain, we don't know whether what we're doing will work.

Another issue is that once you've frozen the brain you need to keep it cold for a few centuries at least. Liquid nitrogen is pretty cheap, but providing it constantly over such a long time is hard. Organizations fall apart: very few stay in business for even 100 years, and those that do often have departed from their original missions. Current cryonics organizations seem no different from others, with financial difficulties and imperfect management, so I don't think 200+ years of full functioning is very likely.

Even if nothing goes wrong with the organization itself, will our society last that long? Nuclear war, 'ordinary' war, bioterrorism, global warming, plagues, and future technologies all pose major risks. Even if these don't kill everyone, they might disrupt the cryonics organizations or stop technological development such that revival technology is never developed.

Taking all these potential problems and risks into account, it's unlikely that you can get around death by signing up for cryonics. In attempts to calculate overall odds for success from estimated chances of each step I've seen various numbers: 1:3, 1:4, 1:7, 1:15 and 1:400. I'm even more pessimistic: I calculated 1:600 when I first posted to lesswrong and have since revised down to 1:1000. To some people the probability doesn't matter, but because it's expensive and there are plenty of other things one can do with money, I don't think it's obviously the sensible thing to do.

(I also posted this on my blog.)

[1] Well, lose your heart and you're gone too. Except that we can make mechanical hearts and you stay the same person on receiving one. Not so much with a mechanical brain.

[2] Plastination is also an option, but it's not yet to a point where we can do it on even a mouse brain.

108 comments

Prediction is hard, especially of medicine

Sat, 24 Dec 2011 07:34:13 +1100

Submitted by gwern • 46 votes • 46 comments

Summary: medical progress has been much slower than even recently predicted.

In the February and March 1988 issues of Cryonics, Mike Darwin (Wikipedia/LessWrong) and Steve Harris published a two-part article “The Future of Medicine” attempting to forecast the medical state of the art for 2008. Darwin has republished it on the New_Cryonet email list.

Darwin is a pretty savvy forecaster (who you will remember correctly predicting in 1981 in “The High Cost of Cryonics”/part 2 ALCOR’s recent troubles with grandfathering), so given my standing interests in tracking predictions, I read it with great interest; but they still blew most of them, and not the ones we would prefer them to’ve.

The full essay is ~10k words, so I will excerpt roughly half of it below; feel free to skip to the reactions section and other links.

1 The Future of Medicine

1.1 Part 1

What we hope we are especially good at as cryonicists is predicting the future — particularly the future of medicine. After all, our lives depend upon it. Because that’s what cryonics is about — tomorrow’s medicine today. In order for cryonics to seem reasonable, in order for it to be reasonable, it is necessary to have some idea, at least in broad outline, of where medicine is going and of where it ultimately can go. I think that the cryonicists’ record on this point in a broad sense has been very good.

…One thing which is rarely seen in cryonics publications is an attempt to see the shape of things to come in the near or intermediate future. Oddly enough, that’s a far more difficult and dangerous undertaking than predicting ultimates. Nor is this a problem confined to cryonics or the future of medicine. Sadi Carnot (the founder of thermodynamics) could tell you all about the “perfect heat engine,” but would have no doubt had trouble giving you hard numbers on how well heat engines would be made to perform over the 20 years or so following publication of his work….When I look over predictions made in the 1950’s or the 1960’s about the future of medicine and/or technology, I always chuckle about just how far afield these guys were. A good example is a list of predictions made by Herman Kahn which was summarized in CRYONICS REPORTS in August of 1967 (volume 2, #8). They are reproduced as Table 1 below. Read ’em and weep — or laugh if you will!

Table 1. Less Likely But Important Possibilities, from: The Next 33 Years: A Framework For Speculation, by Herman Kahn and Anthony J. Weiner (1967) [predictions for 2000 AD]

“True” artificial intelligence

Practical use of sustained fusion to produce neutrons

Artificial growth of new limbs and organs

Room temperature superconductors

Major use of rockets for transportation (either terrestrial or extraterrestrial)

Effective chemical or biological treatment for most mental illnesses

Almost complete control of marginal changes of heredity

Suspended animation (for years or centuries)

Practical materials with nearly “theoretical limit” strengths

Conversion of mammals (humans?) to fluid breathers

Direct input into human memory banks

…

…My personal perspective is one of being a hard-core cryonicist who was involved in clinical medicine for the better part of a decade. My biases about predicting the future could probably be summarized as follows: I have a lot of sympathy for the incrementalist view of progress - particularly in the highly regulated area of medicine. It’s regulated because it directly and powerfully touches people’s well-being and because it is not a very fault-tolerant area — mistakes are costly and since people like being alive (at least in the short run) they get edgy if an error separates them from their actuarial expectations.

I thus believe that any predictions about the future of medicine have to include what I call the “space program factor” (SPF). By this I mean simply that progress in the space program would have proceeded far, far faster (and thus approximated more closely what was theoretically possible) if it were not a high-visibility project with lots of political and social overtones which make it fault-intolerant — if you could burn up as many astronauts as you do test pilots every month, it would cost a lot less to get where you’re going. First-shot fail-safe engineering is costly. Medicine suffers from the same kinds of problems — witness the FDA as both the solution and the problem.

1.1.1 Diagnostics

I foresee a veritable explosion of diagnostic techniques and procedures. A large number of illnesses which are poorly understood today will be well-characterized the next decade and will be easy to diagnose very early in their development or even before they develop because they will be found to have direct or indirect genetic causes. Fairly predictive tests for Alzheimer’s disease, schizophrenia, depression, some malignancies, heart disease, and most of the rest of the major killers and disablers will probably be in place by 2000 to 2010. Many if not most of these ailments will be assessable in terms of a very sophisticated genetic risk profile which it will be possible to generate in infancy or childhood (or in utero). A wide range of genetic probes for illness-generating genes should be available by the end of the century.

A side-note: genetic associations have been a very fertile field for John Ioannidis, and a big study just blew away a bunch of SNP-IQ correlations.

Real-time diagnosis will also be revolutionized by the turn of the century. The next 10 to 15 years will see increasing miniaturization of sensors and chemistry packages. Tissue probes or biosensors which can measure a wide array of biological and biochemical factors will be packaged in very small, very stable devices which hold calibration over prolonged periods of time (weeks to months to years) and which can easily be inserted into the patient’s body or tissues. For example, I foresee multi-sensor units mounted on very small needle or catheter tips which can be inserted intravenously, intracranially, intra-cerebrally, subcutaneously, and so on.

These sensors will be able to give real-time measurements of blood gases, pH, electrolytes, enzyme levels, and a host of other biochemical parameters that now involve costly, time-consuming, and/or impossible “laboratory studies” requiring withdrawal of a sample and processing. Real-time biosensors will revolutionize acute care of critically ill patients.

…The first generation of these devices should be in the marketplace somewhere between 1990 and 1995. More sophisticated instruments capable of a wider array of measurements will quickly follow. These sensors will also have a profound impact in acute stabilization of patients in a field setting. It will be possible for paramedical personnel to quickly and effectively insert such instruments in an acutely ill patient — a victim of cardiac arrest or trauma, and immediately and globally assess that patient’s condition, relaying that information to an expert (more on who that expert will be later).

…Diagnostic imaging should rapidly come down to a battle between ultrasound and MRI (NMR; (nuclear) magnetic resonance imaging). Because ultrasound units owe their size and weight almost entirely to the computer that processes the information, the size and effectiveness of these units will change on the same rapid exponential curve as the size and power of computers. MRI is a technology which has some other physical limitations, but by the year 2000, even MRI units will be far smaller, less costly, and capable of far, far better results. Bedside units or “on floor” units (i.e., units in the ICU or CCU) may be available for repeated assessment of the patient’s condition. MRI and its grandchildren and cousins should in particular be expected to undergo considerable refinement. Metabolic MRI will also be in wider use, allowing for real-time evaluation of the metabolic and working state of patient’s hearts, brains and other organs. By 2000 to 2010 the cost and size of these units may be drastically reduced and they may be in field use for acute metabolic and structural evaluation of patients with trauma or in cardiac arrest.

I recently learned that, besides the usual blame for increasing medical costs, some categories of doctors have been strenuously urged to reduce MRI use as actively harmful.

By the late 1990’s there should be an answer to this problem in the development of the Portable Doctor or Expert Medical Device (EMD). The EMD will be both a diagnostician and therapist integrated into one unit. In an emergency medical setting (either in an ambulance or in an ICU or CCU) this powerful computer will be directly coupled to a wide array of both simple and complex medical assessment devices….EMDs will be a very hot item. Initially (i.e., the 1990’s) they will be confined to ambulances and the ICU, CCU, and specialty areas of the hospital, such as radiology and cardiology labs. But there will be powerful incentives for wider application of these devices. As computing capacity drops in cost and increases radically in sophistication (i.e., parallel processors, neural networks, truly massive memories, and so on) expert medical (and other) systems will see increasing application. There will be devices on the market such as a “Home Doctor” diagnostic program, which will basically be an internal medicine physician in a can.

…After 2000, many people will probably have a small sensor array permanently implanted and coupled to telemetry equipment which can be activated to call for help or alert the person that trouble is brewing. People with a known risk of sudden health problems will be the first to use these kinds of devices. With the development of smaller and cheaper telemetry equipment (directly linked to large-antenna satellites), separate telemetry arrangements will disappear. Implantable, computer-controlled defibrillators are already a reality; analogous devices to deliver drugs in case of cardiac or brain infarct (stroke) will eventually become reality.

1.1.2 Resuscitation

Expect a shift back to open-chest heart massage and away from closed-chest massage in medical and perhaps even paramedical settings. Closed-chest CPR will be realized to be ineffective at maintaining cerebral viability and will be replaced by far more effective open chest methods. In paramedical (i.e., field) settings the emphasis will be on very rapid defibrillation — or actually “leaving the patient alone” until circulation can be effectively restored and medications given to inhibit reperfusion injury. Closed chest CPR and restarting circulation by laymen “in the field” will be realized to be doing more harm than good and there may well be a move away from field CPR, with laymen being instructed to leave the patient without circulation until it can be restarted adequately and under controlled conditions.

By the late 1990’s, extended use of CPR will be a thing of the past and major metropolitan areas will have “death reversal units” (DRUs) in emergency rooms and perhaps even in larger paramedical units. The DRUs will employ rapid femoral cut-downs and blood-pump/oxygenator supported resuscitation to recover people who have suffered extended periods of ischemia (in the 30 minute to 1 hour range). CPR will be realized very often to be ineffective at recovering patients who are profoundly ischemic and the advent of pharmacologic intervention allowing for cerebral resuscitation will provide tremendous pressure for emergency rooms to develop the capability to very rapidly put an ischemic patient on bypass and completely and adequately support his circulatory and respiratory needs until his brain can recover and/or his heart can be repaired and restarted. An intermediate scenario would be the development of small, flexible impeller pumps that can be collapsed and passed through a large bore percutaneous catheter through the femoral artery and into the abdominal aorta. Such a pump (acting much like the propeller on an outboard boat motor) could then be used to supplement CPR, perhaps providing 2–3 liters per minute of cardiac output.

…Another effect of drugs like the lazaroids and calcium channel blockers will be the more effective treatment of acute injuries to a wide range of tissues such as the spinal cord and brain. Much of the damage that occurs to these tissues is free radical related and can be inhibited by use of these drugs…Intervention into secondary inflammation will be most important in the brain and spinal cord. Deployment of these techniques will result in the salvage of many spinal cords that would be considered irreversibly injured by today’s medicine. There will be far, far fewer paraplegics. However, expect an increase in the number of permanently brain-injured patients and in the number of patients with “subtle” forms of cerebral injury resembling mild stroke or the cognitive or mood disorders seen in diseases like multiple sclerosis or acute head injury. These disease states will result because people with brain trauma who would have died acutely from secondary free radical mediated injury (cerebral edema and so on) will be saved with lazaroids and other cerebral rescue techniques.

1.1.3 Antibiotics

The next twenty years should see many powerful new antibiotics engineered directly from knowledge of the structure of the relevant microbial enzyme which it is desired to inhibit. Not only will these antibiotics be more powerful, but because they do not exist in nature, strain resistance will not so easily develop toward them as it has for the antibiotics of today.

In addition, the next generation of antibiotics will include many which have been designed for effect against viruses, an area where medicine is presently largely powerless.

The pharmaceutical industry and antibiotics have been a case-study in stagnation, failure, and diminishing marginal returns. There is only one, highly experimental, anti-viral that I have heard of. In a followup email, Darwin responded to someone else pointing out DRACO:

Finally, while Geoff cites this putative advance in antiviral drug therapy, the fact is that my prediction about a plethora of new and highly effective targeted molecular antimicrobials by 2008 was WRONG. In fact, antibiotic research is all but dead, and there are virtually no fundamentally new antibiotics in the drug pipeline. This should scare the crap out of all us, because we are rapidly approaching complete antibiotic resistance with a number of common and highly lethal bugs, including staph (MRSA), streptococcus, E. coli, pseudomonas and candida. It is only a matter of months to a few years, at most, before completely antibiotic resistance staph and streptococcus emerge. Pharmaceutical companies have a large negative incentive for developing new antimicrobials. At the cost of over a billion dollars a new drug (regulatory) and the high risk of withdrawal of the drug within 5 years (2 out of 3), as well as the near certainty of punishing litigation for adverse effects, antibiotics are not merely uneconomical to develop, they are fiscal suicide. Only drugs that will be chronically used by very large numbers of patients are now worth developing.

(This agrees with my own general impressions, which I didn't feel competent to baldly state.)

1.1.4 Immunology and cancer

…Monoclonal and synthetic antibodies carrying toxins or regulatory molecules will be used to turn off or destroy the fraction of immune cells which initially respond and proliferate when a transplant is carried out. More widespread transplantation of tissues will be undertaken, including transplantation of limbs and scalp. Xenografts will be used increasingly in the mid to late 1990’s and it will not be uncommon for people to have pancreatic tissue from bovine or porcine sources and perhaps hearts, lungs, and livers from other animals. Expect the first workable transplants to be from great apes (chimps, gorillas, orangutans), with porcine and bovine grafts coming later.

Immunology and immunotherapy will also be revolutionized by a far more complete understanding of the immune system resulting from the AIDS epidemic and basic research in the immunology of diseases such as multiple sclerosis and aging. The ability to rapidly and cheaply synthesize bioregulatory molecules will open up a wide array of therapeutic possibilities. Expect effective treatments for most autoimmune diseases (lupus, multiple sclerosis, myasthenia gravis, and so on) by the mid to late 1990’s. The mid to late 1990’s should also see the wider application of immunorestoratives for use with the aged and ill. Cancer therapy will improve considerably as a result of these advances as well as a result of selective targeting techniques. By the early to mid–1990s the first generations of monoclonal antibodies linked to chemotherapeutic agents or powerful natural toxins will be used against a few cancers.

1.1.5 Atherosclerosis

Atherosclerosis will undergo a very marked but nevertheless gradual reduction in frequency and severity of occurrence as physicians slowly become educated about what is already known and begin to use existing therapeutic modalities more aggressively. By the mid to late 1990’s it will be more widely understood that atherosclerosis can be reversed, and there will be wider use of drugs such as lovastatin to reduce serum cholesterol, coupled with sound dietary advice. However, even well into the late 1990’s and perhaps beyond, atherosclerotic disease (heart attack, stroke, ischemic limb disease, and so on) will continue to be a serious source of morbidity and mortality. By the late 1990’s, 2nd and 3rd generation therapies will be coming on-line which will be able to reverse atherosclerotic disease and more directly inhibit it

1.2 Part 2

1.2.1 Anesthesia

Expect “modular” anesthesia by the 1990’s to the early 2000’s. The development of potent anxieolytics (anxiety removers) which do not depress consciousness and the development of total pain inhibitors will allow for complicated surgical procedures on conscious patients. Expect to see major thoracic and limb surgery on high risk patients (i.e., patients unable to tolerate anesthesia) using such agents.Major abdominal surgery requiring deep muscle relaxation will continue to require skeletal muscle paralysis and general anesthesia. However, expect new drugs in the market place in the late 1990’s which induce unconsciousness without respiratory or cardiac depression.

Surgical and post surgical mortality will decrease sharply due to such anesthetics and the use of real-time physiological and biochemical monitoring during and after surgery using biosensors.

1.2.2 Surgery

…Catheters, laparascopes, and thorascopes with sensors, operating tools, and an impressive array of capabilities will be increasingly used. Abdominal surgery will shift more and more towards the use of the fiberoptic laparascope, endoscope, and laser as miniaturization of tools occurs and disease is diagnosed earlier. Early diagnosis will create the need for less drastic procedures.

Fine-tuned repair of heart valves and blood vessels, and examination and biopsy of suspected abdominal and retroperitoneal lesions will be early candidates for application of this technology.

…In contrast to therapeutic surgery, the frequency of cosmetic surgery will probably increase dramatically as techniques are refined and prosthetics improve in quality and drop in cost. As people live longer, and stay productive longer as well, they will increasingly turn to medicine to maintain not only their health but their appearance. Cosmetic surgery will experience a boom until such time as the fundamental mechanisms underlying the aging process can be brought under control.

1.2.3 Geriatrics

Advances will be slow here, but significant. Expect increasing understanding and application of trophic factors and bioregulatory compounds. Early candidates for rejuvenation will be the immune system and other stem cell systems or systems with higher cell turnover. By the early decades of 2000, significant rejuvenation and geroprophylaxis of skin, bone, immune, and other “high turn- over” tissues will be possible as the natural regulatory molecules which control these systems are understood and applied.

…By the early years of the 21st century the first generation of compounds effective at “rejuvenating” (i.e., restoring some degree of normal maintenance and repair to existing brain cells) the central nervous system will be available. These drugs will work by turning on protein synthesis and stimulating natural repair mechanisms.

However, pathologies of the brain and other non-dividing tissues (renal, cardiac, and musculoskeletal system) will continue to be major sources of morbidity and mortality over the next two decades. As atherosclerosis and immune-related disorders are dealt with more effectively, expect an increasing shift of morbidity and mortality to central nervous system-related causes. Beyond 2000 this may be treated to a limited extent with fetal transplant

We all know how well this has worked out. More troubling is that in some respects, we appear further from any solutions or treatments than before; while resveratrol did well in a recent human trial, the sirtuin research that seemed so promising has been battered by null results and failures to replicate. And anti-aging drugs have their own methodological difficulties; from the followup email:

Antiaging drugs are unlikely to be free of adverse effects. In fact, it seems very likely that they will be burdened with many adverse effects and that they will even kill a minority of people who use them. The common perception is that antiaging drugs will make people super fit, healthier and more resistant to disease. And yet, in calorie restriction and effective antiaging drug studies there is emerging evidence that slowing aging comes at the cost of interfering with fundamental processes that make organisms fitter for both reproduction and for surviving in a hostile environment.

Consider the putative antaging drug rapamycin. It seems likely that rapamycin interferes with senesence by affecting the PI3-kinase and TOR: PIKTORing cell growth pathways. This almost certainly means that in some individuals there will serious and even lethal side effects - cancer being one of them. [Persons with a history of promiscuity, and thus a heavy burden of chronic viral infection, and those with certain "unfavorable" genotypes will likely be at very high risk.] But, beyond cancer, interfering with these fundamental and deeply evolutionarily conserved pathways is likely to cause a range of adverse effects that negatively (and possibly irreversibly) impact normal body functions, such as energy level, cognition, sexual performance, and so on.. While some people are now using rapamycin as an antiaging drug...it is virtually inconceivable that any major pharmaceutical company anywhere in the world would (or will) market such a drug for "normal" aging. This is important to understand because it gives us basic insight into what will almost certainly be a major barrier to the development and marketing of antiaging drugs: they will necessarily be used by large numbers of people over the course of many decades (and thus millions of drug/person years) and they are incredibly unlikely to be free of adverse, and sometimes even lethal side effects.

1.2.4 Psychiatry & Behavior

Diagnosis by brain scanning (metabolic MRI) and chemical analysis of cerebrospinal fluids will be commonplace in 20 years. As neuroregulatory compounds are better understood and as the biochemistry underlying mental disorders is elucidated there will be more effective treatments. Expect 2nd and 3rd generation drugs and combinations thereof for treatment of depression and psychosis by the late 1990’s. There will probably be several very effective therapeutic agents for compulsive disorders in the marketplace by the early to mid 1990’s.

From the previously quoted followup email:

Similarly, psychiatric drugs (which are typically chronically used) are no longer economical to develop and market because of the litigation costs associated with them. Widespread chronic use of any drug means that the likelihood of adverse conditions that were impossible to detect in the testing phase of the drug development process are almost certain to emerge. Statistics rule in drug development, and a Phase III study that lasts a year and enrolls 5,000 patients is simply not adequately powered to predict what will happen when 5 million patients take a drug for 20 years! The only way to get that data is to do that study. And therein lies a powerful caution about antiaging drugs. These drugs will likely need to be taken starting in young adulthood, or in middle age, at latest, and they will need to be taken for a lifetime. Indeed, if they are effective, for a longer lifetime than any but a few super-centenarians has previously lived.

1.2.5 Implants & Prosthetics

Early spectacular applications will be small vessel prostheses (wide use by the early to mid 1990’s) for use in traumatized and atherosclerotic limbs and organs and venous prostheses (mid to late 1990’s) for use in treating traumatic injuries and deep vein incompetence (which results in varicosities, chronic pain, and edema-related skin changes in the leg, often leading to non-healing ulcers or limb loss). Another application of non-thrombogenic surfaces will be a practical artificial heart and more widespread use of extracorporeal support for infants, trauma and cardiac arrest victims, and others where anticoagulation provides a major barrier to the use of artificial circulation.

…Good synthetic bone and skin should be available by the late 1990’s to early 2000’s. Good red cell and plasma substitutes (synthetic blood) should be seen increasing in clinical use throughout the early 1990’s and in frequent use by the late 1990’s to early 2000’s.

There will be steady improvement in other synthetic materials such as hip, knee, and other joints, as well as in other less dramatic materials such as connective tissue replacements. Expect a slow replacement of prosthetic approaches to therapy as natural repair and regeneration processes are better understood and utilized. Expect to see synthetic connective tissue products for tendon repair which contain bioregulatory molecules (BRMs) that stimulate tendon regeneration. Artificial tendons made of both synthetic and/or natural materials will come into use in the late 1980’s to early 1990’s. In short, expect stunning advances in tissue replacement technology for all tissues that have primarily structural function and which are not complicated chemical processing plants, such as the liver or kidneys, or mechanically active such as the heart. In addition to connective tissue and bone, a candidate for early (late 1980’s to early 1990’s) replacement is the cornea. Expect evolution in biocompatible materials to allow for replacement of the cornea with an appropriate plastic, much like the lens of the eye is already replaced with polymer inserts.

1.2.6 Hemodialysis

Advances in hemodialysis will also be very incremental. There may be a gradual shift to peritoneal dialysis (PD) if good drugs to block glucosylation of proteins and inhibit cholesterol deposition are available. The major problem with PD today is that it raises blood sugars to astronomical levels, causing diabetic-like side effects. Inhibition of these side effects may lead to renewed application of this modality.

Direct changes in dialysis are likely to be along the lines of better membrane materials which allow for transport of wastes not currently removable by conventional dialysis and nonthrombogenic surfaces which will reduce the need for anticoagulation. The use of BRMs such as erythropoetin to treat anemia and bone growth factors to treat dialysis bone disease will help to improve the quality and quantity of patient’s lives on dialysis.

Perhaps the biggest advance in this area will be advances in immunology and infectious disease treatment. The ability to administer BRMs to stimulate immune function and improve general health should act to extend dialysis patients’ lives considerably.

…Of course, the biggest improvement in the life expectancy and health of dialysis patients will probably come in the form of the increasing use of transplantation and its application to a wider age range of patients with better long term results.

The most striking revolution in prosthetics will probably occur in dentistry. Expect a whole family of new materials to enter the dental operatory. A workable vaccine against streptococcus mutans should be available by the mid to late 1990’s, greatly reducing the incidence of tooth decay by eliminating the major class of mouth organisms that cause it. Similar advances in prevention and in treatment of gum disease can be expected as well, although probably not as soon. Repairing dental defects will also be revolutionized by the introduction of good, tough, and reliable polymers which will replace metallic amalgams. By the late 1990’s to early 2000’s biocompatible ceramics and coated polymers will be available that will allow for workable single tooth and multitooth gum-implanted prostheses.

1.2.7 Organ Preservation

Ever since the work of people like Mazur, Fahy, and Pegg was published, it has become pretty clear what the constraints are on long term viable cryopreservation of organs: don’t form any significant amount of ice; it injures mechanically and it injures chemically. The problem is that water loves to turn into ice when it’s cooled below 0øC. To circumvent this, a lot of very drastic changes have to be made in the system. Whenever you attempt to make a drastic change in a complicated, interdependent living system — like replacing half the water in it with industrial chemicals — you are in for trouble. The trouble will come in the form of a very tight or narrow window for success: everything will have to be “just right.”

This is where current vitrification technology is now. The existence of such a tight window means that vitrification of large masses will be a technological tour-de-force requiring very sophisticated computer controlled perfusion equipment and exotic and very costly high pressure chambers. Quality control and reliable storage and rewarming of organs will be very costly and difficult.

The future holds the possibility of developing better solute systems which vitrify more easily and which are less toxic (have a wider window for success). It is difficult to predict the pace of advance in this area since it will be arrived at by a mixture of empirical methods and theoretical insights. A big determining factor will be luck. Will the NIH and the Red Cross continue to fund such efforts? And, more to the point, will technological advances in other areas of organ preservation obviate the need for them? If we were betting men, we’d put our dollars on the latter rather than on the former. Major advances in organ preservation (as opposed to cell and tissue preservation) over the next decade will probably be in three areas: 1) Extended hypothermic storage of organs in the 2 to 3 weeks range; 2) Extended normothermic or room temperature storage of organs in the weeks to months range and; 3) mixtures of the above two modalities which yield similar available time courses of storage.

…The next 5 to 10 years should also see major advances in our understanding of the effects of deep hypothermia on the tissues and organs of non-hibernating mammals. These advances should be readily translatable into better flush and perfusion storage techniques for organs. A good understanding of lipid metabolism and mechanisms of cell swelling in deep hypothermia may allow for preservation of organs in the 2øC to 10øC temperature range for periods of several months — thus definitively ending the need for long term solid state preservation of transplantable organs.

1.2.8 Other Approaches to Organ Preservation

One possibility for a major advance over the next two decades is room temperature or hypothermic preservation of organs or organisms using metabolic inhibitors. There have been tantalizing clues in the examination of a wide variety of estivators (animals which go into states of profoundly reduced metabolism at normal temperatures, such as the African lungfish, which can shut off metabolism at temperatures in the range of 30øC to 40øC) that anti-metabolite compounds exist which may be able to induce states of profoundly reduced metabolism at ambient (i.e., 70øF) temperatures.

1.2.9 Genetic therapy

Expect very gradual application of this technology. Early candidates for gene replacement will be in storage diseases such as Lesch-Nyhan, Tay-Sachs, and other “single enzyme missing” disorders. Later applications will include treatments for hypercholesterolemia, some forms of hypertension, and other congenital missing enzyme syndromes. Very late applications (2000 or later) may be in the treatment of a wide range of mental illnesses and cancers.

1.2.10 Prevention

The principal lesson is the lesson of the impact of calorie restriction on overall health, well-being, and lifespan. The basic message here is “you are what you eat.” In terms of treating atherosclerotic disease, the role of prevention is already clear. By reducing fat intake and decreasing serum cholesterol to below 150 mg/dl, most atherosclerotic disease can be avoided. Similarly, basic changes in nutrition such as trace element and vitamin supplementation can greatly reduce the number of late onset malignancies. Eliminating smoking will also be a major factor in achieving this end….Calorie restriction achieved by means of education and therapeutic agents seems the next big area of preventics to be explored by medicine. Expect the development of truly effective anorectics for treatment of gross obesity and eating disorders by the late 1980’s and then secondary use of these for treatment of mild obesity and weight control in the normal middle aged. Products with reduced calories employing fat substitutes such as sucrose polyester should also be entering the marketplace in the early 1990’s and these will help to reduce the calorie load further.

1.2.11 The Downside

A little information is a dangerous thing, and sometimes a lot of information can be an even more dangerous thing. The reason is that progress in therapeutics, which is relatively difficult, always lags far behind progress in diagnosis, which is relatively easy. This imbalance results in a tension which forces premature treatment which often does more harm than good. It is well to note that each new diagnostic modality brings with it a flood of new information which will at first be grossly misused before anyone understands what it means (Harris’s Law of Diagnostics Advance).

A recent example of this sort of thing is the EKG machine, which for the first time showed that many seemingly normal people had strange cardiac rhythms, some of which were seen also around the time people died suddenly of heart problems. Because of this association, for the last 15 years, a number of very powerful drugs have been used to treat people with such rhythms. Many drug-induced fatalities resulted. Unfortunately, only now is it beginning to be understood that most people with good heart function are less in danger from such rhythms than they are from the drugs used to treat them — a finding of little consolation to the people already killed by the drugs.

And on to the economics:

There is a second downside to advanced medicine, of course, besides the danger, that is the cost of “middlingly advanced technology” (such as what we’ll see in the next fifty years) in a society takes a socialistic view of health care. Such as ours.

Non-molecular technology is expensive. It should be obvious to the reader, with a bit of thought that in a world of non-molecular technology, the potential demand for medical care as technology advances, is (for all intents and purposes) Iinfinite. In America, we have adopted the unfortunate policy of letting everyone pay for everyone else’s medical care, which has had exactly the same result as if we had let everyone pool their money and pay for each other’s lunch: everyone orders lobster. We have paid for the lobster only by spreading the costs around to places where they are not obvious. For instance, when you buy an American car, you pay more money for the health care costs of the people who built it than you do the steel that goes into it. This kind of thing can continue very subtly and very insidiously until a very large fraction of the gross national product is eaten up by health care costs. (In our country, it is already 11% and rising).

One day, you may find that you have had to forego your family vacation in order to buy Granny that new AUTODOC which measures 245 different chemicals in her blood every minute and transmits all of the results to Medical Multivac in Bethesda. Of course you may not realize this: all you will know is that the vacation went because money is so tight, taxes are so high, and inflation is so bad. But your money went to Granny nevertheless. The only answer to this problem, short of nanotechnology, is rationing.

But rationing itself becomes the last great social cost of advanced medical technology under socialism, because history shows that it is never done on an individual (person by person) basis. When people do not pay for their own medical care, no one (not doctors, families, or the government) has ever been willing to make the decision of who should benefit from a given technology, and who should not. Therefore, all systems of rationing to control medical costs ultimately have come down in the past to rationing technology across the board…So all of the rosy predictions made in this article must be tempered with the “social” realities that medicine will have to deal with in the next 20 years. Many of the advances we have discussed may simply not materialize because we are not wealthy enough to afford them collectively. That will be a great tragedy.

2 Reactions

On reading all the foregoing, I commented: that was a depressing read. As far as I can tell, they were dead on about the dismal economics, somewhat right about the diagnostics, and fairly wrong about everything else. Which is better than the old predictions listed, only one of which struck me as obviously right (but in a useless way, who actually uses perfluorocarbons for liquid breathing?).

To which Darwin said:

At the time I wrote it I kept saying to myself, almost none of this stuff is going to happen in 20 years - not here anyway. However, I have to come up with something.

Ironically, in the area of cerebral resuscitation, where I am a supposed “expert,” I tried very hard to be realistic and to be both accurate and precise. That was arguably the area where I did the worst - exactly the way other experts fare when they try to predict the future of their fields…So, here I am, 24 years out from making those predictions and I read the crap posted on Less Wrong and on Cryonet and I don’t whether to scream in rage and anger, or weep. How is possible to reach and convince this new generation of cryonics “passivists” that Yudkowsky and Alcor are breeding and make them understand that progress will continue to be unacceptably slow unless the system itself is changed?

See also Fight Aging!’s post, “Overestimating the Near Future”:

…Many of the specific predictions in the article were in fact demonstrated in the laboratory to some degree, and were technically feasible to develop as commercial products by the year 2000, and in some cases earlier but at much greater expense. Certainly there are partial hits for many of the predictions by 2010, in the sense of it being possible, somewhat demonstrated, or in the early stages of being shown to be a practical goal. Yet the regulatory environment in much of the developed world essentially rules out any form of adventurous, rapid, highly competitive development in clinical medicine - such as exists in the electrical engineering, computing, and other worlds. We are cursed therefore with the passage of many years between a new medical technology being demonstrated possible and then attempted in the marketplace … if it ever makes it to the marketplace at all. This must change if we are to see significant progress.

Darwin comments there:

I’ve been going over my original manuscript and surfing the web for specific applications (approved or in process) which meet the criteria of my predictions of 24 years ago. While many of my “lesser” predictions are in fact being realized (often in ways totally unforeseen by us when we wrote the article) overall it is a profoundly depressing experience.

Perhaps nowhere has that been more true than in the areas of aging and cerebral resuscitation - two fields of endeavor I’ve spent a lifetime working on, or intimately involved with those who are. In 1999, we announced that we had achieved repeatable recovery of dogs following 16+ minutes of whole body noromothermic cardiac arrest with no neurological deficit. The enabling molecules and techniques (principally a combination of melatonin, alpha-phenyl-n-tert-butyl-nitrone (PBN), and mild post-cardiac arrest therapeutic hypothermia) all seemed eminently applicable in the (then) immediate future. Indeed, an analog of PBN, 2,3-dihydroxy–6-nitro–7-sulfamoyl-benzo(F)quinoxaline (NBQX) had passed Phase I and II clinical trials for the treatment of stroke with flying colors, and seemed destined for approval.

That was 13 years, ago, and there is still not a single drug available (approved or otherwise) anywhere in the world to treat cerebral ischemia-reperfusion injury - the real killer in cardiac arrest and stroke! Do a literature search on Pubmed for melatonin + cerebral ischemia and you will get ~130 hits - almost all of them dramatically positive. Melatonin is a naturally occurring bioregulatory molecule which is inexpensive and freely available as an over the counter “nutrient.” Even as a stand alone molecule, melatonin is powerfully protective in both global and regional cerebral ischemia, and yet no human application has been forthcoming. It’s been 15 years since our patent on melatonin and other cerebroprotective molecules was issued, 17 years since the patent was applied for, and over 20 years since I made the discovery! Indeed, mild therapeutic hypothermia, made the supposed standard of care for post cardiac arrest neuroinjury nearly a decade ago, is still largely ignored and is used well in only a handful of hospitals worldwide.

What kind of black irony is it that I live in terror of stroke and cardiac arrest (for both myself and my loved ones) and yet the very molecules I discovered to combat them are as unavailable as if they had never been found? Change? Yes, change is certainly needed, and soon.

3 Further reading

Previous Darwin-related posts:

See also Tyler Cowen's The Great Stagnation and “Peter Thiel warns of upcoming (and current) stagnation”.

46 comments

On the unpopularity of cryonics: life sucks, but at least then you die

Sat, 30 Jul 2011 07:06:41 +1000

Submitted by gwern • 59 votes • 459 comments

From Mike Darwn's Chronopause, an essay titled "Would You Like Another Plate of This?", discussing people's attitudes to life:

The most important, the most obvious and the most factual reason why cryonics is not more widely accepted is that it fails the “credibility sniff test” in that it makes many critical assumptions which may not be correct...In other words, cryonics is not proven. That is a plenty valid reason for rejecting any costly procedure; dying people do this kind of thing every day for medical procedures which are proven, but which have a very low rate of success and (or) a very high misery quotient. Some (few) people have survived metastatic head/neck cancer – the film critic Roger Ebert, is an example (Figure 1). However, the vast majority of patients who undergo radical neck surgery for cancer die anyway. For the kind and extent of cancer Ebert had, the long term survival rate (>5 years) is ~5% following radical neck dissection and ancillary therapy: usually radiation and chemotherapy. This is thus a proven procedure – it works – and yet the vast majority of patients refuse it.

Cryonics is not proven, and it is aesthetically disturbing (indeed even disgusting) to many people. It is also costly, and not just in terms of money alone. It is costly in countless other ways, ranging from the potential for marital discord, social alienation, ridicule, social isolation, disruption of family relationships (and with grief coping mechanisms) during the dying process, and on and on and on. And it does cost a lot of money, because if you figure the lost present value of capital for life insurance, dues, and end of life expenses related to cryonics, then that is a very significant dollar amount; my guess is that for a whole body patient who signs up at age 35 with Alcor, it is in the range of ~ $500,000 to $750,000 2010 dollars!

...Beyond this, many other factors come into play, such as perceived interference or lack of competitiveness with religion by cryonics, lack of endorsement by authority figures, such as physicians and scientists, actual marketing faux pas’s, such as the Chatsworth debacle and the use the words “death” and “dead” to describe cryonics patients. Then come factors which would, if cryonics were proven to work, be down in the noise, or more accurately, nonexistent, such as they way the current cryonics facilities look, the appearance and qualification of staff and so on.

...Over the past few days, with the passing of Robert Ettinger, cryonics has received a level of planet-wide media attention it has not received in decades. One interesting and valuable result of this is that various news venues have solicited public comment about cryonics, and what’s more, about immortalism, or radical life extension. As usual, cryonicists have been deaf to the criticism, expressed and implied in these remarks from the “marketplace. Or worse, they have been contemptuous, without being clever in their contempt and in their responses.

[quotes from comments & people]

What do these remarks mean? Well, they mean exactly what they say they mean in most cases. That may be hard to understand, especially if you look at the demographic data for how “happy” people are the world over. What you will find, if you do, is that people in Western Developed nation-states are extraordinarily happy. In fact, they are unbelievably happy (Figure 3).

Figure 4: Your life and future prospects can still be grim and relatively hopeless and yet your evaluation of your satisfaction with life vary dramatically depending upon whether you have a full belly, or even if you’ve had a meal in the past few hours.

How is this possible? The answer is that happiness is complex and exists on many different levels. The most important and the most difficult to measure is existential happiness. The issue of their existential happiness is something most people rarely, if ever confront, and almost never do so in public when asked (unless you ask them in the right way, such as, “Would you want to live forever?”). The reason for this is that if they respond by saying “My life is a boring exercise in getting from day-to-day with a lot of nagging miseries and frustrating inconveniences,” they would appear as failures, as whingers , and as losers. Few people find that acceptable!

...Figure 5: Humans were not evolved to be confined to a fixed space day-after-day and to do boring and repetitive work which is usually personally meaningless, and is done on the orders of others who are also omnipresent to supervise its execution. That is the working definition of hell for hunter-gatherers and they are uniformly both horrified and disgusted to to see “civilized” man behave in this way.

...Then there are the other people you must necessarily interact with. Several of the people you work with are complete monsters, in fact, they despise you and they go out of their way to make your job and your hours at work more difficult. And the customers! Most are OK, but some are horrible – encounters with them leave you shaking, and sometimes fearful for your job. Speaking of which, there is always some degree of apprehension present that you might lose your job; you might screw up, the economy may take a nosedive… In any event, your survival is critically dependent upon your job. Others whom you work with are better compensated, and those that own the enterprise you work for are getting rich from it, and that rankles. But, beyond these concerns, this isn’t what you really wanted to do with your life and your time. When you were fifteen, you wanted to _______________, to travel, to see the world, and to meet interesting people and do interesting things. Instead, here you are. And every day you are a little older and a little more run-down. The clock is ticking. When you looked in mirror this morning, you had to face it yet again; you aren’t young anymore and you aren’t going to get any younger.

...And frankly, why should you even try? You were raised with a very limited repertoire of interests, ambitions, and capabilities. It is so hard to survive in this world, even in this relative paradise of Western Technological Civilization, that mostly what you had to learn and spend your time thinking about were how to acquire the skills to compete and to make a living and support your offspring and your dying parents. All so that this cycle can be repeated, yet again (and to what end?). You laugh at people who talk about what makes the stars shine, how long the universe will last, where all the dark matter is, are there multiverses, what would it be like to “see” in the full electromagnetic spectrum, or even what it would be like to sit down and talk with Chinese workers or Egyptian shop keeps, and find out what they really think about Islam, democracy or the USA, without someone on the TV telling you what they think (and getting wrong)?

...The fundamental problems are these, in no special order:

Most people lack autonomy in their daily lives. Next to life itself, freedom is the most precious value; and most people’s lives are functionally devoid of it. Many cryonicists fail to see this, because they are self employed, are in jobs that offer them compensating satisfaction, or that they don’t perceive as “work” (e.g., they are not watching the clock just waiting for the torture to be over for another day).

Most people have a very limited range of interests and possibilities for gratification. This problem cannot be fixed for most by giving them more money, or even more money and autonomy. Do that, and they will drown themselves in what they already have, or kill themselves with drugs. How many cars, planes, and pairs of shoes or houses can you really gain joy from?

The vast majority of people over 30 don’t feel well a significant fraction of the time. They have colds, flu, osteoarthritis, and most importantly, they are poorly conditioned as a result of jobs that enforce immobility and make them sedentary. As a result, they are tired and drained from their work and home responsibilities at the end of each day, and worst of all, they spend that part of the day when they feel the best and are most alert, doing what other people tell them to do – not what they want to do.

They are losing their own youth and health and watching others suffer and die around them. How’s that for a satisfying life experience? Every day they turn on the news or talk to friends or family, and find that another fixture in their life is dead, or dying. As John Donne said, “Any man’s death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the bell tolls; it tolls for thee.”

...Thus, when it comes to happiness, people who are socially inept and who have trouble coping emotionally with the exigencies of life are, on average, the least happy. It should thus come as little surprise that our prisons are currently filled with a disproportionate number of people who are more intelligent than average and who lack the social coping skills to get on in society. They are also smart enough to know that many of the rules and orders given them are arbitrary and have no basis in reason beyond maintaining the status quo. As sociologist and educator Bill Allin has observed: “People with high intelligence, be they children or adults, still rank as social outsiders in most situations, including their skills to be good mates and parents.”[4]

The relevance of this to cryonics should be obvious to most cryonicists; cryonics attracts, with massive disproportionality, the highly intelligent. Indeed, many of the arguments that make cryonics credible, require a remarkable degree of both intelligence and scholarship. Inability to understand the enabling ideas and technologies usually means the inability to understand, let alone embrace, cryonics. A disproportionately unhappy population of smart people translates to a disproportionately large population of ideal market candidates for cryonics being unwilling and indeed, unable to embrace it.

...There is no one solution or easy fix. The first step is to realize that what the marketplace is telling us is true: many people don’t want to live because the existential ground state of their lives is a gray-state of dysphoria at best, and at worst, a state of active misery, relieved only occasionally by a few quickly snatched minutes of relief, or if they are lucky, joy. That state of affairs can only be addressed by showing people very real and concrete ways in which the quality of their lives can be improved, both here and now, and in the future. Heaven isn’t waking up from cryopreservation and having to go into work two weeks later – FOREVER. That is the very definition of hell for most people. And the mystics have been smart enough to carefully exclude any mention of time-cards from their hereafters. The Mormons and the Islamists have even had the good marketing sense to offer up eternities where each man commands his own world, or at the least, his own harem.

Conclusion, graphs, and references in article. As usual, I recommend reading Chronopause.com as Darwin has many good articles; to quickly link a few:

459 comments

The cost of universal cryonics

Thu, 26 May 2011 12:33:58 +1000

Submitted by handoflixue • 37 votes • 37 comments

INTRODUCTION

I recently got sparked by both Eliezer's post on Cryonics(http://lesswrong.com/lw/qx/timeless_identity/) and lsparrish's post on the economies of scale(http://lesswrong.com/lw/2f5/cryonics_wants_to_be_big/) that go in to cryonics, to do some actual research. Unfortunately, while both authors are happy to assert that there are "economies of scale" at work, there doesn't seem to actually be any published research on the matter. If I happen to be wrong, and someone else has more accurate numbers, I'll be pleasantly surprised to see myself corrected :)

Alcor Costs as of 1990 (http://www.alcor.org/Library/html/CostOfCryonicsTables.txt) seems like a reasonably reliable source of information. I'll be using them primarily because they were the only institute I could find that actually provides a break-down of their costs. The accompany article(http://www.alcor.org/Library/html/CostOfCryonics.html) suggests that the labor rates and equipment markups are actually excessively optimistic, but it gives a simple cost of $18,908.76 for neurosuspension (not whole body). Maintenance costs are given as $66.08 annually, which would require a $6600 investment to yield suitable interest. Call it $25K total.

Now, figuring out how economies of scale will affect this is tricky. I'll go ahead and run two estimates, but they're both reasonably crude. I'm trying to be optimistic in my math, because my starting premise is "cryonics is not financially viable, even with economies of scale", and I don't want my numbers to favour my starting hypothesis. It's also worth noting that I am assuming that the major cryonics facilities are already taking advantage of some economies of scale: it is quite true that one can get a 90% discount on liquid nitrogen, if you start at the price that someone would pay for a liter for personal usage; it is far less likely that a business that already dropped it's prices from $0.50/L to $0.13/L [1] can still claim a 90% savings by sufficient economies of scale.

----

METHOD 1

The actual cost of the chemicals and equipment won't scale dramatically - you can't get a 90% discount just because you're huge, unless the company is making a 10x profit off the item normally. A 50% reduction due to bulk savings is therefor a reasonably optimistic assumption.

Transportation is going to remain an issue, although certainly as this becomes more "main stream", you could imagine hospitals having a cryogenics ward and thus only having transportation when someone dies outside a hospital. A quick peruse of Google says ~50% of deaths occur in a hospital, so we can cut transportation costs in half right there. Obviously, transportation costs will also drop as there are more facilities, because distances decrease. However, it's also worth noting that, should we want this to be a truly universal option, transportation costs will rise to include transportation of people who do not live near major urban centers. We should also be able to claim economies of scale on the financial cost of vehicles and equipment. That probably works out about the same as equipment, so another 50% off; we gain a 75% economy of scale on transportation.

Labor is an interesting point: Alcor points out that their labor rates are generally 2-3 times less than you'd expect mainstream, and they use a lot of volunteers. It appears that the Cryonics Institute also has a large volunteer staff. Unless society radically changes, a reliance on volunteer labor is probably not a fair assumption as things scale up. However, we actually get the most powerful economies of scale here, because we're no longer looking at 48-80 hours of standby per person. You'll need a sufficient staff to handle catastrophes quickly (plane crashes, etc.), and thus some degree of standby is still essential for prompt responses. If we reduce standby from 48 hours down to 2 hours, then multiplying costs by 3 to bring pay up to market rates, we get a total savings of 87.5%!

Based on the summarized charges, it looks like the charges break down as approximately:
Transportation: $9,000
Equipment: $4,000
Labor: $15,000

Which, with these new adjustments:
Equipment (50% of original cost): $2,000
Transportation (25% of original cost): $2,250
Labor (12.5% of original cost): $1,875

That gives us a net total of $6,125, before maintenance fees are taken in to account.

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METHOD 2

Alternately, we could extrapolate economies of scale based on observed data. The UK has centralized health care and spends $3,000 per capita on health care. The US is decentralized, and spends $7,500 per capita. So we have reason to assume that medical costs specifically can be cut down to 40% simply based on economies of scale.

Another approximation often used for hospitals is that there is a 10% increase in hospital productivity per doubling in size. Alcor currently has 100 patients. Scaling up to 150,000 is ~17 doublings or, being generous, a tripling of productivity, so cutting costs to ~33%. The two figures are reasonably close, so we'll go with the more favourable 33%.

Given an adjusted grand total of $18,908.76 (this excludes the remote charges and nursing fees), and taking only 33% of the cost yields about $6K. Once again, this figure ignores maintenance fees.

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FINAL COSTS

Either way you do the math (and I'm quite welcome to being told I've been vastly pessimistic, if there's some supporting evidence I've missed in my searches), the final cost per person for cryonics is probably around $6K for the suspension.

Storage costs are another matter, and we will simply assume that storage is magically free, as I am attempting to be optimistic, and storage is probably going to realize the greatest economies of scale. It is worth noting that storage is only approximately 25% of the current expense! Alcor requires an additional $6600 fund and uses the interest from that to pay maintenance costs. CI cites maintenance costs that are 50% higher ($100 vs $66), and thus would presumably require a $10,000 fund. This is against an expense of $18K and $28K for each respective organization.

We thus have a final figure of $6K per person.

If you still think this is an overly pessimistic figure, keep in mind that the current market rate is $80,000 via Alcor, and Alcor's discussion of costs(http://www.alcor.org/Library/html/CostOfCryonics.html) explains a lot of why this is a really quite expensive service. The Cryonics Institute(http://www.cryonics.org/comparisons.html#Prices) charges $88,000 for a complete package (suspension, standby, and transport). Our $6,000 per person figure is a 90% savings due to economies of scale - which, except for the noted quirk of labor charges, is an exceedingly optimistic economy of scale for any enterprise to aim for!

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CONCLUSIONS

The fundamental point here is that economies of scale only take us so far: We still need to pay professionals to do their job, we still need a vast amount amount of equipment and supplies to actually perform the operation, and we still want to attempt vitrification as soon after death as possible. While the actual storage of a human body might come cheaply (I have seen figures of $100/year for CI's whole-body option, and $66/year for Alcor's neuro-only option), even if we discount this to free, we are only managing a 25% savings; as Alcor's numbers demonstrate, storage is a relatively trivial if you assume an investment fund with a mere 2% return. Even the space requirements are modest; maybe 4 buildings the size of the empire state building each year.

The true expense of cryonics is getting someone vitrified, and doing it in a timely manner.

At present, approximately 150,000 people die per day, or 54,750,000 per year. At our optimistic rates of $6K per person, we are looking at a sum expense of $328,500,000,000 ($328 billion). This is approximately half of the US defense budget ($663.8 billion) and approximately 0.56% of the world GDP (58.26 Trillion)

In an ideal, rationalist world, is this a viable figure? Certainly.

In our actual world, with our actual politics, does this even vaguely approach a rational goal to shoot for today? It seems unlikely.

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[1] http://cryonics.org/cryostats.html - About halfway down the page; the search term "Prior to getting the bulk liquid nitrogen" will locate the relevant paragraph.

All other sources are marked via in-line links

37 comments

Cryonics Promotional Video Contest -- 10 BTC Prize

Sun, 01 May 2011 06:31:22 +1000

Submitted by lsparrish • 15 votes • 14 comments

There was recently a proposal that we should create YouTube commercials for cryonics. This is an area where the cryonics community is sorely lacking fresh content, and which in my opinion has higher leverage per unit effort relative to other kinds of content, for making the kinds of cultural changes that need to be made for cryonics to gain acceptance.

One important strategy to beat procrastination, is to turn ideas into concrete action quickly rather than talking about them for too long. Another is to raise the amount of positive feedback a person expects to receive. Prizes have been used successfully in the past for the promotion of creative efforts with considerable success, and I have long thought that this would work for cryonics promotions as well. It's time for a simple empirical test.

To get things started, I am offering the nominal sum of 10 bitcoins¹ as a prize to whoever creates the the most "liked" promotional or educational video for cryonics on YouTube for the month of May, 2011. If anyone wishes to contribute to the prize and thus increase its size, send bitcoins here: <removed>

All funds sent to the above address will be transferred to the address of the person whose YouTube video promoting cryonics receives the most "likes" on YouTube during the month of May. Donors who let me know that they have donated will be given credit for donating below.

Start date: May 1, 2011 at 12:00 AM GMT. Entry video cannot have been released on YouTube sooner than this.
End date: June 1, 2011 at 12:00 AM GMT. This is when the votes (likes) will be tallied and the prize awarded.
Video must promote cryonics and/or answer common questions about cryonics.
Multiple submissions per person are allowed and encouraged, as are collaborations².
Xtranormal videos, slide shows, stick figure cartoons, voice-overs, and anything else that can go in a YouTube video are acceptable.
Winner must have or obtain a bitcoin address³, and must let us know what it is along with a link to their video (which must be posted to YouTube) in the comments section of this post.
In the event that there are multiple videos with substantially similar numbers of likes (to within 1% of the top number) at midnight of June first, they will all be treated as co-winners and receive equal shares of the prize.

Anyone who wants to donate to non-winning entries that they liked is welcome to do so as well (the bitcoin address of each entry will be visible below).

Let the games begin!

These are a digital commodity that I thought would make a more fun and interesting prize than dollars, and seem to have a positive reputation on LW so far. It is also easy for me to keep track of. Market value was about $4 per bitcoin as of April 31.
One bitcoin address per video please. Teams are responsible for divvying up the prize money among members.
The simple way is to create an account on MyBitcoin. You can also install the Bitcoin client.

Current prize fund (to be updated): 14.75 BTC (103.29 USD @ 7.003)

Donors known so far:

drethelin
Pavitra

14 comments

February 27 2011 Southern California Meetup

Thu, 24 Feb 2011 16:05:39 +1100

Submitted by JenniferRM • 7 votes • 10 comments

There will be a LessWrong meetup for Southern California on Sunday February 27th at 1:30PM. The location is being kindly provided by the Harvey Mudd A.I. & Future Technology Club in the Platt Campus Center of Harvey Mudd College. There will food, drinks, small group conversation, a whiteboard, a projector, and an opportunity to try paranoid debating.

For travel planning purposes, the meetup is happening about 10 blocks north of the Claremont Metrolink Station, which connects to the hub at LA Union Station. Train schedules can be searched here. Also there should be car pooling opportunities in the comments.

As more meetups have happened attendance has been increasing. If you want to make sure to see future announcements so you don't miss a meetup, you can sign up for the mailing list. The room should be comfy for up to 40 people and we've never had more than that number yet, but for planning purposes it would be helpful if people RSVP in the comments.

See you there!

10 comments

January 2011 Southern California Meetup

Tue, 18 Jan 2011 15:50:20 +1100

Submitted by JenniferRM • 8 votes • 20 comments

There will be a meetup for Southern California this Sunday, January 23, 2011 at 4PM and running for three to five hours. The meetup is happening at Marco's Trattoria. The address is:

8200 Santa Monica Blvd
West Hollywood, CA 90046

If all the people (including guests and high end group estimates) show up we'll be at the limit of the space with 24 attendees. Previous meetups had room for walk-ins and future meetups should as well, but this one is full. If you didn't RSVP in time for this one but want to get an email reminder when the February meetup is scheduled send me a PM with contact info.

For those interested in carpooling, see comments for: San Diego, Lake Forest.

The format for past meetups has varied based on the number of attendees and their interests. At various points we have either tried or considered: paranoid debating, small group "dinner party conversations", structured rationality exercises, large discussions with people sharing personal experiences with sleep and "nutraceutical" interventions for intelligence augmentation, and specialized subprojects to develop tools for quantitatively estimating the value of things like cryonics or existential risk interventions.

People at these meetups are generally up for being subjects of fun experiments in group or individual rationality. Also, past experience indicates that interesting top level articles are inspired by conversations that happen at meetups. Expect something awesome to happen... or bring something neat to make something awesome happen!

20 comments