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.”
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.”