CRYOPRESERVATION: CAN WE RETURN FROM THE DEAD? ❄️

“What if you were told that you could cheat death by having your veins filled with chemicals, before being hung upside down in a sleeping bag inside a freezing vat of liquid nitrogen, to be resurrected in decades or centuries to come?”

For this week’s topic I’ve picked something right out of the unknown. The field of cryonics is very interesting, mysterious and definitely very controversial. I’ll be honest, the first time I heard about this was around 4-5 years ago through reading Beth Revis’ triology of Across The Universe, A Million Suns and Shades of Earth. These books were absolutely amazing! (As a side note, if you haven’t read them I really would recommend that you find yourself a copy and delve right into the incredible world of science fiction that’s created!) The book starts off with humans who are cryogenically frozen and then placed on a spaceship enroute to a different planet. It’s written from two perspectives, one from the ‘future leader’ of the ship and the second from one of the people who are frozen. It’s definitely a worthwhile read! Anyhow, to me back then, it was just some science fiction and I didn’t think any more of it, however, nowadays it’s something that some people are choosing to have done upon their death. I wouldn’t say it’s becoming popular, with only a few hundred people having undergone the procedure globally, but it’s definitelybecoming  something to talk about, so to speak.

Cryonics is regarded with skepticism within the mainstream scientific community and is not part of normal medical practice. In this blog post I want to discuss the ethics of allowing the scientific community to offer such a procedure and also what I think of the future of cryogenics. First off, let’s answer the question of what exactly it is, for those of you that don’t know.

Cryopreservation is the process of instantly freezing a patient after their death. When a person has been declared legally dead, the cryonic preservation company is informed and it dispatches a response team to attempt to keep the person’s blood pumping around their body. Doctors will then drain the body of all blood and replace it with an anti-freeze fluid designed to stop harmful ice crystals forming. The body is packed in ice and injected with various chemicals in an attempt to reduce blood clotting and damage to the brain. It will then be transferred to one of the three cryonic storage facilities (2 of which are in the US and 1 in Russia) where it will remain. Those who sign up for the procedure do so hoping that in the future, science will advance to the point where they will be brought back and given a second chance at life.

In the cryonic facilities the body is lowered upside down into a tank of liquid nitrogen at a temperature of -196 degrees Celsius. The purpose of the bodies being stored upside down is as a security mechanism ensuring that if there was a leak, the head, the most important part of the body, could still be revived.

The Debate

Before we delve right into this fascinating debate, I just want to bring up a few thought-provoking points starting with the definition of death. There are several different definitions of death. A patient is ‘clinically dead’ up to the point that they have no signs of a heartbeat and are not breathing. ‘Biological death’ has a different meaning, resuscitatiois impossible by any known means currently. ‘Cellular death’ is the degeneration of bodily cells. By taking the biological definition of death, can we call a cryonic patient as truly dead? They may appear to be dead, but the whole idea of cyropreservation states that they could potentially be alive at some point in the future.

The second interesting thought stems from the fact that people who are taking on this procedure are actually placing themselves in a bet. They know that becoming cryonically frozen doesn’t indefinitely mean they will live again, but they are willing to take the chance to allow scientists to see if they can revive them. In essence, these patients are donating their bodies to this cause, in the same way that you may donate your body to medical education or cancer research. Bear this in mind, it bring a very interesting ethical point up.

The third and final thought before we start looking at the ethics of cryopreservation is the fact that the theory of this procedure states that for the process to be successful the individual must be frozen at the point of death in order to prevent cell death and limit the damage to the brain. With terminally ill patients who have a rough estimate of their remaining life expectancy, that wouldn’t be a problem. They could make the company they have signed up with aware, and ensure there’s a team on stand by to quickly handle the patient. But what about the over 1,000 living people who have registered themselves and paid for a membership with a cryonic facility for the procedure? What if they have a sudden unexpected death, will their money be wasted? The best way to actually to cryonically freeze a person, is just before their death…does that mean we should allow euthanasia at the correct time to achieve successful crypreservation. This a slippery slope, no doubt about that…

Now, to begin the debate. First of all, surely the patient’s have a right to choose their treatment and with cryonic preservation being a treatment shouldn’t they be treated in the same way? People decide how they would like their funeral to be held, so therefore they should be given the freedom to choose to be frozen, if they so wish. The patient’s body, therefore the patient’s right to choose. This begs the question of whether a patient’s autonomy persists even after their death. I recently read the case about the 14-year old girl who wanted to have this procedure as she was nearing the end of her life due to a terminal cancer. Her parents could not agree on the idea so the case was taken to court. Ultimately, she had given informed consent and demonstrated capacity and understanding of the choice she was making, therefore it was granted to her. She has now become the youngest person to undergo cryopreservation.

Non-maleficence is a difficult consideration as the individuals will not technically be alive, but if we are preserving a human body, surely that it less damaging to the body compared to cremation or burial. With regards to beneficence, the patient requesting it will definitely believe that this is in their best interests as their chance to prolong their life. Especially when a patient is on their death bed, with a dying wish, it will serve their interests for the doctors to make this wish accessible to them. Knowing that they will be able to be preserved as planned with undoubtedly provide comfort and ease for them, giving supporters of the procedure the hope that they will perhaps live again.

Another argument FOR this procedure, pulls on the fact that we already successfully cryopreserve human embryos at the same temperatures. The embroyonic procedure seems to limit damage to DNA. The outcome from using cryopreserved embryos has uniformly been positive with no increase in birth defects or development abnormalities. This, to some, serves as hope and evidence that human cryopreservation could be equally as successful. Pregnancies have been reported from embryos stored for 16 years. Furthermore, a study of more than 11,000 cryopreserved human embryos showed no significant effect of storage time on post-thaw survival. (Note: embryos in the UK are only allowed to be stored for maximum 10 years now.) At the beginning of this year there was also some news about cryonically frozen rabbit brain that managed to return from preservation in near-perfect condition. Researchers behind the breakthrough said that there is no reason their technique could not be applied to larger mammals, including cows and primates, for long-term cryonic preservation.

The Against Arguement

There are several reasons why cryopreservation is opposed by some. First of all, it hasn’t actually been proven. No human has ever been brought back using this technique yet. Imagine spending a huge sum of money for something that turns out to be a disaster in the end. Medical treatment is evidence based and must go through several rigorous trials before being allowed as a mainstream treatment. The same has not been done for cryopreservation. The technique has been tested on mammals but it has not worked and yet companies are offering the service for a fee.

The fact that there is no guarantee that it will work causes many difficult ethical and moral questions to be brought to the table. The companies providing these services can’t promise reincarnation, the patient’s are essentially paying for a storage space in freezing liquid nitrogen. It’s almost like buying a coffin, only much much more expensive and a little different considering that your body will be in the possession of someone else. This, to me doesn’t seem very assuring. What happens if the company shuts down, will the bodies just be thrown away alongside the business plans? Or will the people responsible for the facility still have a duty of care to the bodies? This decision is one that could potentially last forever…it’s longer than life binding. How long will cryopreservation be a ‘thing’? And what happens when it stops?

Imagine the scenario in which the technology malfunctions causing the cryopreserved body to defrost and damage the cells within. What happens then? What about the money that was paid by the person to guarantee them this storage spot?

There is of course the question of what would happen if the procedure wasn’t successful, but we can assume that the individuals knew that it was not a guaranteed success when deciding where her to go ahead with it. But…what if it only partially works and the person is left with extreme side effects. What about the principle of non-maleficene then? This is very unfamiliar ground that we are treading on. Cheating death is a phenomenon that the majority of the world would only accept in fantasy books. There could be hugely devastating unintended consequences to this and that’s something worth considering before diving into it blindfolded. According to scientists, it is hard to believe that people thawed after cryopreservation would not be fundamentally altered in mind and body because of the extraordinary complexities of what would need to achieved to restore life. The brain, which has as many as 10,000 connections for each of the 100 billion neurones, is particularly sensitive to heating and cooling so there is the huge risk of fracturing these connections during the warming, like glass under thermal stress.

Putting aside the complexities of the theories procedure and eventualities of its failure, let’s concentrate on the the ultimate goal of cryopreservation that seems to attract some. These people would be returning to a very unfamiliar time and place, centuries (perhaps even longer) after they left it, without friends and family. The world could have completely transformed in the meantime. Humans would have evolved, natural selection would have played its role. The question is…how would they survive? What kind of world would they be inhabiting? Bioethicists have suggested that isolation, loneliness, depression and illness could all follow. Knowing these are all potential outcomes if this was a success, how can we call this an act of beneficence?

Now let’s think about the wider public…how will having people from th least millennia coming back affect them? Some would say it is selfish to prolong life, particularly if people have lived to a respectable age, when the world is already over-populated and there are finite resources. Death is a natural way of renewing and replacing the population – so shouldn’t we accept our fate, concentrate on looking after those who are alive and give up on immortality?

Earlier on I spoke about the idea that putting your name down for cryopreservation is similar to donating your body for science. Here’s where the problem stems. Imagine if a person is restored their life, do you think they would be let out the moment a breath of air fills their lungs? Just let free to run with the wind and sing with the birds. No. Absolutely not. Scientists who managed a procedure like this would want to run tests, experiment on the function of the body…these people would just become human lab rats. Think about it, this is a dangerous step out into the wilderness. There’s no way the atrocity of ‘human testing’ could be reversed if that’s what becomes of it.

Conclusion

Yes, cryopreservation would be incredible, but to me it’s just an incredible storyline. There is no concrete evidence to suggest that it’s worth investing your life savings into hanging upside down in a cold freezer, for…umm…forever. I definitely think this should be investigated and validated more before allowing people to grasp this unfounded ‘hope’. In my opinion it’s too much of an immense commitment and responsibility to keep care of a dead body for a hopeful time in the future that may even never come. However, it is important to respect a person’s wishes and if that is the way a person would like their dead body to be handled, that should be something that is given to them in the best way possible.

What do you think?