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.
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.