I second your suggestion, though not necessarily your impression. If she would not sign up with such an organization it doesn’t mean she can’t be an objective observer, but it does make it less likely.
Someone who wouldn’t use a service but criticizes it is more likely to be criticizing it because they don’t like the idea rather than because they have concluded it’s done poorly based on evidence. Obviously it doesn’t make it certain that that’s the case.
Honestly, the fact that she’s not signed up makes her far more credible in my eyes. Has no one here heard of consistency bias? Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works. For someone without a horse in the race to look at cryonics and have a low opinion of it does provide me information.
it provides me no information that he thinks cryonics works.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological information that encodes personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress during cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
I have never said I “don’t believe anybody’s survival actually depends on cryonics because it won’t work.”
I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works.
I don’t recall making any context-less statements that cryonics works. Obviously I think that cryonics is worth doing, but that’s not same as thinking it “works.”
I explicitly stated that the damage done by the best cryopreservation technology is severe by contemporary standards. It’s not compatible with revival by any near-term technology, no matter who does it. Nobody should be under any illusions that human cryopreservation by available technology is easily reversible.
The goal of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of human identity. Any criticism of cryonics procedures, and the extent to which procedures impact the prognosis of cryonics patients, must be with reference to that. That has been absent in any of the recent criticisms of cryonics related to qualifications of personnel. Recent criticisms of cryonics cases have been with reference to what would have happened to living medical patients had the same case problems occurred (i.e. they might have died). The criticisms have not been with reference to the biological impact on someone who’s already suffered a “fatal” period of cardiac arrest before the hospital even let cryonics procedures begin, and who is going to be perfused with cryoprotectants for hours, dehydrated, and then cooled to a temperature that results in thermal stress fractures through all major organs of the body, likely including the brain. In such circumstances, ultimately getting cryoprotectants into tissue is enormously more important than how long cannulation for field blood washout takes, within reason.
Regarding what Ms. Maxim believes about cryonics working, it was Ms. Maxim who took exception to me saying that she believed cryonics won’t work. She said:
I have never said I “don’t believe anybody’s survival actually depends on cryonics because it won’t work.”
I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.
There are two possible interpretations of this. Either she believes that cryonics today done by the right people could result in a sufficiently pristine state, in which case she believes that cryonics today could work. Or she believes that the cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures that are unavoidable with today’s technology are not sufficiently pristine to permit revival. In that case, the entire debate of qualifications of personnel and procedural details are academic to whether cryonics today does anybody any good because the technology is intrinsically not good enough to work.
it provides me no information that he thinks cryonics works.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress doing cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
I have never said I “don’t believe anybody’s survival actually depends on cryonics because it won’t work.”
I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
it provides me no information that he thinks cryonics works.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress doing cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
I have never said I “don’t believe anybody’s survival actually depends on cryonics because it won’t work.”
I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
My objection is not so much that she isn’t signed up but that she has no plans to sign up, even when her moral outrage issues are resolved. So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it’s not simply a criticism of the cryonics industry, but of cryonics itself.
What makes it suspect to me is that she argues as though it is a criticism only of the current cryonics industry and yet makes no defense whatsoever of the general notion of cryonics (except a very vague version that sounds more like long-term hypothermic hibernation). Most critics seem to support some kind of future advancement suspended animation—but that’s a very different idea from cryonics from a service (and technological) perspective.
So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it’s not simply a criticism of the cryonics industry, but of cryonics itself.
So? Why is her opinion on the technical feasibility or personal desirability of cryonics at all relevant to her claims of organizational or technical incompetence on the part of current cryonics organizations?
Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim? (for example, “a vascular surgeon that takes 30 minutes to cannulate a femoral artery is unqualified to perform surgery”, with all the technical word’s accuracy limited by my memory and my time writing this post- I am not a doctor)
If so, then something is rotten in the state of Denmark, regardless of who pointed it out originally.
Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim?
Yes. This is precisely what I would have thought advocates needed to be researching, and I’m amazed there’s so far just been defensiveness, circling of the wagons and ad hominem dismissal (“it’s just motivated cognition”, “she has no plans to sign up”) which really obviously dodges actually addressing the claims. Which are natural human reactions, but that doesn’t make them good ideas.
Yes. This is precisely what I would have thought advocates needed to be researching, and I’m amazed there’s so far just been defensiveness, circling of the wagons and ad hominem dismissal of the claims (“it’s just motivated cognition”, “she has no plans to sign up”). Which are natural human reactions, but that doesn’t make them good ideas.
Against the technology, no (I’d say obviously not). Against the organisational robustness of present-day cryonics? I’d say it could well be. I suspect Charles Platt would agree.
By the way, many of your posts are both enlightening and smile-inducing… and yet, I think I mocked you in the past (I think it was at Pharyngula). Since I suddenly feel guilty about this, I ask that you give me a downvote for atonement.
Again, why does it have to be evidence against cryonics instead of, say, Alcor or SA or CI? She’s not discussing the theoretical desirability or practicality of cryonics.
The theoretical desirability and practicality of cryonics is what matters at this point. It’s what the real controversy is about. If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced. But, supposing that is necessary, we would need new people to replace them with. People who actually care about cryonics. Melody is not contributing to that cause, in my estimation. Rather she seems to be contributing to, and playing upon, the existing cocktail of mockery, misunderstanding, and marginalization that has plagued cryonics for years.
The theoretical desirability and practicality of cryonics is what matters at this point. It’s what the real controversy is about.
Upvoted. But I’ll still talk about organizational matters below :)
The thing I like about Mike Darwin is that he offers technical criticisms of cryonics organizations without resorting to threats of strict regulation. Of course, I understand there are people who do not think highly of Darwin, and condescendingly claim we are being duped by this “dialysis technician” (who then conveniently leave out that he received additional training from Jerry Leaf). Perhaps those people should inform David Crippen MD that he has been duped by Mike. David is with the Department of Critical Care Medicine at the University of Pittsburgh Medical Center, and Mike must have lied about his credentials when submitting to his book “End-of-Life Communication in the ICU: A Global Perspective”
With that in mind, since I deeply care about useful external criticism (as opposed to mainstream medicine’s silent apathy… because they are still stuck at the starting line by thinking that immortality is some separate magical state of being...), I want Melody to continue with her more technical critiques. However, I do want her to drop her threats of strict regulation, unless she can find many people who have gone through all of the paperwork of signing up and suddenly proclaiming, “Oh my god. You mean to tell me that Atul Gawande is not going to be at my bedside?” I understand the need in politics to sometimes play hardball, but this is different.
I encourage Less Wrong users to look at the language being employed here. Dr. Wowk is saying things like “Mayo clinic” from a life-saving perspective. Melody is saying things like “last wishes,” and emphasizing licensed embalmers. I do not feel comfortable with such language being floated around regulation that its (potential) members don’t want. At all. If any Less Wrong users do want such regulation without even having the intent of utilizing cryonics, then.… well.… shoo, go away.
This is precisely what I would have thought advocates needed to be researching, and I’m amazed there’s so far just been defensiveness, circling of the wagons and ad hominem dismissal....
As I’ve tried to explain, the entire line of criticism is based on a false analogy of cryonics to hypothermic medicine.
OF COURSE, if cryonics were an elective procedure in which a patient were to be cooled to +18 degC and heart stopped for brain surgery, you wouldn’t use paramedics, scientists, or contract cardiothoracic surgeons who may or may not able to show up to do the surgery. OF COURSE, you would use a Certified Clinical Perfusionist to work alongside the surgeon, no exceptions. OF COURSE, any less qualified people are bound to make mistakes, and have made mistakes, mistakes that could be fatal in a mainstream medical setting in which someone was expected to be warmed right back up from +18 degC and woken up at the end of the procedure. OF COURSE, anyone with common sense (no independent medical expert needed) would say that! But that’s not what cryonics is, or could be with any near-term technology.
Cryonics doesn’t stop at +18 degC. The hypothermic phase continues down to 0 degC, and then the cryothermic phase down to −196 degC, doing injuries far beyond reversbility by mainstream medicine. Cryonics is an information preservation excercise at liquid nitrogen temperature, not an attempt to recover people in real-time from minor cooling in clinical settings. The procedures during the hypothermic phase aren’t even the same in many major respects, but I won’t bother getting into that.
Isn’t anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures?? What medical standards or established specialties exist for that?
Isn’t anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures??
Mostly the latter. I see someone use the absurdity heuristic, my conditioning kicks in, and I link to the post about it.
As for the “hypothermic vs cryothermic” criticism, well, no, I don’t see the difference. The less the damage that’s done to our decapitated, frozen, fractured heads between clinical death and freezing, the easier it will be to recover the person from the corpse. As far as I can tell, an extra 30 minutes of decay at room temperature really could end up making a significant difference.
So? Why is her opinion on the technical feasibility or personal desirability of cryonics at all relevant to her claims of organizational or technical incompetence on the part of current cryonics organizations?
Does it need to be? Her claims of organizational and technical incompetence could be entirely factual and she could still be doing more damage than help to the cryonics cause, if she takes a bad situation (the current unpopularity of cryonics) and makes it worse by presenting valid arguments in ways that overemphasize their actual importance. All the insightful new data in the world isn’t actually helpful if it is delivered with rhetoric that emboldens hostile parties to pass harmful regulations.
Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against.
I’m feeling kind of condescended to here… Do you honestly think I’m deciding whether to accept her advice based on her beliefs? I should certainly hope I’m not—nor would I advocating anyone do so! What I do advocate is treating her claims with more skepticism, on grounds that she may not be able to accurately model how things look from the perspective of someone whose life actually lies in the balance, or who has internalized the notion that future technologies will be able to fix certain really hard kinds of damage.
I’m feeling kind of condescended to here… Do you honestly think I’m deciding whether to accept her advice based on her beliefs?
Let’s keep reading, and find out!
What I do advocate is treating her claims with more skepticism, on grounds that she may not be able to accurately model how things look from the perspective of someone whose life actually lies in the balance
I wonder at your self-awareness that you do not realize that this exactly describes the failure mode I’m talking about. Let’s try switching some of the words around and seeing how it looks:
What I do advocate is treating Dawkins’ claims with more skepticism, on grounds that he may not be able to accurately model how things look from the perspective of someone whose soul actually lies in the balance
So, you shouldn’t feel condescended to, but you should alter your position and behavior. Don’t think that I’m tricked by you writing “treat her claims with skepticism” instead of “disbelieve”- these are testable claims that you could be testing. So perhaps you should do that, and then I will be willing to grant you use of the word ‘skeptical.’
Now, let’s talk about some of your substantial points. Instead of “incompetence is bad, we should set about replacing those people right now” I’m hearing “If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced.”
That suggests to me you either know woefully little about organizational dynamics (if you want to replace people for a crime, defending them for that specific crime and then trying to turn on them later is very hard to pull off) or are more interested in holding the banner for this idea then actually seeing it implemented well. Even if the second is appropriate- you don’t care what it is SA and their like actually do, you just want cryonics to catch on and not seem kooky- then you should read some risk management.
Cover-ups are notoriously stupid. It’s a known finding in psychology that simply censoring something makes it seem more credible, not less, and so attempts to silence Johnson or Maxim make them more persuasive. If you want cryonics to be thought of as a trustworthy venture, it needs to have trustworthy boots on the ground, not in the far-off future. Without improving its temporal presence, cryonics will only attract people who buy into promises about the future without kicking the tires first.
these are testable claims that you could be testing.
If this wasn’t clear from my last post (the one with “OF COURSE” everywhere), let me say it again. I participate in the leadership of a cryonics organization (Alcor). Speaking for myself, I stipulate to the correctness of Melody Maxim’s central claim that cryonics procedures do not meet the same standards, or sometimes qualifications of personnel, as hypothermic medical procedures. There’s nothing to test. It’s true. It’s the significance of this that is dispute, not the fact of it.
The moral outrage, indignation, allegations of fraud and self-interest, and claims of no progress in cryonics in 40 years are not justified. 40 years ago, cryoprotectants weren’t even being seriously used. 35 years ago they were being administered by morticians with embalming pumps. 30 years ago a mainstream cardiothoracic surgery researcher brought medical techniques to Alcor. 20 years ago there were vigorous debates between Alcor and CI about the importance of medical techniques. 10 years ago, vitrification was introduced. Several years ago, contract professional perfusionists began to be used by SA for field procedures. None of this is ever acknowledged. Instead, it’s an outrage that full-time cardiovascular surgeons and perfusionists don’t yet work in cryonics. An outrage.
Something else that may not be apparent to casual observers is the selectivity of Ms. Maxim’s criticisms. For the first two years after she left SA in 2006, SA was practically the exclusive target of her criticisms. Alcor officials, including myself, had cordial correspondence with her about a variety of perfusion topics in which she kindly shared her expertise. In August, 2008, one of my emails to her said:
I agree with you about the value of professionals in cryonics
field work. I hope cryonics can manage to make that transition. It
is regrettable that you ran into the obstacles that you did.
In 2009, for reasons unrelated to changes in service as far as I can tell, she began criticizing Alcor as harshly as SA. SA and Alcor have been targets ever since.
Conspicuous by absence have been criticisms of CI, except for criticisms that CI allows its members to contract with SA for standby/stabilization services. There is no criticism of what happens to CI members who do not contract with SA for service: packing in ice by a local mortician for shipment to CI with no stabilization or field perfusion whatsoever. There is no analysis or critique of the biological consequences of THAT, and no demand for government regulation to prevent such treatment.
Nor is there much criticism of procedures at CI itself, open-circuit perfusion by a mortician for every CI case. That is not even remotely comparable to a hospital hypothermic surgery procedure, but there is no criticism of it.
What SA and Alcor have in common is that they both aspire to a higher standard of cryonics care than possible with morticians, one that draws upon some aspects of hypothermic medicine for the early stages of procedures. So perhaps what can be said about the selectivity of Ms. Maxim’s criticisms is that she focuses on criticizing those who aspire to a higher standard of care, but who fail to consistently deliver it. The missing context, and missing criticism, is what happens to cryonics patients when there is no such aspiration. And, frankly, when there is no cryonics at all.
In 2009, for reasons unrelated to changes in service as far as I can tell, she began criticizing Alcor as harshly as SA. SA and Alcor have been targets ever since.<
Prior to 2009, I had relatively little knowledge of what went on, at Alcor. When the Johnson book was published, (in 2009), I read a lot of stories, which were already familiar to me, (gossip I had heard at SA), and I did a lot of further reading on Alcor’s own website. As I’m sure Dr. Wowk knows, whenever I dared to question Alcor, or remark on the Johnson book, I was subjected to the usual lies and personal attacks, (as opposed to polite, intelligent opposing arguments and/or explanations). I doubt he’s as mystified by my response, as he states.
Conspicuous by absence have been criticisms of CI...open-circuit perfusion by a mortician for every CI case.<
I saw no reason to criticize CI, (at least, not until the “Cryogirl” and “Temple of Vampire” scandals, which I criticized, extensively), as I believed CI to be accurately representing the (however poor) quality of their services. Dr. Wowk is intelligent enough to realize what I have been objecting to, all these years, is the publishing of information, which might mislead people into believing the quality of services they are purchasing, is significantly greater than what it actually is. I have no idea as to why he seems to find CI’s use of a licensed mortician, (someone skilled in vascular cannulations), to be inferior to some of the laymen, who have attempted to perform surgical procedures, on behalf of SA and/or Alcor.
That (CI’s service), is not even remotely comparable to a hospital hypothermic surgery procedure, but there is no criticism of it.<
Again, why should I have criticized CI’s primitive procedures, when they were forthcoming about the quality of services they were delivering?
What SA and Alcor have in common is that they both aspire to a higher standard of cryonics care than possible with morticians...<
Vraiment? Does Dr. Wowk really believe SA’s Catherine Baldwin, or any other staff member of SA and/or Alcor, (during the time I was making my objections), could deliver a femoral cannulation, with more skill than CI’s mortician? If his “higher standard of cryonics care” means simply putting someone in an ice bath, just about anyone off the street could have supplied that.
Dr. Wowk’s “conspiracy theory” is ridiculous. My goal should have been clear, all along: Cryonics organizations needed to either (a) deliver cutting-edge technology, or (b) be honest about what they were selling. I haven’t kept up with cryonics, for more than a year, (indeed, tonight is the first time I read Dr. Wowk’s 14-month-old post), and I don’t want to spend much time on it, now, but when I see someone as reputable as Dr. Wowk, attempting to paint the situation, (and me!), as something it is not, I must object.
Another reason that the fact that cryonics stabilization does not meet the standards of hypopthermic medicine is not exactly evidence of incompetence is that there is not a competitor out there providing better stabilizations.
That is, if we are assuming a sufficiently narrow and connotation-free definition of incompetence which involves comparison to competitors, the test of being substantially worse than one’s competitors is one that SA fails with flying colors.
Your map does not match the territory regarding my beliefs on this matter. Please read the sequences Noticing Confusion and Against Rationalization before making any further remarks concerning my reasoning processes.
I intended no more or less than what I said regarding skepticism. The test you have proposed would not get an accurate result due to embedded assumptions which you are not taking into consideration: 1) “Competence” as commonly understood implies comparison to a competitor. Competitors do exist for hypothermic medical procedures but not for cryonics stabilization services as a whole. Hiring more qualified personnel would be an advancement. The entire complaint would be regarding the speed of progress in this area, which is a more complex issue than you give it credit for being. 2) The overall importance of hypothermic damage (including limited warm ischemic time) compared to cryothermic damage is questionable. It is a legitimate proposition that some hypothermic damage should be considered an acceptable trade-off for financial and other factors (complexity and mobility of equipment, flexibility of the personnel’s schedule, etc.) which affect the patient’s risk in this context.
In short: The claim “SA is incompetent” predicts that competitors exist, and that hypothermic damage is significant compared to the damage of the process as a whole. And it fails both of these predictions.
I certainly do care about stabilization quality and preventable damage, including the warm ischemic times seen. However my map regarding this territory is dramatically different from yours. You vastly overestimate the significance of procedural damage to the overall situation. The most important part of a stabilization company’s job is to ensure that the tissue is vitrified, if at all possible, because straight freezing is thought to be more destructive to information than the early stages of ischemic cascade. There are complicating factors in every stabilization case (and in particular remote stabilization which is what SA does), most of which are not the fault nor responsibility of the stabilization company but are caused by outside factors beyond their control. With an eye towards incremental advances, I believe that the biggest possible improvements would be a shift in outside attitudes towards tolerance and understanding of what this entails. A rational person who wishes to maximize preservation quality should attempt to avoid remote stabilization to begin with by moving close to Alcor or CI prior to deanimation because of the inherent complications in remote standby.
To my knowledge, no one has attempted to cover up Melody. I do wish she would quit making the same set of remarks in a highly political and condescending tone, repeatedly, even after they have been answered, but that is an objection to her rationality and not her free speech rights. I believe Larry Johnson has obtained and spread confidential patient information from Alcor (including pictures), and this is legitimate grounds for a lawsuit (and significant moral outrage) if you consider the same rules applying to cryonics as apply to medicine, with regards to patient privacy.
I spent much of the day preparing a long post with hyperlinks to relevant articles, but then I realized it would be a bit of a jerk move and distract from the most important aspects of the discussion. I think this way is more succinct. I can’t guarantee he will be accurately modeling the reality afterward, but it should at least help.
Incidentally, Politics is the Mind-Killer is one of my favorite articles from the How To Actually Change Your Mind sequence. The sub-sequence of the same name is also quite good, although I haven’t read it all the way through yet. The basic point is that instead of taking sides (or thinking in terms of sides) we should be aiming to increase the correspondence of the map to the territory.
I do have somewhat tribal feelings towards cryonics (I don’t know how you’d expect me not to) but I question them frequently and attempt to not let them be a factor in the reasoning process. If new evidence comes up, I definitely plan to update on it.
SA underdelivers and overcharges for services, (“incompetence”) while representing itself in a disingenuous and probably legally prohibited way.
The industry SA operates in should be regulated because of claim 1.
It appears to me that your counterargument for Claim 1 is to claim that’s a poor definition of incompetence.
Your replacement definition- “not as good as a real competitor”- is not one I’ve ever heard of, and I strongly contest that is the common understanding. Is Miss Cleo “competent” at predicting the future because she’s just as good as the next psychic hotline? Or are psychics who present themselves as anything but entertainers incompetent at their stated goal?
But even if we grant your replacement definition, Claim 1 barely changes. We have two options: narrow our focus to services SA provides that are provided by competitors or switch words from ‘incompetent’ to ‘fraud’.
One of the serious things Maxim has said is that SA and others have spent their time recreating devices that could have been bought cheaper, better, and faster by using currently available devices. That’s hardly a good use of customer or benefactor money, and delays like that seem inexcusable if you believe effective cryonics stands between mortality and immortality.
On the other hand, simply misrepresenting themselves is sufficient to earn the “fraud” description and be a target for regulation (either new, or already existing), even if the word ‘incompetent’ is inappropriate.
If I recall correctly, SA charges CI members $60,000 for field standby, stabilization, and transport. SA does approximately one or two cases per year, apparently using contract perfusionists and surgeons when available for the blood washout phase of procedures. The alternative for CI members is simple packing in ice some unspecified period after legal death, and shipment by a local mortician; no cardiopulmonary support, no associated rapid cooling, no blood washout.
As I understand it, Maxim makes two claims:
SA underdelivers and overcharges for services, (“incompetence”) while representing itself in a disingenuous and probably legally prohibited way.
The industry SA operates in should be regulated because of claim 1.
If so, she is apparently saying that government regulations be put in place to force an organization with ~ $100K in annual revenues to spend up to $470K on salaries (recently computed elsewhere on Less Wrong) for a full-time certified perfusionist and a cardiovascular surgeon (how they would maintain skills is unspecified), or nobody should be allowed to attempt to provide any cryonics field service other than simple packing in ice. And the government should provide this consumer protection for two citizens per year even though nearly every medical expert, politician, regulator, inspector, and enforcement official will believe that these enforced medical standards are cargo cult science applied to dead bodies who could not possibly be revived because (a) they are already dead, and (b) the later cryopreservation itself is certainly fatal.
Why isn’t there concern that by prematurely requiring highly credentialed people, by law, to do cryonics stabilizations that the government itself wouldn’t be misleading people about the legitimacy of cryonics? The way things are now, people don’t look to the government to evaluate cryonics procedures. (Nor should they for a field as small and misunderstood as cryonics.) People have to kick the tires themselves. They have to know how limited present cryopreservation procedures are. They have to read the case reports, know that mistakes happen, and decide for themselves whether $60,000 is likely to be worth more than simple packing in ice. They have to know what they are getting into.
The reason, in a nutshell, why I’m concerned about government regulation in the present state of development of cryonics is that by not understanding cryonics, not really caring about it, not actually valuing it, they will almost certainly get the regulation wrong. The extreme political hostility that has traditionally motivated calls for cryonics regulation also helps insure this. Good regulation requires good dialog, not name-calling.
Why isn’t there concern that by prematurely requiring highly credentialed people, by law, to do cryonics stabilizations that the government itself wouldn’t be misleading people about the legitimacy of cryonics?
I agree this is a major concern. What’s the standard procedure in medicine for experimental treatments? As far as I’m aware (and I am not a doctor), subjects generally don’t pay for them (I do know a lot of drug trials occur in Texas because you can compensate the subjects, so apparently the cash flow is in the opposite direction for at least one other field).
And so the most appropriate model for cryonics right now might be “if you want to volunteer your body at death, we’d like to try to get better at preserving people.” That strikes me as a lot more honest than charging people for a service, and make it a lot clearer what’s going on. In efficient markets, prices convey information- and so a pretty common bias is to consider price a good proxy of quality.
And so the most appropriate model for cryonics right now might be “if you want to volunteer your body at death, we’d like to try to get better at preserving people.” That strikes me as a lot more honest than charging people for a service, and make it a lot clearer what’s going on. In efficient markets, prices convey information- and so a pretty common bias is to consider price a good proxy of quality.
Does anyone have a realistic commercial interest in developing cryonics based treatments?
SA underdelivers and overcharges for services, (“incompetence”).
Yes, that is a good definition of incompetence. If they charge more than a competing service yet deliver less, to a sufficiently extreme degree, they meet that definition. However we could also compare to other points of references. What has historically been available in terms of cryonics stabilization?
Your replacement definition- “not as good as a real competitor”- is not one I’ve ever heard of, and I strongly contest that is the common understanding.
There is a difference between replacing a definition and narrowing in on a more specific form of a definition to eliminate connotative noise. That you are choose to refer to it in this way is insulting and misleading.
Is Miss Cleo “competent” at predicting the future because she’s just as good as the next psychic hotline? Or are psychics who present themselves as anything but entertainers incompetent at their stated goal?
The term “incompetent” certainly does imply a standard to compare it to. Competitors (i.e. potential replacements) are commonplace for this purpose, hence the connotative meaning I chose to call attention to. Your stated example does have competitors by which we can objectively judge it inferior. A psychic is incompetent in comparison to rational thought in conjunction with adequate data on the matter of what one’s future is. We wouldn’t judge Miss Cleo incompetent relative to other psychics, we would judge her incompetent relative to the best available methods of predicting the future.
An alternative definition would be to judge competence by the standard of ability to accomplish a given expected end. However you would have to state exactly what that standard is, and establish that it is a reasonable one to expect, e.g. if the person or organization had promised to fulfill some particular obligation. A psychic fails at providing accurate descriptions of the future despite claiming to do so. Yet they are competent at invoking the proper cognitive biases in people to make them feel like their future is predicted accurately.
But even if we grant your replacement definition
Not a replacement, see above.
Claim 1 barely changes. We have two options: narrow our focus to services SA provides that are provided by competitors or switch words from ‘incompetent’ to ‘fraud’.
I take this to refer to the person who naively used the term surgeon to refer to the person who was doing surgery on the patient in a case report?
One of the serious things Maxim has said is that SA and others have spent their time recreating devices that could have been bought cheaper, better, and faster by using currently available devices. That’s hardly a good use of customer or benefactor money, and delays like that seem inexcusable if you believe effective cryonics stands between mortality and immortality.
This is a very, very weak argument for fraud or fakery. Furthermore, my understanding is that the money being wasted came from the guy who founded the company, not from patient stabilizations.
On the other hand, simply misrepresenting themselves is sufficient to earn the “fraud” description and be a target for regulation (either new, or already existing), even if the word ‘incompetent’ is inappropriate.
Which brings us to:
The industry SA operates in should be regulated because of claim 1.
You may not realize this, but you are claiming not only that SA is misrepresenting themselves, but doing so in a way that implies they should be regulated. That is a far stronger claim than the misrepresentation claim by itself.
There are plenty of people who misrepresent themselves in trivial ways and get away with it every day because the costs of regulation would outweigh the benefits. A person who is smiling may actually be unhappy, which is misrepresenting themselves. But the cost of regulating smiles is higher than the benefit. Your claim carries with it the implicit claim that regulating SA would do less harm than good. The history of regulation pertaining to cryonics suggests otherwise.
As to the term fraud, the hypothesis would have to be that there are patients being deceived and tricked out of their money under false pretenses. The existence of a cryonics stabilization customer who believes laymen are not employed in remote stabilization would provide strong evidence for this. The fact that their website does give the impression (in the pictures) that only medical professionals will work on you could be taken as evidence of this, I suppose—but not overwhelmingly strong evidence, if you ask me.
So, I’m afraid we’ve gotten to the point where I’m snarking for the crowd, and so I think this’ll be my last post in this thread.
The term “incompetent” certainly does imply a standard to compare it to.
Right. What’s the standard for a femoral cannulation?
Competence is a bit less restrictive, actually- it implies ‘adequacy.’ The standard for psychics could be unobtainable, but that doesn’t mean a faker is competent because they’re the best psychics in town- they have to be adequate at predicting the future.
I take this to refer to the person who naively used the term surgeon to refer to the person who was doing surgery on the patient in a case report?
While ‘naive’ is a good description, note that this is a felony. As is practicing medicine with a license (are they patients?). As is practicing medicine without a license from that state (in most states). Which is why I made the “existing regulation” comment.
I’m relatively certain there are also fairly heavy licensing requirements when it comes to cutting up corpses, if it’s decided inadvisable to consider them patients.
I’m in favor of seriously deregulating medicine, but I recognize the difference between where I want the law to be and where it is.
the guy who founded the company
You mean, like a benefactor?
You may not realize this, but you are claiming not only that SA is misrepresenting themselves, but doing so in a way that implies they should be regulated.
I actually did realize that! I signaled that through clever placement of the words “because of.”
If your current map of reality reallypredicts that I am apathetic regarding the quality of stabilizations, I strongly recommend that you notice your confusion and update.
If I am over-politicizing things I’d ratherknow. But you aren’t allowed to give weight to that without giving equal weight to Melody’s ownpoliticizing.
Just because something matches a given notion doesn’t make it true even if there is a grain of truth to it. The article you reference (and the sequence to which it belongs) is a personal favorite of mine, and I’ve long had a deep appreciation for the point that politics messes with people’s heads inhorribleways. What you do not seem to grasp about the situation is that I’ve been arguing the politics of the matter because Melody has been arguing politically to begin with. Hypothermic procedures are “near and dear to her heart”, the personnel are “overgrown adolescents” and so forth. No, I don’t want her silenced—I want her false points refuted and her correct points taken to heart in and acted upon a measured and rational manner that corresponds optimally to the reality of the situation.
This wonderfully skepticism-oriented and anti-political defense you are giving comes across as, well, ironic, given her historical tendency to politicize the situation. That said, I absolutely don’t mind being criticized for being overly political myself (in fact I’d prefer it if it is true), provided the criticism is applied even-handedly to all equally guilty parties involved. The fact that you have not offered equivalent criticism towards Melody makes your (perhaps unintentionally) condescending tone much more of an insult than it would otherwise be.
On the topic of testable claims, it is first of all important to begin with agreed-upon, connotation-independent definitions of the claims that make sense in the given context and are specific enough to be falsifiable. For this purpose, I find it reasonable to define incompetence as doing more harm than good, relative to a comparable service that could be obtained elsewhere.
The claim that SA is “incompetent” might make sense if you use a different definition—but clearly by this definition it tests as false. The only equivalent services currently available are incredibly worse for a cryonics patient. Furthermore, this has always been the case in the past. If there were a competing organization offering top of the line stabilization services of a better nature, Melody’s claim could be true within the framework of this definition of incompetence, based on the evidence she has given. But at the present time, that would not be an opinion—or an emotional reaction—that corresponds to reality.
Even if the second is appropriate- you don’t care what it is SA and their like actually do, you just want cryonics to catch on and not seem kooky- then you should read some risk management.
I shall plan to take your recommendation to read up on risk management and group dynamics while paying attention to how this could be critical or instructive towards my approach to cryonics advocacy (and mapping of cryonics-related territory in general). However it would be false to say that my present defense of existing organizations implies that I don’t care about the stabilization quality they provide. I certainly do care, but happen to be considerably more enthusiastic about participating in incrementalprogress than the revolutionary overthrow of the only people who happen to be doing the job at present.
If you believe that the defense of currently existing services implies that the person defending them does not care about improving their quality, perhaps it is time for you to notice your confusion in this matter.
I second your suggestion, though not necessarily your impression. If she would not sign up with such an organization it doesn’t mean she can’t be an objective observer, but it does make it less likely.
How precisely does it make it less likely?
Someone who wouldn’t use a service but criticizes it is more likely to be criticizing it because they don’t like the idea rather than because they have concluded it’s done poorly based on evidence. Obviously it doesn’t make it certain that that’s the case.
Honestly, the fact that she’s not signed up makes her far more credible in my eyes. Has no one here heard of consistency bias? Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works. For someone without a horse in the race to look at cryonics and have a low opinion of it does provide me information.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological information that encodes personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress during cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
I don’t recall making any context-less statements that cryonics works. Obviously I think that cryonics is worth doing, but that’s not same as thinking it “works.”
I explicitly stated that the damage done by the best cryopreservation technology is severe by contemporary standards. It’s not compatible with revival by any near-term technology, no matter who does it. Nobody should be under any illusions that human cryopreservation by available technology is easily reversible.
The goal of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of human identity. Any criticism of cryonics procedures, and the extent to which procedures impact the prognosis of cryonics patients, must be with reference to that. That has been absent in any of the recent criticisms of cryonics related to qualifications of personnel. Recent criticisms of cryonics cases have been with reference to what would have happened to living medical patients had the same case problems occurred (i.e. they might have died). The criticisms have not been with reference to the biological impact on someone who’s already suffered a “fatal” period of cardiac arrest before the hospital even let cryonics procedures begin, and who is going to be perfused with cryoprotectants for hours, dehydrated, and then cooled to a temperature that results in thermal stress fractures through all major organs of the body, likely including the brain. In such circumstances, ultimately getting cryoprotectants into tissue is enormously more important than how long cannulation for field blood washout takes, within reason.
Regarding what Ms. Maxim believes about cryonics working, it was Ms. Maxim who took exception to me saying that she believed cryonics won’t work. She said:
There are two possible interpretations of this. Either she believes that cryonics today done by the right people could result in a sufficiently pristine state, in which case she believes that cryonics today could work. Or she believes that the cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures that are unavoidable with today’s technology are not sufficiently pristine to permit revival. In that case, the entire debate of qualifications of personnel and procedural details are academic to whether cryonics today does anybody any good because the technology is intrinsically not good enough to work.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress doing cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
I don’t think cryonics “works.” I think it’s worth doing. That’s not the same thing. I’ve explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.
The purpose of cryonics is to prevent “information theoretic death,” or erasure of the neurological basis of personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.
Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I’ve seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a “fatal” period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress doing cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.
To be clear, this bad stuff is going to happen no matter who does the procedures. It’s intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.
Getting back to the question of whether cryonics “works,” it was actually Ms. Maxim who took exception to me saying that she didn’t believe cryonics could work. She said:
There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a “fairly pristine state,” and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today’s cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn’t good enough to work for anyone.
My objection is not so much that she isn’t signed up but that she has no plans to sign up, even when her moral outrage issues are resolved. So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it’s not simply a criticism of the cryonics industry, but of cryonics itself.
What makes it suspect to me is that she argues as though it is a criticism only of the current cryonics industry and yet makes no defense whatsoever of the general notion of cryonics (except a very vague version that sounds more like long-term hypothermic hibernation). Most critics seem to support some kind of future advancement suspended animation—but that’s a very different idea from cryonics from a service (and technological) perspective.
So? Why is her opinion on the technical feasibility or personal desirability of cryonics at all relevant to her claims of organizational or technical incompetence on the part of current cryonics organizations?
Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim? (for example, “a vascular surgeon that takes 30 minutes to cannulate a femoral artery is unqualified to perform surgery”, with all the technical word’s accuracy limited by my memory and my time writing this post- I am not a doctor)
If so, then something is rotten in the state of Denmark, regardless of who pointed it out originally.
Yes. This is precisely what I would have thought advocates needed to be researching, and I’m amazed there’s so far just been defensiveness, circling of the wagons and ad hominem dismissal (“it’s just motivated cognition”, “she has no plans to sign up”) which really obviously dodges actually addressing the claims. Which are natural human reactions, but that doesn’t make them good ideas.
Is this reaction evidence against cryonics?
Against the technology, no (I’d say obviously not). Against the organisational robustness of present-day cryonics? I’d say it could well be. I suspect Charles Platt would agree.
(voted up as good question)
Upvoted. Did you check out the analysis by Freitas as well? Here’s a link with some additional commentary by Dr. Wowk: http://www.imminst.org/forum/topic/45324-alcor-finances/
By the way, many of your posts are both enlightening and smile-inducing… and yet, I think I mocked you in the past (I think it was at Pharyngula). Since I suddenly feel guilty about this, I ask that you give me a downvote for atonement.
Upvoted to leave you beholden to me. BWAAAhahaha. I learnt that trick from Draco in HP:MOR.
I am sorry, but this is all that came to mind for me.
Again, why does it have to be evidence against cryonics instead of, say, Alcor or SA or CI? She’s not discussing the theoretical desirability or practicality of cryonics.
The theoretical desirability and practicality of cryonics is what matters at this point. It’s what the real controversy is about. If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced. But, supposing that is necessary, we would need new people to replace them with. People who actually care about cryonics. Melody is not contributing to that cause, in my estimation. Rather she seems to be contributing to, and playing upon, the existing cocktail of mockery, misunderstanding, and marginalization that has plagued cryonics for years.
Upvoted. But I’ll still talk about organizational matters below :)
The thing I like about Mike Darwin is that he offers technical criticisms of cryonics organizations without resorting to threats of strict regulation. Of course, I understand there are people who do not think highly of Darwin, and condescendingly claim we are being duped by this “dialysis technician” (who then conveniently leave out that he received additional training from Jerry Leaf). Perhaps those people should inform David Crippen MD that he has been duped by Mike. David is with the Department of Critical Care Medicine at the University of Pittsburgh Medical Center, and Mike must have lied about his credentials when submitting to his book “End-of-Life Communication in the ICU: A Global Perspective”
Mike also probably lied to get into this debate too: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414041/
;)
With that in mind, since I deeply care about useful external criticism (as opposed to mainstream medicine’s silent apathy… because they are still stuck at the starting line by thinking that immortality is some separate magical state of being...), I want Melody to continue with her more technical critiques. However, I do want her to drop her threats of strict regulation, unless she can find many people who have gone through all of the paperwork of signing up and suddenly proclaiming, “Oh my god. You mean to tell me that Atul Gawande is not going to be at my bedside?” I understand the need in politics to sometimes play hardball, but this is different.
I encourage Less Wrong users to look at the language being employed here. Dr. Wowk is saying things like “Mayo clinic” from a life-saving perspective. Melody is saying things like “last wishes,” and emphasizing licensed embalmers. I do not feel comfortable with such language being floated around regulation that its (potential) members don’t want. At all. If any Less Wrong users do want such regulation without even having the intent of utilizing cryonics, then.… well.… shoo, go away.
As I’ve tried to explain, the entire line of criticism is based on a false analogy of cryonics to hypothermic medicine.
OF COURSE, if cryonics were an elective procedure in which a patient were to be cooled to +18 degC and heart stopped for brain surgery, you wouldn’t use paramedics, scientists, or contract cardiothoracic surgeons who may or may not able to show up to do the surgery. OF COURSE, you would use a Certified Clinical Perfusionist to work alongside the surgeon, no exceptions. OF COURSE, any less qualified people are bound to make mistakes, and have made mistakes, mistakes that could be fatal in a mainstream medical setting in which someone was expected to be warmed right back up from +18 degC and woken up at the end of the procedure. OF COURSE, anyone with common sense (no independent medical expert needed) would say that! But that’s not what cryonics is, or could be with any near-term technology.
Cryonics doesn’t stop at +18 degC. The hypothermic phase continues down to 0 degC, and then the cryothermic phase down to −196 degC, doing injuries far beyond reversbility by mainstream medicine. Cryonics is an information preservation excercise at liquid nitrogen temperature, not an attempt to recover people in real-time from minor cooling in clinical settings. The procedures during the hypothermic phase aren’t even the same in many major respects, but I won’t bother getting into that.
Isn’t anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures?? What medical standards or established specialties exist for that?
No, why do you ask?
Be honest. Was your one-liner typed with the full understanding of his points on hypothermic vs. cryothermic phases? Or were you just participating in the Less Wrong zombie ritual of linking to other posts? Whatever the case, bring me the down votes on a silver platter :)
Mostly the latter. I see someone use the absurdity heuristic, my conditioning kicks in, and I link to the post about it.
As for the “hypothermic vs cryothermic” criticism, well, no, I don’t see the difference. The less the damage that’s done to our decapitated, frozen, fractured heads between clinical death and freezing, the easier it will be to recover the person from the corpse. As far as I can tell, an extra 30 minutes of decay at room temperature really could end up making a significant difference.
Emergent! (waves garlic and cross)
Does it need to be? Her claims of organizational and technical incompetence could be entirely factual and she could still be doing more damage than help to the cryonics cause, if she takes a bad situation (the current unpopularity of cryonics) and makes it worse by presenting valid arguments in ways that overemphasize their actual importance. All the insightful new data in the world isn’t actually helpful if it is delivered with rhetoric that emboldens hostile parties to pass harmful regulations.
I’m feeling kind of condescended to here… Do you honestly think I’m deciding whether to accept her advice based on her beliefs? I should certainly hope I’m not—nor would I advocating anyone do so! What I do advocate is treating her claims with more skepticism, on grounds that she may not be able to accurately model how things look from the perspective of someone whose life actually lies in the balance, or who has internalized the notion that future technologies will be able to fix certain really hard kinds of damage.
Politics is the Mind-Killer.
Let’s keep reading, and find out!
I wonder at your self-awareness that you do not realize that this exactly describes the failure mode I’m talking about. Let’s try switching some of the words around and seeing how it looks:
So, you shouldn’t feel condescended to, but you should alter your position and behavior. Don’t think that I’m tricked by you writing “treat her claims with skepticism” instead of “disbelieve”- these are testable claims that you could be testing. So perhaps you should do that, and then I will be willing to grant you use of the word ‘skeptical.’
Now, let’s talk about some of your substantial points. Instead of “incompetence is bad, we should set about replacing those people right now” I’m hearing “If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced.”
That suggests to me you either know woefully little about organizational dynamics (if you want to replace people for a crime, defending them for that specific crime and then trying to turn on them later is very hard to pull off) or are more interested in holding the banner for this idea then actually seeing it implemented well. Even if the second is appropriate- you don’t care what it is SA and their like actually do, you just want cryonics to catch on and not seem kooky- then you should read some risk management.
Cover-ups are notoriously stupid. It’s a known finding in psychology that simply censoring something makes it seem more credible, not less, and so attempts to silence Johnson or Maxim make them more persuasive. If you want cryonics to be thought of as a trustworthy venture, it needs to have trustworthy boots on the ground, not in the far-off future. Without improving its temporal presence, cryonics will only attract people who buy into promises about the future without kicking the tires first.
If this wasn’t clear from my last post (the one with “OF COURSE” everywhere), let me say it again. I participate in the leadership of a cryonics organization (Alcor). Speaking for myself, I stipulate to the correctness of Melody Maxim’s central claim that cryonics procedures do not meet the same standards, or sometimes qualifications of personnel, as hypothermic medical procedures. There’s nothing to test. It’s true. It’s the significance of this that is dispute, not the fact of it.
The moral outrage, indignation, allegations of fraud and self-interest, and claims of no progress in cryonics in 40 years are not justified. 40 years ago, cryoprotectants weren’t even being seriously used. 35 years ago they were being administered by morticians with embalming pumps. 30 years ago a mainstream cardiothoracic surgery researcher brought medical techniques to Alcor. 20 years ago there were vigorous debates between Alcor and CI about the importance of medical techniques. 10 years ago, vitrification was introduced. Several years ago, contract professional perfusionists began to be used by SA for field procedures. None of this is ever acknowledged. Instead, it’s an outrage that full-time cardiovascular surgeons and perfusionists don’t yet work in cryonics. An outrage.
Something else that may not be apparent to casual observers is the selectivity of Ms. Maxim’s criticisms. For the first two years after she left SA in 2006, SA was practically the exclusive target of her criticisms. Alcor officials, including myself, had cordial correspondence with her about a variety of perfusion topics in which she kindly shared her expertise. In August, 2008, one of my emails to her said:
In 2009, for reasons unrelated to changes in service as far as I can tell, she began criticizing Alcor as harshly as SA. SA and Alcor have been targets ever since.
Conspicuous by absence have been criticisms of CI, except for criticisms that CI allows its members to contract with SA for standby/stabilization services. There is no criticism of what happens to CI members who do not contract with SA for service: packing in ice by a local mortician for shipment to CI with no stabilization or field perfusion whatsoever. There is no analysis or critique of the biological consequences of THAT, and no demand for government regulation to prevent such treatment.
Nor is there much criticism of procedures at CI itself, open-circuit perfusion by a mortician for every CI case. That is not even remotely comparable to a hospital hypothermic surgery procedure, but there is no criticism of it.
What SA and Alcor have in common is that they both aspire to a higher standard of cryonics care than possible with morticians, one that draws upon some aspects of hypothermic medicine for the early stages of procedures. So perhaps what can be said about the selectivity of Ms. Maxim’s criticisms is that she focuses on criticizing those who aspire to a higher standard of care, but who fail to consistently deliver it. The missing context, and missing criticism, is what happens to cryonics patients when there is no such aspiration. And, frankly, when there is no cryonics at all.
Prior to 2009, I had relatively little knowledge of what went on, at Alcor. When the Johnson book was published, (in 2009), I read a lot of stories, which were already familiar to me, (gossip I had heard at SA), and I did a lot of further reading on Alcor’s own website. As I’m sure Dr. Wowk knows, whenever I dared to question Alcor, or remark on the Johnson book, I was subjected to the usual lies and personal attacks, (as opposed to polite, intelligent opposing arguments and/or explanations). I doubt he’s as mystified by my response, as he states.
I saw no reason to criticize CI, (at least, not until the “Cryogirl” and “Temple of Vampire” scandals, which I criticized, extensively), as I believed CI to be accurately representing the (however poor) quality of their services. Dr. Wowk is intelligent enough to realize what I have been objecting to, all these years, is the publishing of information, which might mislead people into believing the quality of services they are purchasing, is significantly greater than what it actually is. I have no idea as to why he seems to find CI’s use of a licensed mortician, (someone skilled in vascular cannulations), to be inferior to some of the laymen, who have attempted to perform surgical procedures, on behalf of SA and/or Alcor.
Again, why should I have criticized CI’s primitive procedures, when they were forthcoming about the quality of services they were delivering?
Vraiment? Does Dr. Wowk really believe SA’s Catherine Baldwin, or any other staff member of SA and/or Alcor, (during the time I was making my objections), could deliver a femoral cannulation, with more skill than CI’s mortician? If his “higher standard of cryonics care” means simply putting someone in an ice bath, just about anyone off the street could have supplied that.
Dr. Wowk’s “conspiracy theory” is ridiculous. My goal should have been clear, all along: Cryonics organizations needed to either (a) deliver cutting-edge technology, or (b) be honest about what they were selling. I haven’t kept up with cryonics, for more than a year, (indeed, tonight is the first time I read Dr. Wowk’s 14-month-old post), and I don’t want to spend much time on it, now, but when I see someone as reputable as Dr. Wowk, attempting to paint the situation, (and me!), as something it is not, I must object.
Another reason that the fact that cryonics stabilization does not meet the standards of hypopthermic medicine is not exactly evidence of incompetence is that there is not a competitor out there providing better stabilizations.
That is, if we are assuming a sufficiently narrow and connotation-free definition of incompetence which involves comparison to competitors, the test of being substantially worse than one’s competitors is one that SA fails with flying colors.
Your map does not match the territory regarding my beliefs on this matter. Please read the sequences Noticing Confusion and Against Rationalization before making any further remarks concerning my reasoning processes.
I intended no more or less than what I said regarding skepticism. The test you have proposed would not get an accurate result due to embedded assumptions which you are not taking into consideration: 1) “Competence” as commonly understood implies comparison to a competitor. Competitors do exist for hypothermic medical procedures but not for cryonics stabilization services as a whole. Hiring more qualified personnel would be an advancement. The entire complaint would be regarding the speed of progress in this area, which is a more complex issue than you give it credit for being. 2) The overall importance of hypothermic damage (including limited warm ischemic time) compared to cryothermic damage is questionable. It is a legitimate proposition that some hypothermic damage should be considered an acceptable trade-off for financial and other factors (complexity and mobility of equipment, flexibility of the personnel’s schedule, etc.) which affect the patient’s risk in this context.
In short: The claim “SA is incompetent” predicts that competitors exist, and that hypothermic damage is significant compared to the damage of the process as a whole. And it fails both of these predictions.
I certainly do care about stabilization quality and preventable damage, including the warm ischemic times seen. However my map regarding this territory is dramatically different from yours. You vastly overestimate the significance of procedural damage to the overall situation. The most important part of a stabilization company’s job is to ensure that the tissue is vitrified, if at all possible, because straight freezing is thought to be more destructive to information than the early stages of ischemic cascade. There are complicating factors in every stabilization case (and in particular remote stabilization which is what SA does), most of which are not the fault nor responsibility of the stabilization company but are caused by outside factors beyond their control. With an eye towards incremental advances, I believe that the biggest possible improvements would be a shift in outside attitudes towards tolerance and understanding of what this entails. A rational person who wishes to maximize preservation quality should attempt to avoid remote stabilization to begin with by moving close to Alcor or CI prior to deanimation because of the inherent complications in remote standby.
To my knowledge, no one has attempted to cover up Melody. I do wish she would quit making the same set of remarks in a highly political and condescending tone, repeatedly, even after they have been answered, but that is an objection to her rationality and not her free speech rights. I believe Larry Johnson has obtained and spread confidential patient information from Alcor (including pictures), and this is legitimate grounds for a lawsuit (and significant moral outrage) if you consider the same rules applying to cryonics as apply to medicine, with regards to patient privacy.
“You really should read the sequences” is the LessWrong phrase for …
I spent much of the day preparing a long post with hyperlinks to relevant articles, but then I realized it would be a bit of a jerk move and distract from the most important aspects of the discussion. I think this way is more succinct. I can’t guarantee he will be accurately modeling the reality afterward, but it should at least help.
Incidentally, Politics is the Mind-Killer is one of my favorite articles from the How To Actually Change Your Mind sequence. The sub-sequence of the same name is also quite good, although I haven’t read it all the way through yet. The basic point is that instead of taking sides (or thinking in terms of sides) we should be aiming to increase the correspondence of the map to the territory.
I do have somewhat tribal feelings towards cryonics (I don’t know how you’d expect me not to) but I question them frequently and attempt to not let them be a factor in the reasoning process. If new evidence comes up, I definitely plan to update on it.
As I understand it, Maxim makes two claims:
SA underdelivers and overcharges for services, (“incompetence”) while representing itself in a disingenuous and probably legally prohibited way.
The industry SA operates in should be regulated because of claim 1.
It appears to me that your counterargument for Claim 1 is to claim that’s a poor definition of incompetence.
Your replacement definition- “not as good as a real competitor”- is not one I’ve ever heard of, and I strongly contest that is the common understanding. Is Miss Cleo “competent” at predicting the future because she’s just as good as the next psychic hotline? Or are psychics who present themselves as anything but entertainers incompetent at their stated goal?
But even if we grant your replacement definition, Claim 1 barely changes. We have two options: narrow our focus to services SA provides that are provided by competitors or switch words from ‘incompetent’ to ‘fraud’.
One of the serious things Maxim has said is that SA and others have spent their time recreating devices that could have been bought cheaper, better, and faster by using currently available devices. That’s hardly a good use of customer or benefactor money, and delays like that seem inexcusable if you believe effective cryonics stands between mortality and immortality.
On the other hand, simply misrepresenting themselves is sufficient to earn the “fraud” description and be a target for regulation (either new, or already existing), even if the word ‘incompetent’ is inappropriate.
If I recall correctly, SA charges CI members $60,000 for field standby, stabilization, and transport. SA does approximately one or two cases per year, apparently using contract perfusionists and surgeons when available for the blood washout phase of procedures. The alternative for CI members is simple packing in ice some unspecified period after legal death, and shipment by a local mortician; no cardiopulmonary support, no associated rapid cooling, no blood washout.
If so, she is apparently saying that government regulations be put in place to force an organization with ~ $100K in annual revenues to spend up to $470K on salaries (recently computed elsewhere on Less Wrong) for a full-time certified perfusionist and a cardiovascular surgeon (how they would maintain skills is unspecified), or nobody should be allowed to attempt to provide any cryonics field service other than simple packing in ice. And the government should provide this consumer protection for two citizens per year even though nearly every medical expert, politician, regulator, inspector, and enforcement official will believe that these enforced medical standards are cargo cult science applied to dead bodies who could not possibly be revived because (a) they are already dead, and (b) the later cryopreservation itself is certainly fatal.
Why isn’t there concern that by prematurely requiring highly credentialed people, by law, to do cryonics stabilizations that the government itself wouldn’t be misleading people about the legitimacy of cryonics? The way things are now, people don’t look to the government to evaluate cryonics procedures. (Nor should they for a field as small and misunderstood as cryonics.) People have to kick the tires themselves. They have to know how limited present cryopreservation procedures are. They have to read the case reports, know that mistakes happen, and decide for themselves whether $60,000 is likely to be worth more than simple packing in ice. They have to know what they are getting into.
The reason, in a nutshell, why I’m concerned about government regulation in the present state of development of cryonics is that by not understanding cryonics, not really caring about it, not actually valuing it, they will almost certainly get the regulation wrong. The extreme political hostility that has traditionally motivated calls for cryonics regulation also helps insure this. Good regulation requires good dialog, not name-calling.
I agree this is a major concern. What’s the standard procedure in medicine for experimental treatments? As far as I’m aware (and I am not a doctor), subjects generally don’t pay for them (I do know a lot of drug trials occur in Texas because you can compensate the subjects, so apparently the cash flow is in the opposite direction for at least one other field).
And so the most appropriate model for cryonics right now might be “if you want to volunteer your body at death, we’d like to try to get better at preserving people.” That strikes me as a lot more honest than charging people for a service, and make it a lot clearer what’s going on. In efficient markets, prices convey information- and so a pretty common bias is to consider price a good proxy of quality.
Does anyone have a realistic commercial interest in developing cryonics based treatments?
Yes, that is a good definition of incompetence. If they charge more than a competing service yet deliver less, to a sufficiently extreme degree, they meet that definition. However we could also compare to other points of references. What has historically been available in terms of cryonics stabilization?
There is a difference between replacing a definition and narrowing in on a more specific form of a definition to eliminate connotative noise. That you are choose to refer to it in this way is insulting and misleading.
The term “incompetent” certainly does imply a standard to compare it to. Competitors (i.e. potential replacements) are commonplace for this purpose, hence the connotative meaning I chose to call attention to. Your stated example does have competitors by which we can objectively judge it inferior. A psychic is incompetent in comparison to rational thought in conjunction with adequate data on the matter of what one’s future is. We wouldn’t judge Miss Cleo incompetent relative to other psychics, we would judge her incompetent relative to the best available methods of predicting the future.
An alternative definition would be to judge competence by the standard of ability to accomplish a given expected end. However you would have to state exactly what that standard is, and establish that it is a reasonable one to expect, e.g. if the person or organization had promised to fulfill some particular obligation. A psychic fails at providing accurate descriptions of the future despite claiming to do so. Yet they are competent at invoking the proper cognitive biases in people to make them feel like their future is predicted accurately.
Not a replacement, see above.
In other words, we change the subject to:
I take this to refer to the person who naively used the term surgeon to refer to the person who was doing surgery on the patient in a case report?
This is a very, very weak argument for fraud or fakery. Furthermore, my understanding is that the money being wasted came from the guy who founded the company, not from patient stabilizations.
Which brings us to:
You may not realize this, but you are claiming not only that SA is misrepresenting themselves, but doing so in a way that implies they should be regulated. That is a far stronger claim than the misrepresentation claim by itself.
There are plenty of people who misrepresent themselves in trivial ways and get away with it every day because the costs of regulation would outweigh the benefits. A person who is smiling may actually be unhappy, which is misrepresenting themselves. But the cost of regulating smiles is higher than the benefit. Your claim carries with it the implicit claim that regulating SA would do less harm than good. The history of regulation pertaining to cryonics suggests otherwise.
As to the term fraud, the hypothesis would have to be that there are patients being deceived and tricked out of their money under false pretenses. The existence of a cryonics stabilization customer who believes laymen are not employed in remote stabilization would provide strong evidence for this. The fact that their website does give the impression (in the pictures) that only medical professionals will work on you could be taken as evidence of this, I suppose—but not overwhelmingly strong evidence, if you ask me.
So, I’m afraid we’ve gotten to the point where I’m snarking for the crowd, and so I think this’ll be my last post in this thread.
Right. What’s the standard for a femoral cannulation?
Competence is a bit less restrictive, actually- it implies ‘adequacy.’ The standard for psychics could be unobtainable, but that doesn’t mean a faker is competent because they’re the best psychics in town- they have to be adequate at predicting the future.
While ‘naive’ is a good description, note that this is a felony. As is practicing medicine with a license (are they patients?). As is practicing medicine without a license from that state (in most states). Which is why I made the “existing regulation” comment.
I’m relatively certain there are also fairly heavy licensing requirements when it comes to cutting up corpses, if it’s decided inadvisable to consider them patients.
I’m in favor of seriously deregulating medicine, but I recognize the difference between where I want the law to be and where it is.
You mean, like a benefactor?
I actually did realize that! I signaled that through clever placement of the words “because of.”
If your current map of reality really predicts that I am apathetic regarding the quality of stabilizations, I strongly recommend that you notice your confusion and update.
If I am over-politicizing things I’d rather know. But you aren’t allowed to give weight to that without giving equal weight to Melody’s own politicizing.
Condescending link to the first article of one of my favorite sequences is duly noted.
Just because something matches a given notion doesn’t make it true even if there is a grain of truth to it. The article you reference (and the sequence to which it belongs) is a personal favorite of mine, and I’ve long had a deep appreciation for the point that politics messes with people’s heads in horrible ways. What you do not seem to grasp about the situation is that I’ve been arguing the politics of the matter because Melody has been arguing politically to begin with. Hypothermic procedures are “near and dear to her heart”, the personnel are “overgrown adolescents” and so forth. No, I don’t want her silenced—I want her false points refuted and her correct points taken to heart in and acted upon a measured and rational manner that corresponds optimally to the reality of the situation.
This wonderfully skepticism-oriented and anti-political defense you are giving comes across as, well, ironic, given her historical tendency to politicize the situation. That said, I absolutely don’t mind being criticized for being overly political myself (in fact I’d prefer it if it is true), provided the criticism is applied even-handedly to all equally guilty parties involved. The fact that you have not offered equivalent criticism towards Melody makes your (perhaps unintentionally) condescending tone much more of an insult than it would otherwise be.
On the topic of testable claims, it is first of all important to begin with agreed-upon, connotation-independent definitions of the claims that make sense in the given context and are specific enough to be falsifiable. For this purpose, I find it reasonable to define incompetence as doing more harm than good, relative to a comparable service that could be obtained elsewhere.
The claim that SA is “incompetent” might make sense if you use a different definition—but clearly by this definition it tests as false. The only equivalent services currently available are incredibly worse for a cryonics patient. Furthermore, this has always been the case in the past. If there were a competing organization offering top of the line stabilization services of a better nature, Melody’s claim could be true within the framework of this definition of incompetence, based on the evidence she has given. But at the present time, that would not be an opinion—or an emotional reaction—that corresponds to reality.
I shall plan to take your recommendation to read up on risk management and group dynamics while paying attention to how this could be critical or instructive towards my approach to cryonics advocacy (and mapping of cryonics-related territory in general). However it would be false to say that my present defense of existing organizations implies that I don’t care about the stabilization quality they provide. I certainly do care, but happen to be considerably more enthusiastic about participating in incremental progress than the revolutionary overthrow of the only people who happen to be doing the job at present.
If you believe that the defense of currently existing services implies that the person defending them does not care about improving their quality, perhaps it is time for you to notice your confusion in this matter.