Love for Life

Alcor Life Extension Foundation

The Alcor Life Extension Foundation is the world leader in cryonics, cryonics research, and cryonics technology. Cryonics is the science of using ultra-cold temperature to preserve human life with the intent of restoring good health when technology becomes available to do so. Alcor is a non-profit organization located in Scottsdale, Arizona, founded in 1972.

What Cryonics Is

Cryonics is a speculative life support technology that seeks to preserve human life in a state that will be viable and treatable by future medicine. It is expected that future medicine will include mature nanotechnology, and the ability to heal at the cellular and molecular levels.

What Cryonics Is Not

Cryonics as practiced by Alcor is not an interment method, mortuary practice, or dead tissue preservation. Just as organ donation involves recovery of living organs from a donor that is brain dead, cryonics involves stabilizing the viable brain of a patient who is legally deceased based on cardiac death. Cryonics cannot work for anyone who is truly brain dead.

Cryonics and Religion

Cryonics is an attempt to preserve and protect the gift of human life. The purpose of cryonics is to maintain life, not reverse death. Lack of legal status as a person does not imply lack of moral status as a person. The spiritual status of cryonics patients is the same as frozen human embryos, or unconscious medical patients. When properly examined, cryonics has been endorsed by both clergy and theologians.

Cryonics and Science

Banking of transplantable organs at low temperature is a recognized specialty of the science of cryobiology. Alcor applies breakthroughs in organ banking research to the much more difficult problem of preserving whole people. Although cryonics is not reversible today, the eventual perfection of cryonics will be of great value to fields such as medicine and space travel.

Information about Cryonics

The intent and practice of cryonics are frequently misreported by news media. We invite you to explore this site and reach your own conclusions.

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Comment/Email Reply To Stan 27th June 2007 2.24pm

Hi Stan
It (Alcor Life Extension) is an extreme version of Self-Centredness that man or woman could ever conceive and achieve. This is a complete denial of consciousness*. A complete rejection of The Supreme Creator and The Divine Plan. They have forgotten their eternal interconnectedness with all of real life. This is an extreme example of greed and selfishness at play.

They are bound to the fiction-fantasy word-stories of time and space to survive their deluded fantasies "I-dentity" existence. Instead of living in the moment free-to-be, allowing the river of life (consciousness) to fill them with life, from one moment to the next, on an endless journey from one life (experience) of consciousness to another, through one transition of consciousness to another, they are rebelling against The Supreme Creator (consciousness) by resisting consciousness.

It all bores down to a loss of TRUST with consciousness.

Just how greedy and selfish (self----------i-----sh) can we get.

What's Next?

Arthur Cristian

Stan Szopa wrote 27th June 2007:
Hi,
What is your opinion on this approach to life?
Alcor Life Extension .................... (link to Alcor website located at bottom of this article)

Best regards,
Stan

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* LIFE: Taken from the not completed booklet we are writing "Corporation Australia" located in the Love For Life Campaign Website, See http://www.loveforlife.com.au/node/67 - Arthur Cristian

LIFE

Live for the benefit of life
and the benefit of life lives for you

We are all dependent on life from the day we are born. We cannot exist without breathing the air, drinking the water and eating the food of nature.

We cannot exist without life and cannot create life out of thin air; we can only work with what life has given us to create with. In this way we are all equal: there is no hierarchy in terms of us and nature, as we are all just part of the intricate interconnectedness of life. The supreme power is life itself, not any of us. When we fail to share our lives with all of life, humanity self-destructs.

Our problems begin when some human beings start to believe they are greater than other forms of life, forgetting or ignoring the fact that we all exist by responding to life and that nothing of life can exist, without some form of life before it, to respond to. Whether you call it God, the Source, the Creator, the Supreme Power or by any other name, there is a match that lit the flame of life for all of us. However, some human beings who call themselves directors, politicians, leaders, CEOs, experts, priests and Judges, for example, seem to believe they are greater than the rest of us and that they have the power to dictate how we live our lives, despite the fact that they too, completely rely on life for their lives.

Even while they breathe the same air, drink the same water and eat the same food that keeps them alive, there are some psychotic human beings who arrogantly believe they have all the power of life in their hands and act as if they are superior to most members of the human race. They consider themselves the chosen people, destined to rule over the human race. It is a psychotic state of mind that allows them to believe that they are greater than all other life forms.

No one has the right to be greater than or less than any other being; whoever has a life is equal to all of life. We are all responsible for all of life so that all of life is taken care of, and together we all benefit as we each grow and evolve uniquely and individually, alone and yet together. We can see this happening in nature where each individual aspect of life works for the benefit of all of life, keeping the planet alive and evolving for the benefit of the solar system, the galaxy and the universe

Life is an invisible empathetic chain of interconnectedness that spiritually binds us to each other and to all of life. We each have the personal responsibility to maintain and protect our conscience and sense of morality so that we never fracture these empathetic links with all of life. When we do, we allow egos to unfold and grow unchecked and egos, only think and accumulate for themselves & not for all of life. It is only when we choose to break away from this essential, universal act of love for all of life, that life is no longer able to service all our needs fairly and equally. When all men and women can take care of all men and women equally, then all men and women are being taken care of equally throughout life.

The great cultures that existed for thousands of years before “civilisation” came along, such as the Native American and Aboriginal cultures, were successful because they considered themselves connected to and, therefore, responsible for all of life. One Native American saying explains how they lived their lives keeping in mind the lives of those coming five generations ahead. How different would our world be if we all did the same?

Arthur Cristian

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What is Cryonics?
Cryonics is the speculative practice of using cold to preserve the life of a person who can no longer be supported by ordinary medicine. The goal is to carry the person forward through time, for however many decades or centuries might be necessary, until the preservation process can be reversed, and the person restored to full health.

While cryonics sounds like science fiction, there is a basis for it in real science. The complete scientific story of cryonics is seldom told in media reports, leaving cryonics widely misunderstood.

Cryonics is justified by three facts that are not well known:

1) Life can be stopped and restarted if its basic structure is preserved.

Human embryos are routinely preserved for years at temperatures that completely stop the chemistry of life. Adult humans have survived cooling to temperatures that stop the heart, brain, and all other organs from functioning for up to an hour. These and many other lessons of biology teach us that life is a particular structure of matter. Life can be stopped and restarted if cell structure and chemistry are preserved sufficiently well.

2) Vitrification (not freezing) can preserve biological structure very well.

Adding high concentrations of chemicals called cryoprotectants to cells permits tissue to be cooled to very low temperatures with little or no ice formation. The state of no ice formation at temperatures below -120°C is called vitrification. It is now possible to physically vitrify organs as large as the human brain, achieving excellent structural preservation without freezing.

3) Methods for repairing structure at the molecular level can now be foreseen.

The emerging science of nanotechnology will eventually lead to devices capable of extensive tissue repair and regeneration, including repair of individual cells one molecule at a time. This future nanomedicine could theoretically recover any preserved person in which the basic brain structures encoding memory and personality remain intact.

So...

If survival of structure means survival of the person;

If cold can preserve essential structure with sufficient fidelity;

If foreseeable technology can repair injuries of the preservation process;
Then cryonics should work, even though it cannot be demonstrated to work today. That is the scientific justification for cryonics. It is a justification that grows stronger with every new advance in preservation technology.

Preventing Death
Death occurs when the chemistry of life becomes so disorganized that normal operation cannot be restored. (Death is not when life turns off. People can and have survived being "turned off".) How much chemical disorder can be survived depends on medical technology. A hundred years ago, cardiac arrest was irreversible. People were called dead when their heart stopped beating. Today death is believed to occur 4 to 6 minutes after the heart stops beating because after several minutes it is difficult to resuscitate the brain. However, with new experimental treatments, more than 10 minutes of warm cardiac arrest can now be survived without brain injury. Future technologies for molecular repair may extend the frontiers of resuscitation beyond 60 minutes or more, making today's beliefs about when death occurs obsolete.

Ultimately, real death occurs when cell structure and chemistry become so disorganized that no technology could restore the original state. This is called the information-theoretic criterion for death. Any other definition of death is arbitrary and subject to continual revision as technology changes. That is certainly the case for death pronounced on the basis of absent "vital signs" today, which is not real death at all.

The object of cryonics is to prevent death by preserving sufficient cell structure and chemistry so that recovery (including recovery of memory and personality) remains possible by foreseeable technology. If indeed cryonics patients are recoverable in the future, then clearly they were never really dead in the first place. Today’s physicians will simply have been wrong about when death occurs, as they have been so many times in the past. The argument that cryonics cannot work because cryonics patients are dead is a circular argument.

Cryonics Today
More than one hundred people have been cryopreserved since the first case in 1967. More than one thousand people have made legal and financial arrangements for cryonics with one of several organizations, usually by means of affordable life insurance. Alcor is the largest organization, and distinguished among cryonics organizations by its advanced technology and advocacy of a medical approach to cryonics.

Alcor procedures ideally begin within moments of cardiac arrest. Blood circulation and breathing are artificially restored, and a series of medications are administered to protect the brain from lack of oxygen. Rapid cooling also begins, which further protects the brain. The goal is to keep the brain alive by present-day criteria for as long as possible into the procedure. It is not always possible to respond so rapidly and aggressively, but that is Alcor's ideal, and it has been achieved in many cases.

In 2001 Alcor adapted published breakthroughs in the field of organ preservation to achieve what we believe is ice-free preservation (vitrification) of the human brain. This is a method of stabilizing the physical basis of the human mind for practically unlimited periods of time. The procedure involves partly replacing water in cells with a mixture of chemicals that prevent ice formation. Kidneys have fully recovered after exposure to similar chemicals in published studies. Alcor's formula is more concentrated than formulas that permit survival of small organs, but its similarity to these formulas suggests that it is preserving biochemistry very effectively.

Alcor's future goals include expanding ice-free cryopreservation (vitrification) beyond the brain to include the entire human body, and reducing the biochemical alterations of the process to move closer to demonstrable reversibility. Based on the remarkable progress being made in conventional organ banking research, we believe that demonstrably reversible preservation of the human brain is a medical objective that could be achieved in the natural lifetime of most people living today.

To learn more, please read our list of Frequently Asked Questions and the many articles in the Alcor Library. See Alcor link at bottom of this article.

Cryonics Myths

Cryonics has attracted a huge amount of attention since the concept was first promoted in the late 1960s. Unfortunately, much of the news coverage has been based on misconceptions and statements from "authorities" who lack basic information about the field. This page corrects some of the most widespread inaccuracies about cryonics as practiced by Alcor.

Myth 1: Cryonics is consumer fraud.

Myth 2: Cryonics freezes people.

Myth 3: Cryonics preserves dead people.

Myth 4: Experts say cryonics cannot work.

Myth 5: No reputable scientists or physicians support cryonics.

Myth 6: Cryonics preserves "heads."

Myth 7: Cryonics conflicts with religion.

Myth 8: Cryonics is an indulgence of rich people.

Myth 9: Cryonics is motivated by an irrational fear of death.

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Myth 1: Cryonics is consumer fraud.

Some people believe that cryonics is a scam intended to separate grieving families from their money. The reality is that Alcor is operated by people who sincerely believe in the worth of cryonics, and who want cryonics available for themselves, people they care about, and the world in general. Alcor's primary interest is therefore attracting young and healthy people to join Alcor and help build the cryonics field. Alcor has no interest in pushing cryonics on people who are dead or dying.

The history of cryonics is full of individuals who made great sacrifices for the benefit of the field, and (so far) bereft of people enriched by it. Sincere idealism is not fraud. While reading the many articles by physicians and scientists on this website, we ask you to remember one thing: We mean it.

Myth 2: Cryonics freezes people.

The current technology favored by Alcor is vitrification, not freezing. Vitrification is an ice-free process in which more than 60% of the water inside cells is replaced with protective chemicals. This completely prevents freezing during deep cooling. Instead of freezing, molecules just move slower and slower until all chemistry stops at the glass transition temperature (approximately -124°C). Unlike freezing, there is no ice formation or ice damage in vitrified tissue. Blood vessels have been reversibly vitrified, and whole kidneys have been recovered and successfully transplanted after cooling to -45°C while protected with vitrification chemicals.

Left: A rabbit kidney suspended in a transparent solution of vitrification chemicals, but without vitrification solution inside it, is frozen solid at a temperature of -140°C.

Right: Another kidney with vitrification solution inside it is preserved without freezing at the same temperature of -140°C.

The above work was originally reported in Cryobiology 21, 407-426 (1984).

In 2001, Alcor drew on published advances in the field of organ vitrification to implement a protocol for vitrifying the human brain. This procedure is not yet reversible because of biochemical effects of the vitrification solution, but structural preservation is excellent.

The less advanced methods used by Alcor before 2001 still suppressed most freezing damage. Comparisons of cryonics to frozen vegetables and other ridiculous analogies therefore never had merit, even before the advent of vitrification.

Myth 3: Cryonics preserves dead people.

The purpose of cryonics is to save the lives of living people, not inter the bodies of dead people. Death is a neurological process that begins after the heart stops. A stopped heart only causes death if nothing is done when the heart stops. Cryonics proposes to do something. In the words of a mainstream critical care expert writing for the American College of Surgeons, "In this era of critical care, death is more a process than an event.... A prognosis of death...cannot serve as a diagnosis."

Alcor uses life support equipment to restore blood circulation to maintain brain viability after the heart stops, ideally within minutes. This means that every cell and tissue of a cryonics patient can be just as alive at the beginning of cryonics procedures as any other medical patient. Care of a terminally-ill patient can legally be transferred to Alcor as soon as the heart stops beating. Legal death declared at that moment is simply a certification that there's nothing more contemporary medicine can do for a dying patient.

Dying is a process, not an event. The purpose of cryonics is to intercept and stop this dying process within the window of time that it may be reversible in the future. The first few minutes of clinical death are certainly reversible, even today. There are good reasons to believe that this window will extend further in the future. That is why cryonics is sometimes implemented even long after the heart stops. Cryonics is not a belief that the dead can be revived. Cryonics is a belief that no one is really dead until their mind is destroyed, and that low temperatures can prevent this destruction.

The cryopreservation phase of cryonics will not be reversible for a very long time. But this still does not mean cryonics patients are dead. Life can be stopped and restarted under the right conditions, and life is often mistaken for death when resuscitation methods are not sufficiently advanced. If cryonics patients are ever successfully recovered, they will not have been dead by definition. They will have been unconscious, not dead. Saying cryonics cannot work because cryonics patients are dead is a circular argument. The statement assumes the conclusion it claims to prove!

Myth 4: Experts say cryonics cannot work.

Most experts in any single field will rightly say that they know of no evidence that cryonics can work. That's because cryonics is an interdisciplinary field based on three facts from diverse unrelated sciences. Without all these facts, cryonics seems ridiculous. Unfortunately that makes the number of experts qualified to comment on cryonics very small. For example, very few scientists even know what vitrification is. Fewer still know that vitrification can preserve cell structure of whole organs or whole brains. Even though this use of vitrification has been published, it is so uncommon outside of cryonics that only a handful of cryobiologists know it is possible.

The situation is comparable to the development of space travel before World War II. At that time, "aeronautical experts" were adamant that space travel was impossible. Only Robert Goddard and a few German rocket scientists knew that multi-stage rockets could escape the earth. As is often the case, the experts best qualified to comment on a new field are the experts working in that field. No properly qualified expert has ever said cryonics can't work. The problem is finding experts qualified to comment on cryonics.

Myth 5: No reputable scientists or physicians support cryonics.

More than 60 scientists and ethicists have signed a Scientists' Open Letter endorsing the scientific basis of cryonics. Alcor also has reputable scientists and physicians within its membership and medical and scientific advisory boards, including scientists who have testified before the U.S. Congress on matters unrelated to cryonics, and a member of the U.S. National Academy of Sciences. In court testimony, prominent scientists have also provided Alcor with scientist declarations in support of cryonics.

Most cryobiologists (scientists specializing in low temperature biology) do not publicly support cryonics. This is in part because sensational publicity surrounding cryonics tends to cause mainstream accomplishments of cryobiology in reproductive biology, organ preservation, and cancer treatment to be unfairly overlooked. Conversely, most cryobiologists unfairly overlook the data and arguments that have been put forth in favor of cryonics. The history of the politicization of cryonics among cryobiologists is documented in the article: COLD WAR: The Conflict Between Cryonicists and Cryobiologists.

Myth 6: Cryonics preserves "heads."

Alcor has no specific interest in preserving heads. Alcor's interest is preserving people. In the entire human body, there is one organ that is absolutely essential to personhood: the brain. Injuries outside the brain are wounds to be healed. Injuries to the brain are injuries to who we are.

Alcor's neuropreservation option therefore seeks to preserve the brain with the highest possible fidelity. Currently the best preservation technologies, such as vitrification, can only be applied to single organs. Alcor members must therefore choose between inferior preservation (freezing) of their entire body, or excellent preservation of their brain by vitrification. Most Alcor members choose not to compromise survival for aesthetics, and therefore choose neuropreservation.

The goal of neuropreservation is to preserve the brain, and only the brain, using the best possible means. It is expected that future technologies developed for healing trauma victims will someday regrow an entire new body around the brain. However, removing a brain today from its protective enclosure (the skull) would cause unnecessary damage. Alcor therefore leaves the brain protected within the head during preservation and storage. While neuropreservation may seem strange, it is scientifically the best way known to preserve a human life indefinitely. Alcor preserves people, not "heads."

Myth 7: Cryonics conflicts with religion.

The goal of cryonics is to overcome serious illness by preserving and protecting life. Cryonics is therefore consistent with pro-life principles of both medicine and religion. Hypothermia victims have been revived after more than an hour without breathing, heartbeat, or brain activity. Deep cooling is sometimes used to "turn off" patients for long periods during neurosurgery when the heart must be stopped. Human embryos are routinely cryopreserved and revived. If cryonics works, it will work because it is fundamentally the same as these other forms of "suspended animation" that are already known in medicine. Patients in these states are understood to be in deep coma, not death.

Cryonics patients are theologically equivalent to unconscious patients in a hospital with an uncertain prognosis. Moving essays affirming the morality and worth of cryonics have been written from both Catholic and Protestant perspectives. Members of diverse Christian denominations, including the Church of Jesus Christ of Latter-day Saints, have joined Alcor, in addition to people of other faiths. For further information, please read Christianity and Cryonics and other articles in the Religion Section of the Alcor Library. Alcor welcomes written contributions from all faiths attesting to the life-affirming nature of cryonics.

Myth 8: Cryonics is an indulgence of rich people.

Most of Alcor's membership is middle class, and funds cryonics by life insurance. Cryonics is within reach of any healthy young person in the industrialized world who plans for it. For a young person, the lifetime cost of cryonics is no greater than that of smoking, cable TV, or regular eating out.

Myth 9: Cryonics is motivated by an irrational fear of death.

If a strong will to live is no more than an expression of cowardice, then why treat any serious illness? Interestingly, cryonics founders Robert Ettinger and Jerry Leaf are both veterans of military combat who have demonstrated far more courage than the average idle critic of cryonics. A rational desire to continue living is not the same as an irrational fear of death. In the words of biologist Peter Medawar, "...there is no more deep-seated biological instinct than that which expresses itself as a firm grasp upon life, there is more dignity, as there is more humanity, in fighting for life than in a passive abdication from our most hardly won and most deeply prized possession."

The Good

"Although no one can quantify the probability of cryonics working, I estimate it is at least 90% -- and certainly nobody can say it is zero."

— Sir Arthur C. Clarke (inventor of the communications satellite) in a letter to Alcor.

"This gamble involves the value of life, the cost of (cryonics), the odds that the technology will work (which seem excellent), and the odds that humanity will survive, develop the technology, and revive people."

— Dr. K. Eric Drexler (originator of molecular nanotechnology), from Engines of Creation, Chapter 9,"A Door to the Future".

"Cryonics is an experiment. So far the control group isn't doing very well."

— Dr. Ralph Merkle (inventor of public key cryptography), an observation made during public talks about cryonics.

The Bad

"If you have enough money (for cryonics), then you have enough money to help somebody in need today."

— Dr. Kenneth Goodman (bioethicist), "Frozen in Time," Miami Herald, Sept. 17, 2002.

Comment: If you have enough money for health insurance (which costs a lot more than cryonics), then you have enough money to help somebody else in need today. In fact, if you have enough money for any discretionary expenditure (travel, sports, movies, beer), then you have enough money to help somebody in need today. Of all the ways people choose to spend substantial sums of money over a lifetime, singling out the health care choice of cryonics as selfish is completely arbitrary.

"The individual who freezes himself or herself to come back in the future makes the assumption he will be a contributor to that society and that they would want him."

— Dr. John Baust (cryobiologist), "Frozen in Time," Miami Herald, Sept. 17, 2002.

Comment: To suggest that human beings have no intrinsic value, but only have value based on whether they "contribute to society" or whether others "want" them, is ethically questionable. If someone made this suggestion regarding care of the handicapped, the elderly, or indeed any medical patient, people would be shocked.

"Money invested to preserve human life in the deep freeze is money wasted, the sums involved being large enough to fulfill a punitive function as a self-imposed fine for gullibility and vanity."

— Jean Medawar (biologist and author), quoted in University of Calgary online course on Cryobiology, Chapter 15.

Comment: Nobody would ever imagine calling the first recipients of bone marrow transplants or artificial hearts "gullible and vain". And what of dying children who are cryopreserved? Cryonics is an experiment, and people who choose this experiment are worthy of the same respect as other participants in high risk medical endeavors.

The Ugly

"When defrosted, all the intracellular goo oozes out, turning your strawberries into runny mush. This is your brain on cryonics."

— Dr. Michael Shermer (historian and founder of Skeptic magazine), "Nano Nonsense and Cryonics," Scientific American, Sept. 2001.

Comment: While Michael Shermer is usually a beacon for science and reason, his treatment of cryonics has not always been fair. In this case he preferred a sensational soundbite over substance, despite apparently knowing better. Alcor took strong exception to this soundbite, and Dr. Shermer later acknowledged in a column called Cryonics Redux that his quote may not have been appropriate.

This is "your brain on cryonics":

Transmission electron micrograph of tissue rewarmed from -130°C after in-situ vitrification of a whole mammalian brain. This is essentially normal looking brain tissue (hippocampal region). Not only is there no "intracellular goo," no "hamburger," and no "pulverization and destruction," there is no ice damage whatsoever!

"Believing cryonics could reanimate somebody who has been frozen is like believing you can turn hamburger back into a cow."

— Dr. Arthur Rowe (cryobiologist), quoted in "Frozen Future", National Review, July 9. 2002. Dr. Rowe’s quote has been recylced so many times that we don’t know the original source. It dates back at least as far as 1986 in an Omni magazine article entitled "Souls on Ice". Anyone who knows an earlier citation, please email the webmaster.

Comment: Molecular technology to reassemble hamburger back into a cow already exists (just feed the hamburger to another cow). More importantly, well-cryopreserved tissue is not "hamburger." Preservation of cell structure can be excellent (see illustration above.) This widely-recycled quote is odd given Dr. Rowe's past encouragement of cryonics activities. The history of this quote shows that scientific opinions about cryonics typically depend more on prevailing political winds than underlying science.

"What happens is, every single cell in the organism breaks. Everything is crushed, and it is not just a tiny little bit of damage, it is not damage like a hole in a dike, it's damage like complete pulverization and destruction. Not just the destruction of cells, but also the information contained in them. The DNA is broken up, destroyed, and oxidized. There is not a single salvageable piece of anything that is molecular inside those things [Alcor patients]."

— Dr. Kenneth Storey (cryobiologist), television appearance on CBS "Sunday Morning", July 21, 2002.

Comment: Every single claim in this remarkable statement is false. As the illustration above shows, structural preservation of brain tissue in the presence of high concentrations of cryoprotectant is excellent. Furthermore, much of what is now known about Alzheimer's and other brain diseases was learned by histochemical analysis of brains from neurological research banks that were frozen without any cryoprotectant at all. These brain banks would not exist if biomolecules could not be preserved by freezing, even hours after clinical death. It is no wonder that cryonics faces an uphill battle for scientific credibility when such grossly mistaken information is presented by respected cryobiologists on a national stage.

For more information on the political history of cryobiologists' attitude toward cryonics, please see the article Cold War: The Conflict Between Cryonicists and Cryobiologists.

The Expert

"There is no hope for the fanciful idea of reaching the Moon because of insurmountable barriers to escaping the Earth's gravity."

— Dr. Forest Ray Moulton, University of Chicago astronomer, 1932.

Buzz Aldrin, July, 1969
"All this writing about space travel is utter bilge."

— Sir Richard Woolley, Astronomer Royal of Britain, 1956

"To place a man in a multi-stage rocket and project him into the controlling gravitational field of the moon.... I am bold enough to say that such a man-made voyage will never occur regardless of all future advances."

— Dr. Lee De Forest, famous engineer, 1957

First they ignore you,
then they laugh at you,
then they fight you,
then you win.

Mohandas Gandhi

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Problems Associated with Cryonics
(and some possible solutions)

When you buy a house, the seller is legally obliged to disclose any known defects. When you review a company's annual report, it tells you every problem that could affect the corporate share value. Since arrangements for cryopreservation may have a much greater impact on your life than home ownership or stock investments, we feel an ethical obligation to disclose problems that affect cryonics in general and Alcor specifically. We also believe that an organization which admits its problems is more likely to address them than an organization which pretends it has none. Thus full disclosure should encourage, rather than discourage, consumer confidence.

Startup Status

Alcor was founded more than thirty years ago. Our Patient Care Trust Fund is currently endowed with more than 2.5 million dollars and is responsible for the long-term care of at least 67 cryopatients. In almost every year since its inception Alcor has enjoyed positive membership growth. We are the largest cryonics organization in the world — yet in many respects we are still a startup company. We have fewer than a dozen employees in Scottsdale, Arizona and approximately 20 part-time independent contractors in various locations around the USA, mostly dedicated to emergency standby and rescue efforts. We serve fewer than 1,000 members and the protocols that aid our pursuit of the goal of reversible suspended animation continue to be developed. At the present time the technology required for the realization of our goal far exceeds current technical capabilities. Cryonics will not be comparable with mainstream medicine until our patients can be revived using contemporary technology, and we expect to wait for decades to see this vision fulfilled. Nevertheless, we have made important progress by introducing brain vitrification to improve patient tissue structure preservation.

Alcor shares some of the characteristics of startup companies. The organization is understaffed in some important areas and lacks as much capitalization as would be desired to support maximum growth. Limited resources prevent the organization from hiring as many highly qualified and experienced personnel as desired, and sometimes we have to postpone enhancements to equipment and procedures.

Because Alcor must react quickly to circumstances, it cannot always handle multiple tasks simultaneously. We feel a significant impact if, for example, several members experience legal death in quick succession. A heavy caseload generally means that administrative and even technical development work is postponed while member emergencies take precedence.

On the other hand, Alcor staff believe very strongly in the mission of the organization and are extremely dedicated. Alcor transport team members feel that they are saving lives, and behave accordingly. Most of all, everyone at Alcor is concerned with insuring the security of the patients who have been cryopreserved for the indefinite future. The organization's powerful sense of purpose is reinforced by the fact that all Alcor directors and most staff members have made arrangements to be cryopreserved themselves in the future.

Unlike most startups, Alcor is unlikely to fail for financial reasons. Due to the legally independent status of the Patient Care Trust from Alcor, patients can be maintained indefinitely through its portfolio of cash, investments, real estate, and capital equipment. Some wealthy Alcor members have contributed gifts and endowments to help the organization to advance, and in the event of a financial crisis, many of the people who hope ultimately to be cryopreserved would probably provide assistance. In this sense Alcor benefits from its small size, since it maintains an intimate relationship with many members which would be more problematic if our membership was ten times as large.

Inability to Verify Results

When a conventional surgical procedure is successful, usually the patient recovers and is cured. If the same surgical procedure is unsuccessful or a surgeon makes a serious error, the patient may die. These clear outcomes provide prompt feedback for the people involved. A physician may feel deeply satisfied if a life is saved, or may be deeply troubled (and may be sued for malpractice) if errors cause a death that should have been avoidable.

Clear feedback of this type does not exist in cryonics, because the outcome of our procedures will not be known definitively until decades or even a century from now. We have good reason to expect future technologies capable of repairing cellular damage in cryonics patients, but we feel equally certain that if a patient experiences very severe brain damage prior to cryopreservation, repairs may be delayed, may be incomplete, or may be impossible. The dividing line between these positive and negative outcomes cannot be established clearly at this time.

Suppose a patient experiences 30 minutes of warm ischemia (lack of blood flow at near-normal body temperature) after legal death occurs. Will this downtime create damage that is irreversible by any imaginable technology? Probably not. But what if the ischemic interval lasts for an hour — or two hours, or a day? We simply don't know where to draw the line between one patient who is potentially viable, and another who is not.

Of course we can refer to experimental work that has evaluated the injury which occurs when cells are deprived of essential nutrients. These studies provide some guidance regarding the likely damage that a patient may experience, but they still cannot tell us with certainty if future science will be able to reverse that damage.

Another problem afflicting cryonics cases is that many uncontrolled variables prevent us from developing objective criteria to compare one case with another. Consider these two examples:

Patient A has received blood thinners prescribed by a primary care physician, independent of Alcor, to treat a pre-existing condition. These drugs have the fortunate effect of helping to keep the circulatory system open after legal death is pronounced. Since the patient is in a hospital which allows prompt access by a transport team, postmortem cardiopulmonary support and cooling can begin immediately, and all medications are administered. Blood washout is performed successfully at a local mortuary, reducing body temperature to 3 degrees Celsius. So far, so good: This is a textbook case. However, because the patient is in a remote location and is insufficiently funded to pay for a chartered jet, transport to Alcor must be via scheduled airlines. The patient must wait overnight for the first flight out in the morning. A missed connection causes additional delay, and then all flights are grounded by exceptionally bad weather. When the patient reaches Alcor he is still packed in ice but has experienced a total transport time of 36 hours.

Patient B experiences cardiac arrest while alone at home, and remains undiscovered for several hours. Since she happens to be located very close to Alcor, our team members arrive quickly to administer anticoagulants and clot-busting drugs, supplemented with hand-held cardiopulmonary support. The patient is transported to our operating room and receives cooling and cryoprotective perfusion just two hours after legal death was pronounced.
In the first case, will the long transport time negate the advantage of a rapid initial response and replacement of blood with a chilled preservation solution? In the second case, will the initial hours of warm ischemia outweigh the advantage of the rapid transport to Alcor? We can make educated guesses, but we cannot answer these questions definitively. We have no certain way of knowing which case will work out better, because we have no evidence — no outcome.

We do have some simple ways to determine if a patient's circulatory system allows good perfusion with cryoprotectant. Personnel in the operating room will notice if blood clots emerge when perfusion begins. The surface of the brain, visible through burr holes which are created to enable observation, should be pearly white in color. The brain should shrink slightly as water is replaced with cryoprotectant. When perfusion is complete the patient's features should have acquired a sallow color indicating that cryoprotectant has diffused through the tissues.

These simple observations are helpful, but still the people who work hard to minimize transport time and maximize the rate of cooling can never enjoy the satisfying payoff that a physician receives when one of his patients recovers and returns to a normal, active life. This lack of positive outcome can cause feelings of frustration and futility, sometimes leading to disillusionment and burnout.

Conversely, if a case goes badly, team members will be protected from negative feedback. A team leader can never say to one of the personnel, "Because of your error, the patient has no chance of recovery."

The lack of a clear outcome also prevents us from refuting people who claim that future science will be able to undo almost any degree of damage. The danger of this extreme positive thinking is that it can lead to laziness. Why bother to make heroic efforts to minimize injury, if nanotechnology will fix everything?

Alcor's stated policy firmly rejects this attitude. Team members are very highly motivated to minimize injury because we believe that our members should not bet their lives on unknown capabilities of future science. Alcor generally hosts a debriefing after each case, encouraging all participants to share complaints, frustrations, and suggestions for improvement. Ideally, each case should be a learning experience, and participants should welcome criticism as an opportunity to identify weaknesses and overcome them in the future.

Still the lack of a clear outcome remains one of the biggest weaknesses in cryonics, since it encourages complacency and prevents accountability. The antidote to this problem is a better set of objective criteria to evaluate cases, and Alcor is working in consultation with brain ischemia experts to develop such criteria.

Volunteer Help

During the 1960s the first cryonics organizations were run entirely by volunteers. The field was not sufficiently reputable to attract qualified medical staff, and no one could have paid for professional help anyway.

Today cryonics is making a transition to professionalism, but financial limitations are prolonging the process. Some paramedics are associated with Alcor, and we hope for more in the future. We have an MD medical director, access to three contract surgeons, access to a hospice nurse, and assistance from an ischemia research laboratory in California where staff has extensive experience in relevant procedures such as vascular cannulation and perfusion. Alcor also communicates with a cryobiology laboratory that has made the most important advances in organ preservation during the past decade. Still, most transport team members who work remotely from the facility are volunteers who receive a week or two of training and modest payment for their work.

In the future, as Alcor becomes more financially secure and is able to offer higher salaries, the organization will attract more medical professionals. At this time, the transition is incomplete.

Limited Support from Mainstream Science

In the 1960s scientists in mainstream laboratories investigated techniques to cryopreserve whole organs. By the end of the 1970s most of this work had ended, and the field of cryobiology separated itself very emphatically from cryonics. The Society for Cryobiology has discouraged scientists from doing work that could advance cryonics, and has adopted a bylaw that threatens to expel any member who practices or promotes cryonics. Consequently the few scientists who are willing to do cryonics-related research live in fear of being excluded from the scientific specialty that is most relevant to their work.

The rift between cryonics and cryobiology may have been caused initially by fears among mainstream scientists that cryonics had a "tabloid journalism" flavor incompatible with science. In addition many scientists have been dissatisfied with the idea of applying procedures without a complete and full understanding of their outcome. Generally, in medicine, first a technique is studied, validated, and perfected, and then it is applied clinically. Cryonics has, of necessity, done an end-run around this formal approach by rushing to apply a technique based on theoretical arguments rather than validated clinical effectiveness.

During the past decade our knowledge and procedures have advanced far beyond the crude freezing methods imagined by most cryobiologists, and experts in molecular nanotechnology have voiced strong support. As more papers are published describing technical advances, we expect that cryobiologists and other scientists will revise their negative assessment of cryonics. In the future we believe that the arbitrary barrier between cryonics and cryobiology will gradually dissolve, and cryonics research will be recognized as a legitimate specialty of the field. However, for the time being the dim view taken of cryonics by most cryobiologists remains problematic, impairing Alcor's ability to achieve respectable status among other relevant groups such as prospective members, regulatory officials, and legislators.

Limited Legal and Government Support

Cryonics is not explicitly recognized in the laws of any state in the United States (see The Legal Status of Cryonics Patients). This does not mean that cryonics is illegal or unregulated. In fact, Alcor must comply with state laws controlling the transport and disposition of human remains, and we make arrangements with licensed morticians to insure than these requirements are met. Alcor also complies with federal regulations established by agencies such as OSHA and EPA.

Still, the lack of specific enabling legislation for cryonics can cause problems. In the late 1980s the California Department of Health Services (DHS) asserted that because there was no statutory procedure for becoming a cryonics organization, human remains could not be conveyed to a cryonics organization via the Uniform Anatomical Gift Act (UAGA), and therefore cryonics was illegal. Fortunately, the courts were unimpressed by this argument. In 1992 the legality of cryonics, and the legality of using the UAGA for cryonics, were upheld at the appellate level.

In 1990 the Canadian province of British Columbia enacted a law that specifically banned the sale of cryonics services in that province. In 2002 the Solicitor General (Canadian equivalent of a state Attorney General) issued a written clarification stating that the law only prohibited funeral homes from selling cryonics arrangements. Cryonics could still be performed in the province, even with the paid assistance of funeral homes, provided they were not involved in the direct sale of cryonics. This position is affirmed by the Business Practices and Consumer Protection Authority of British Columbia. Despite these assurances, anxiety about the law remains.

In 2004 a bill was passed by the Arizona House of Representatives to place cryonics and cryonics procedures under the regulation of the state funeral board. In its original form this law would have prevented our use of the UAGA. The bill was ultimately withdrawn, but may be revived at a later date. Very hostile comments were made about cryonics during the floor debate of this bill. We cannot guarantee that any future legislation will be friendly to cryonics or will permit cryonics to continue in Arizona.

Despite these uncertainties, the United States enjoys a strong cultural tradition to honor the wishes of terminal patients. We believe that the freedom to choose cryonics is constitutionally protected, and so far courts have agreed. We are hopeful that we will be able to continue performing cryonics without technical compromise, under state supervision where necessary, for the indefinite future.

Limited Mainstream Medical Support

Cryonics is not an accepted or recognized "therapy" in the general medical community. To the average medical professional, cryonics is at best an unusual anatomical donation. At worst it can be viewed by some physicians as fraud upon their patient. Hospitals have sometimes deliberately delayed pronouncement of legal death, delayed release of patients to Alcor, or forbade the use of cryonics life support equipment or medications within their facilities. On one occasion in 1988 Alcor had to obtain a court order to compel a hospital to release a patient to Alcor promptly at legal death and permit our stabilization procedures on their premises.

Relations with hospitals and their staff are not always difficult. Usually when nurses and physicians learn that cryonics is a sincere practice that is overseen by other medical professionals, they will be willing to accommodate a patient's wishes, or at least will not interfere with them. Sometimes medical staff will even assist with cryonics procedures such as administering medications and performing chest compressions if Alcor personnel are not present when legal death occurs.

The lack of formal medical recognition or support for cryonics generally means that cryonics patients remote from Alcor must be moved to a mortuary for blood replacement before transport to Alcor. Ideally these preparatory procedures should be performed within hospitals, not mortuaries. Hospitals presently allow organ procurement personnel to harvest organs from deceased patients (a fairly elaborate procedure) within their walls. We are hopeful that similar privileges will be extended to cryonics more often as the process becomes better understood and accepted, but we cannot predict how quickly this change will occur.

High Incidence of Poor Cases

In more than 50 percent of cryonics cases legal death occurs before Alcor standby personnel can be deployed, and is often followed by hours of warm ischemia. This downtime may cause severe cellular damage.

The threat of autopsy, in which the brain is routinely dissected, is an even greater danger. Any person who suffers legal death under unexpected circumstances, especially involving accidents or foul play, is liable to be autopsied. Alcor strongly urges members living in California, Maryland, New Jersey, New York, and Ohio to sign Religious Objection to Autopsy forms.

Sometimes cryonicists perish under circumstances resulting in complete destruction or disappearance of their remains. Cryonicists have been lost at sea, suffered misadventures abroad, or even disappeared without a trace. Two members of cryonics organizations were lost in the 2001 collapse of the World Trade Center towers. One was a policeman performing rescue operations.

Cryonics is not a panacea or a "cure" for death. The cryonics ideal of immediate cooling and cardiopulmonary support following cardiac arrest cannot be achieved in the majority of cases. We have good reasons to believe that molecular records of memory persist in the brain even after hours of clinical death, but only future physicians using medical technology which we do not yet possess will be able to determine, finally, whether such a person is really still "there."

What can be done?

If you are:

An attorney interested in protecting cryonics rights in your state...
A scientist interested in advising Alcor, or publicly supporting cryonics...
A medical professional interested in advising or assisting Alcor...
A paramedic or EMT interested in becoming involved in cryonics field work...
A layperson interested in training to do cryonics field work...
Someone with ideas or resources to help address any of the many problems above...
...then please contact us at solutions@alcor.org

You can also discuss cryonics issues in the Alcor United online discussion forum.

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About Alcor:

In 1964, a physics teacher named Robert Ettinger published The Prospect of Immortality, a book which promoted the concept of cryonics to a wide audience. Ettinger subsequently founded his own cryonics organization.

In 1972, Alcor was incorporated as the Alcor Society for Solid State Hypothermia in the State of California by Fred and Linda Chamberlain. (The name was changed to Alcor Life Extension Foundation in 1977.) The nonprofit organization was conceived as a rational, technology-oriented cryonics organization that would be managed on a fiscally conservative basis. Alcor advertised in direct mailings and offered seminars in order to attract members and bring attention to the cryonics movement. The first of these seminars attracted 30 people.

On July 16, 1976, Alcor performed its first human cryopreservation. That same year, research in cryonics began with initial funding provided by the Manrise Corporation. At this time, Alcor’s office consisted of a mobile surgical unit in a large van. Trans Time, Inc., a cryonics organization in the San Francisco Bay Area, provided long-term patient storage until Alcor began doing its own storage in 1982.

In 1977, articles of incorporation were filed in Indianapolis by the Institute for Advanced Biological Studies (IABS) and Soma, Inc. IABS was a nonprofit research startup led by a young cryonics enthusiast named Steve Bridge, while Soma was intended as a for-profit organization to provide cryopreservation and human storage services. Its president, Mike Darwin, subsequently became a president of Alcor. Bridge filled the same position many years later. IABS and Soma relocated to California in 1981. (Soma was disbanded while IABS merged with Alcor in 1982.)

In 1978, Cryovita Laboratories was founded by Jerry Leaf, who had been teaching surgery at UCLA. Cryovita was a for-profit organization which provided cryopreservation services for Alcor in the 1980s. During this time Leaf also collaborated with Michael Darwin in a series of hypothermia experiments in which dogs were resuscitated with no measurable neurological deficit after hours in deep hypothermia, just a few degrees above zero Celsius. The blood substitute which was developed for these experiments became the basis for the washout solution used at Alcor. Together, Leaf and Darwin developed a standby-transport model for human cryonics cases with the goal of intervening immediately after cardiac arrest and minimizing ischemic injury. (Leaf was cryopreserved by Alcor in 1991; since 1992 Alcor has provided its own cryopreservation as well as patient-storage services.) Today, Alcor is the only full-service cryonics organization that performs remote standbys.

Alcor grew slowly in its early years, before the concept of nanotechnology helped to legitimize the possibility that future science could repair cell damage caused by freezing. The organization counted only 50 members in 1985, which was the year it cryopreserved its third patient.

In 1986 some of Alcor’s members formed Symbex, a small investment company which funded a building in Riverside, California, for lease by Alcor. That same year, Eric Drexler introduced the concept of nanotechnology in his landmark book, Engines of Creation. Alcor moved from Fullerton, California, to the new building in Riverside in 1987.

Alcor cryopreserved a member’s companion animal in 1986, and two people in 1987. Three human cases were handled in 1988, and one in 1989.

By 1990 Alcor had grown to 300 members. In response to concerns that the California facility was too small and vulnerable to earthquake risk, the organization purchased a building in Scottsdale, Arizona in 1993 and moved its patients to it in 1994.

In 1997, after a substantial effort led by then-president Steve Bridge, Alcor formed the Patient Care Trust as an entirely separate entity to manage and protect the funding for cryopatients. Alcor remains the only cryonics organization to segregate and protect patient funding in this way.

In 2001 Alcor adapted cryoprotectant formulas from published scientific literature into a more concentrated formula capable of achieving ice-free preservation (vitrification) of the human brain ("neurovitrification").

Near the end of 2002 Alcor embarked on an ambitious expansion project, taking over another unit in its Scottsdale building (where remaining units currently are rented to other tenants). The first issue of an online newsletter, Alcor News, was distributed late in 2002. During 2003, new staff members joined the organization and work continued to create a new patient care bay, operating room, and laboratory area. A truck was purchased for conversion as an ambulance that would be large enough to permit surgical procedures. Alcor made radical changes to its medications to conform with results of resuscitation research, and purchased the prototype of an intermediate temperature storage device that promises to reduce or eliminate the risk of fracturing in cryopatients.

As of the end of April 2007, Alcor had 820 members and 76 patients in cryopreservation.

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Alcor Procedures

The purpose of cryonics is to preserve life. Alcor therefore intervenes in the dying process at the earliest moment that is legally possible. If proper procedures are followed immediately after the heart stops, then legal death need not impact the biology of cryonics or its prospects for success. For further information concerning this issue see Cardiopulmonary Support in Cryonics.

Ideal Cases

It is customary practice in medicine to discontinue care of terminal patients, and declare legal death, when the heart stops beating. The several minutes of time between when the heart stops and the brain dies (by conventional criteria) provides a window of opportunity for Alcor to artificially restore blood circulation and preserve brain viability even though a patient is legally deceased. Cryonics cases in which life support techniques are promptly used to maintain brain viability after the heart stops are considered to be ideal cases.

Standby

Alcor strongly encourages members who are terminally ill to relocate to cooperative hospice facilities in Scottsdale, Arizona. If relocation is not possible, Alcor may deploy equipment and a transport team to a remote location. As a dying patient's condition becomes critical, Alcor personnel wait nearby on a 24-hour basis. This is called "standby." When the heart stops beating, an independent nurse or physician pronounces legal death, and the Alcor team begins life support procedures as described below.

Stabilization

The patient is placed in an ice water bath, and blood circulation and breathing are artificially restored by a heart-lung resuscitator (HLR). The HLR, or "thumper," is a mechanical device used in emergency medicine to perform CPR. In cryonics, the term CPS (cardiopulmonary support) is used instead of CPR because the intent is to provide life support, not cardiac resuscitation. Because cryonics patients are legally deceased, Alcor can use methods that are not yet approved for conventional medical use. This enables Alcor to use new technologies that can support the brain longer and more effectively than traditional CPR. In particular, the combination of simultaneous compression-decompression CPS and rapid cooling are known to be especially effective for protecting the brain during cardiac arrest.

Intravenous lines are also established, and protective medications are administered. These include:
Free radical inhibitors
NOS (nitric oxide synthase) inhibitors
PARP (Poly ADP-ribose polymerase) inhibitors
Excitotoxicity inhibitors
Anticoagulants
Pressors
pH buffers
Anesthetic

These drugs help maintain blood pressure during CPS, and protect the brain from "reperfusion" injury. Anesthesia reduces brain oxygen consumption, which further protects the brain.

The LUCAS chest compression device, shown in the photo at right, is used by Alcor to re-establish blood circulation and oxygenation in cryonics patients following cardiac arrest.

Alcor also uses the Michigan Instruments Thumper. Both devices are powered by pressurized oxygen, and restore blood flow much better than manual CPR.

Transport

If the patient is in a hospital where the administration is unwilling to allow cryonics procedures, the patient is moved to an alternate location while CPS and cooling are maintained without interruption. Femoral arteries and veins are surgically accessed and the patient is placed on cardiopulmonary bypass. This means that blood is circulated through a portable heart-lung machine (pictured below) that takes over the function of the patient's own heart and lungs. External CPS is no longer necessary, and is discontinued.

Within minutes, a heat exchanger in the heart-lung machine reduces the patient's temperature to a few degrees above the freezing point of water. Blood is also replaced with an organ preservation solution that is specially designed to support life at low temperature. If the patient is located outside of Arizona, they are packed in ice for air shipment to Alcor's facility in Scottsdale, Arizona.

This treatment is similar to procedures used by transplant surgeons to support the life of organs moved around the country for transplant, except that Alcor's procedures are applied to whole patients. Remarkably, studies show that whole animals can survive up to three hours of cold storage on ice using existing medical technology. Even longer periods can be survived if the preservation solution is continuously circulated. The MHP2 preservation solution used by Alcor was developed in 1984 during pioneering experiments in which animals were successfully recovered after 4 hours of bloodless perfusion at +4°C.

After large blood vessels are surgically accessed, Alcor’s Air Transportable Perfusion kit (ATP), shown in the photo below, is able to quickly cool the patient to temperatures at which oxygen is no longer necessary. The ATP also replaces blood with an organ preservation solution that supports life at low temperature (note the solution reservoir in the case on the left). See our online PDF manual (1.4 megs).

Cryoprotective Perfusion

At Alcor a surgeon connects major blood vessels to a perfusion circuit. The preferred vascular access points are the aortic arch and right auricle of the heart, which are accessed by thoracic surgery (median sternotomy). Traditionally, neuropreservation patients have been treated by this same procedure, except that the descending aorta was clamped. In 2000, Alcor began treating neuropreservation patients by directly accessing the carotid and vertebral arteries. This requires careful surgical transection of the spinal column because vertebral arteries are located within the column.

A base perfusate similar to the preservation solution used during transport is circulated through the patient at a temperature near 0°C (the freezing point of water) for several minutes. This washes out any remaining blood. The cryoprotectant concentration is then linearly increased over 2 hours to one half the final target concentration. This slow introduction minimizes osmotic stress, and allows time for the cryoprotectant concentration to equilibrate (become the same) inside and outside cells. A rapid increase to the final concentration is then made, and the final concentration is held until the venous outflow concentration equals the target concentration (approximately one hour). Temperature, pressure, and cryoprotectant concentration data are continuously monitored and acquired by computer.

The status of the brain is visually monitored through two small holes in the skull made using a standard neurosurgical tool (14 mm Codman perforator). This permits verification of brain perfusion by dye injection, and observation of the osmotic response of the brain. A healthy brain slightly retracts from the skull in response to cryoprotectant perfusion. An injured brain swells, indicating that the blood-brain barrier has been compromised. This injury is often seen in patients who suffered a long period of untreated cardiac arrest.

The cryoprotectant solution Alcor uses to prevent freezing is a mixture of chemicals developed by mainstream cryobiologists for long-term banking of transplantable organs. The solution has been specifically validated for structural preservation of the brain. At the end of perfusion, these chemicals are present at a concentration of approximately 60%. In tissues adequately penetrated by the solution, the small amount of remaining water is not able to freeze. Instead of freezing, tissues vitrify when they are cooled to cryogenic temperatures. Variable penetration of the solution appears to result in a combination of vitrification and partial freezing in various body tissues, but total vitrification (ice-free preservation) of the brain, at least under ideal conditions.

Cooling

After cryoprotective perfusion, patients are cooled under computer control by fans circulating nitrogen gas at a temperature near -125°C. The goal is to cool all parts of the patient below -124°C (the glass transition temperature) as quickly as possible to avoid any ice formation. This requires approximately three hours, at the end of which the patient will have "vitrified" (reached a stable ice-free state). The patient is then further cooled to -196°C over approximately two weeks.

Patients are monitored by sensitive "crackphone" instruments during this long cooling period to detect fracturing events that tend to occur when large objects are cooled below the glass transition temperature. Contrary to media reports, fracturing is not a result of mishandling. It is a universal problem for large organs cooled to liquid nitrogen temperature. The federal government recently awarded $1.3 million dollars to specifically study the problem of fracturing during cryopreservation.

Long-Term Care

Currently Alcor patients are stored under liquid nitrogen at a temperature of -196°C. The liquid nitrogen is held in vacuum-insulated dewars that require replenishment every few weeks. Liquid nitrogen is used because it is inexpensive and reliable.

Alcor is currently experimenting with an alternative "vapor phase" storage system that would retain the safety and reliability advantages of liquid nitrogen, but allow patients to be maintained at controlled temperatures warmer than liquid nitrogen. This will reduce or eliminate fracturing injury.

Non-ideal Cases

Unfortunately not all Alcor members can be reached at the moment their heart stops. In cases of sudden illness or serious injury, blood circulation may stop for hours before any cryonics procedures are possible. If a physician determines that an Alcor member in cardiac arrest cannot be resuscitated by current technology (i.e. declares legal death), the most important actions are administration of heparin (a drug that prevents blood clotting) followed by chest compressions to circulate the heparin, cooling with ice, and prompt shipment on ice to Alcor. Alcor will cooperate with local funeral directors in making these arrangements. Alcor will also negotiate with authorities to limit the extent of any autopsy that may be required. (Alcor recommends that all members execute a Religious Objection to Autopsy).

The application of cryonics to patients who are clinically dead is perhaps the single most misunderstood aspect of cryonics. How can cryonics help someone who is clinically dead? The answer is that life and death are not binary "on-off" states. For cells, organs, and people, death is a process, not an event.

For example, the brain is commonly believed to "die" after 5 minutes without oxygen at normal body temperature. This is a myth. Brains have been revived after one hour of warm cardiac arrest, and living human brain cells have been recovered after 4 hours and even 8 hours of clinical death at normal temperature. What really happens is that after 5 minutes without oxygen, chemical changes occur in the brain that cause blood vessels to swell when circulation is restored. Without special interventions, this swelling eventually stops the restored blood flow, resulting in the death of all brain cells hours later. The practical result is that a brain that is deprived of oxygen for more than 5 minutes is usually doomed to die within hours. But doomed is not the same as dead.

The biological changes known to occur in the first hours following cardiac arrest are fundamentally minor and reversible in principle. Technology already exists that could recover people after more than 5 minutes of cardiac arrest, although it is seldom used. The conventional medical research value of donated brain tissue and living brain cells recovered from post-mortem donors further highlights the minor nature of brain changes in the early hours of clinical death.

Ultimately the difference between life and death for a cell, an organ, or an organism reduces to a difference in how atoms are arranged inside it. It therefore seems certain that future medicine capable of diagnosis and repair at a molecular level will be able to resuscitate people after longer periods of clinical death than medicine can today. How much memory and personality would survive repair and healing after hours of cardiac arrest is not currently known.

Ethics of Non-Ideal Cases

Cryopreservation of clinically dead patients is double speculation. First, as with all cryonics cases, it is assumed that the cryopreservation process will someday be reversible. Second, it is assumed that future medicine will be able to successfully recover people after long periods of cardiac arrest. Alcor therefore encourages members to reduce their risk profile for heart attack and stroke, and relocate close to Alcor during serious illness if possible. If despite these precautions a member experiences unattended cardiac arrest, Alcor will still proceed with cryopreservation unless a member indicates otherwise in their paperwork.

Cryonics should never be confused with funeral arrangements. Alcor rarely accepts cases involving legal death of a non-member. The combination of strong emotion, false hope, unfamiliarity with cryonics, low probability of success, and high cost of cryonics without life insurance make accepting such cases ethically difficult. People who think they may someday be interested in cryonics should therefore investigate cryonics now. Waiting until cryonics is needed almost always means it won't be available.

For Alcor members who have chosen to be cryopreserved under poor conditions if necessary, there is a final ethical point. As long as resuscitation medicine remains an unfinished science, it is unethical to use the label "dead" as a basis to dismiss cryonics. Calling someone "dead" is merely medicine's way of excusing itself from resuscitation problems it cannot fix today. This makes people feel better about abandoning the patient and making the unwarranted assumption that nobody could ever fix the problem. Cryonics, in contrast, is conservative care that acknowledges that the real line between life and death is unclear and not currently known. It is humility in the face of the unknown. It is the right thing to do.

Further information on Alcor procedures can be found in the Alcor Library section on Alcor Procedure and Training Manuals. See also the Alcor at Work Photo Gallery.

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Link to Alcor's Wwebsite: http://www.alcor.org/index.html