Suspended Animation Inc. accused of incompetence

I recently found something that may be of concern to some of the readers here.

On her blog, Melody Maxim, former employee of Suspended Animation, provider of "standby services" for Cryonics Institute customers, describes several examples of gross incompetence in providing those services. Specifically, spending large amounts of money on designing and manufacturing novel perfusion equipment when cheaper, more effective devices that could be adapted to serve their purposes already existed, hiring laymen to perform difficult medical procedures who then botched them, and even finding themselves unable to get their equipment loaded onto a plane because it exceeded the weight limit.

An excerpt from one of her posts, "Why I Believe Cryonics Should Be Regulated":

It is no longer possible for me to believe what I witnessed was an isolated bit of corruption, and the picture gets bigger, by the year...

For forty years, cryonics "research" has primarily consisted of laymen attempting to build equipment that already exists, and laymen trying to train other laymen how to perform the tasks of paramedics, perfusionists, and vascular surgeons...much of this time with the benefactors having ample funding to provide the real thing, in regard to both equipment and personnel. Organizations such as Alcor and Suspended Animation, which want to charge $60,000 to $150,000, (not to mention other extra charges, or years worth of membership dues), are not capable of preserving brains and/or bodies in a condition likely to be viable in the future. People associated with these companies, have been known to encourage people, not only to leave hefty life insurance policies with their organizations listed as the beneficiaries, to pay for these amateur surgical procedures, but to leave their estates and irrevocable trusts to cryonics organizations.

...

Again, I have no problem with people receiving their last wishes. If people want to be cryopreserved, I think they should have that right. BUT...companies should not be allowed to deceive people who wish to be cryopreserved. They should not be allowed to publish photos of what looks like medical professionals performing surgery, but in actuality, is a group of laymen playing doctor with a dead body...people whose incompetency will result in their clients being left warm (and decaying), for many hours while they struggle to perform a vascular cannulation, or people whose brains will be underperfused or turned to mush, by laymen who have no idea how to properly and safely operate a perfusion circuit. Cryonics companies should not be allowed to refer to laymen as "Chief Surgeon," "Surgeon," "Perfusionist," when these people hold no medical credentials.

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Lies travel halfway around the world while the truth is putting on its shoes. This reply is mostly directed to David Gerard, whose comments have been generally sensible except for some misinformation.

Re:

"And Alcor (Mike Darwin in particular) is famously litigation-happy against those it perceives as critics, which is a BIG cultural warning sign these days."

That Alcor has a history of suing critics is apparently becoming a self-perpetuating myth. The truth is that Alcor has a long history of litigating rights to cryopreserve its members and keep them in cryopreservation. However, since 1972, I'm not aware of anyone being sued for defamation by Alcor prior to Larry Johnson in 2009. Not that there's been any shortage of people saying false things about Alcor during all that time. Anyone who wants to know why Johnson achieved the dubious distinction of being the first to actually be sued can read the civil complaint

http://www.alcor.org/Library/pdfs/NewYorkComplaintAmendedJan2010.pdf

and other information about the case

http://www.alcor.org/press/response.html

While he may have been the first, I can't promise he'll be the last. There comes a point where defamation becomes so extreme, persistent and damaging that if you don't seek legal redress, people will assume you can't. In Johnson's case there were also other issues that no decent organization could allow uncontested, such as selling alleged photographs of the remains of Ted Williams on the Internet. Not suing for something like that would expose the organization itself to liability.

By the way, I'm not aware of Mike Darwin suing any critics, at least not in the context of cryonics. Also, Darwin hasn't done anything for Alcor since 2002, or been an Alcor employee since 1991.

Another misapprehension is that Alcor doesn't use medical professionals, or is averse to using them. This is dealt with at some length here

http://www.imminst.org/forum/topic/44772-is-cryonics-quackery/page__p__437779#entry437779

and here

http://www.alcor.org/Library/html/professionals.html

Alcor also has medical doctors among its advisors and board of directors.

The person making criticisms against SA hasn't worked there in years, and never under present management. SA in fact contracts with professional perfusionists and surgeons, despite the efforts of critics to sabotage that relationship. Something is really wrong when an organization that makes conscientious efforts to professionalize is held by critics at a lower stature than other organizations that are committed on principle to using only morticians to do cryonics procedures, and that criticized Alcor for decades for aspiring to a medical model.

Re:

"Cryonics deeply needs strong advocates who apply scepticism to it."

I don't know you if you mean skepticism in the card-carrying sense, or some other unspecified standard that you assume no advocates adhere to. If the former, for whatever it is worth, Alcor's Chief Medical Advisor, Steven B. Harris, MD, has sat on the Editorial Board of Skeptic magazine for many years and is respected for his contributions to scientific skepticism.

There are data showing the quality with which cryopreservation can preserve the fine structures of the brain.

http://www.alcor.org/Library/html/cambridge.html

http://www.alcor.org/Library/html/micrographs.html

and vitrification is currently a leading contender for the Brain Preservation Prize as a method for preserving "the connectome"

http://www.brainpreservation.org/index.php?path=prize

Finally, with respect to the question of whether there is skepticism in cryonics, and whether cryonics advocates are properly circumspect, consider this comment from a leading advocate of cryonics:

"There will never be proof that cryonics will work."

http://www.alcor.org/Library/html/NeuralArcheology.html

The basis of the comment is that there are two separate ideas called cryonics. The first is the proposition that people cryopreserved under ideal conditions with the best available methods might be recoverable in the future. That is certainly amenable to skeptical analysis and discussion, and maybe someday be provably correct. Indeed it must someday be proven correct if cryonics is ever to succeed. However the second idea called "cryonics" is that cryopreserving people even when they are badly damaged, and you don't know whether they will ever be recoverable based on present analysis, is the morally right thing to do. That idea, when adopted as a matter of principle, is hard to subject to scientific scrutiny barring obvious dissolution of the brain. However I don't think the difficulty of that scrutiny is reason to think less of people who adopt that idea as a moral principle or personal "medical" preference.

Like Steve Harris MD, (Chief Medical Advisor to Alcor, and someone who responded to my criticisms of SA with secondhand blatant lies that were later retracted on the advice of an attorney), Dr. Wowk's activities are largely funded by Life Extension Foundation, the very same company that funds Suspended Animation.

Dr. Wowk informs the readers of lesswrong that SA contracts with professional perfusionists, but what does that really mean, to SA's clients? It's my understanding that contract does not require the perfusionists to actually show up for cases, and that SA does not guarantee medical professionals, of any kind, will perform their procedures. I believe they can send anyone they want, no matter how unqualified, to perform their cases, without repercussion. The same goes for Alcor.

Dr. Wowk also maintains that SA contracts with surgeons. If that is true, perhaps Dr. Wowk would like to enlighten us as to why historical cryonics figure, Curtis Henderson, was butchered last year, by SA manager, Catherine Baldwin, who is NOT a physician, much less a surgeon, (though she referred to herself as a "surgeon," in SA's case report, which was published on the SA website). Then, maybe Dr. Wowk could explain why another SA "surgeon," (again, someone who is not a physician, at all), butchered an Alcor member, during a case that also occurred, just last year. It seems neither Ms. Baldwin, nor the other SA pseudo-surgeon, could FIND the femoral artery and vein, (two of the largest blood vessels in the human body), much less competently cannulate those vessels. If SA has surgeons, they are a recent addition, (no doubt a response to harsh criticism), and it is extremely unlikely SA is willing to guarantee that a surgeon, qualified to perform vascular cannulations, will actually perform any of their surgical procedures. (Note that SA neglects to name their staff members, or to reveal their qualifications, (or the lack thereof), on the SA website.)

SA charges $60,000 for their services, and Alcor charges up to $200,000 for theirs, (not to mention membership dues, and additional fees, on top of that), all without any guarantee of competently-performed vascular cannulations and/or perfusion, (the procedures necessary to deliver cryonics washout and/or vitrification solutions). Take 40 years of making an almost-total mockery of existing conventional hypothermic medical procedures, and add the fact that cryonicists are encouraged to leave trusts and bequests to cryonics organizations, and the situation looks "shady," at best.

Please see my further comments, here: http://cryomedical.blogspot.com/2010/11/cryonics-well-oiled-propaganda-machine.html

I don't have enough information to comment on the cases in question, except that I believe SA, like everyone else in cryonics right now, makes a good faith effort to do work that nobody else wants to do, and that most cryonics cases don't fully pay for. SA was founded and is heavily subsidized by people who want the cryonics stabilization service it provides. SA has motive to do a good job, and use the best people that resources and case logistics permit. Prior to SA, the best CI members could expect was to be collected by a local mortician. Prior to CI, the best CI members could expect from clinical medicine was to be put in the ground.

I can attest from experience on the board that Alcor also makes a good faith effort to do a good job consistent with resources available. In fact, it often makes extraordinary efforts. Nobody has any personal financial incentive to skimp. In fact there is incentive to develop and implement high standards of care because we are all signed up for that care. I've explained the qualifications of the contract surgeons (including a neurosurgeon) whom Alcor uses in its operating room, and I'm generally satisfied with the quality of cryoprotective perfusion.

The financial challenges of employing more full-time medical professionals than Alcor already does at its present size is apparent from this analysis

http://www.alcor.org/Library/pdfs/EconometricModelOfAlcorFinances.pdf

For example, although the new whole body cryopreservation minimum at Alcor is $200K, $110K of that is required for the Patient Care Trust to fund long-term storage. Of the remaining amount, $20K is earmarked for the CMS fund, and the balance pays for consumables, contract labor, overhead, and sometimes legal expenses to gain access to remains. Worst of all, the $200K is inflation-discounted future dollars at the time of cryopreservation, which may be decades in the future. Signing up today requires a six-figure life insurance policy, but some of the people actually being cryopreserved today are funded with only $35K policies arranged when they signed up in the 1980s.

Cryonics is a constant struggle to meet expectations that exceed available resources, while subject to withering public criticism and even personal attack. I believe that's why cryonics leaders don't engage in public dialog anymore.

A couple of factual corrections:

Alcor did sue Larry Johnson in 2003 for selling photographs of human remains on the Internet that year. Johnson had no misgivings about it because he did the same thing in bookstores in 2009.

I never called Johnson's book “400 pages of lies.” Without referring back to the original transcript, my recollection was that I said it was full of "disparagement, defamation, and privacy violation" or words to that effect. If I am to be quoted from a legal proceeding, I respectfully request that the quote be accurate and in context.

Peace.

Dr. Wowk steps in to defend SA, with comments such as "SA contracts with professional perfusionists and surgeons," but then admits he "(doesn't) have enough information to comment on the cases in question," (two of their most recent perfusion cases). He also does not deny there is no guarantee Alcor, or SA's, clients/members will be cared for, by such professionals. (The situation brings to mind "bait and switch" sales tactics.)

My argument is that Dr. Wowk has little knowledge of SA's procedures, or capabilities, something he seems to be confirming. Now that he can't argue their actual capabilities, in regard to providing the very expensive medical procedures they are selling, Dr. Wowk seems to want to argue "good intentions." I think Dr. Wowk, (who has not worked at SA), should probably consider it possible he may also be lacking enough information, to come to that conclusion. Judging by the events I witnessed as an SA employee, my reviews of their recent case reports, SA's secrecy, and my knowledge of the medical procedures they are attempting to perform, I would say "good intentions" are not the prevailing winds, at SA.

I don't know why Dr. Wowk even mentions "skimp(ing)," as though I'm accusing SA of not providing quality services, due to financial reasons, when that has never been the case. In my opinion, SA spends significantly more than they need to, while providing seriously-deficient services. Qualified professionals, using state-of-the-art medical equipment, would cost a lot less than their ridiculous amateur engineering projects; their absurd laymen-training endeavors; their contracted professionals, who are not guaranteed to show up for cases; and their grossly-overpaid, underqualified staff. SA is anything but "financially-challenged," they are more likely "leadership challenged." The problem is, no one there really knows how to properly perform the surgical procedures they are selling. When they DID have someone who knew how to perform the procedures, they didn't want to accept the suggested changes, because it would have meant the end of quite a few very misguided equipment "R&D" projects, which were quite lucrative, for a handful of individuals.

Dr. Wowk disparages "local morticians," but the truth is, licensed embalmers are sure to be more adept at performing vascular cannulations, than SA's laymen! CI's funeral director/licensed embalmer is said to be very skilled in performing vascular cannulations, and he is almost-certainly more skilled in these procedures, than anyone on SA, or Alcor's, staff.

I was unaware Alcor sued Johnson, back in 2003. Is that what resulted in the settlement agreement, in which Alcor tried to pay Johnson to keep his mouth shut? Isn't that a little unusual? I would think it typical, in a civil suit, for the defendent to be the one who offers to pay, in a settlement, yet Alcor (the plaintiff) was the party willing to pay? Personally, I tend to think Alcor was much more interested in keeping Johnson from discussing their questionable activities, than anything else.

I distinctly recall reading Dr. Wowk's sworn testimony, in which he referred to Larry Johnson's book as something like "400 pages of lies intended to disparage Alcor." That may not be verbatim, but I'm quite sure it is a fairly-accurate representation of his testimony. It seems those documents, (I believe they were made publicly-available in February 2010), have been removed from the court's website, (for what reason, I do not know). I will request copies of that testimony, from Johnson's attorneys, and if I am wrong I will certainly apologize to Dr. Wowk. (I'm quite sure that, given Alcor did not hesitate to publish text from Johnson's deposition, Johnson's attorneys won't mind disclosing the details of Dr. Wowk's testimony.)

As for Dr. Wowk's belief that cryonics leaders no longer engage in public dialog, due to "withering public criticism and even personal attack" from people whose "expectations exceed available resources," I say, "Nonsense." Vascular cannulations and perfusion were handed to the cryonics community, on a silver platter, courtesy of conventional medicine, decades ago, and both Alcor and SA have adequate funding to provide these procedures, with some degree of competence. If it were not for a handful of six-figure salary-and-benefits packages, being paid to unqualified persons, who have wasted decades trying to reinvent these procedures, cryonics might be a lot further along. It's my opinion cryonics "leaders" don't partake of public dialog, because they cannot defend their mostly-ludicrous activities. (If Dr. Wowk wants to discuss personal attacks, perhaps he might recall the response of his peers, Harris and Platt, to my discussions of SA's activities.)

Except for the very small number of people who choose to sign up for it, practically no one values or cares about cryonics. No one takes the time to learn its premises, its history, the technologies it's predicated upon, or what technical elements will ultimately determine its success or failure. There are no schools or generally-recognized standards. No one cares. This includes mainstream medicine and mortuary science. My understanding is that you yourself have no personal interest in cryonics.

Against this backdrop, it's not credible that there is a conspiracy among cryonics companies-- companies run by people who want cryonics for themselves --to suppress a tide of experts who could easily step in and do cryonics better. There is no corps of knowledgeable physicians or morticians ready and able to deliver cryonics services that is being displaced by incompetent lay people.

So what do cryonics organizations do? They train lay people and Emergency Medical Technicians to do tasks suited to those levels of expertise. They use morticians to help with some aspects of cases, including vascular cannulation. They contract with sympathetic medical professionals who help with expertise-intensive aspects of cryonics cases when they can, ideally multiple professionals for redundancy. They hire full-time medical professionals for certain roles when they can afford to do so, and when candidates can be found. Or they allow their members to contract with companies, like SA, who do the above.

This mixture of people is then cast into world where they must perform these unscheduled procedures at short notice anywhere within the country, and sometimes beyond. Where they must lug hundreds of pounds of equipment and perfusate to do it. Where sometimes they have to wait weeks at bedside, only for the patient to recover. And where there is no mainstream infrastructure, support, or understanding of what they do. And, recently, where they are bitterly criticized when cryonics cases fail to meet the same standards as scheduled mainstream medical procedures with entire hospitals, universities, and industries that support them.

There have been claims that cryonics has not progressed in 40 years. Leaving aside the enormous improvements in the cryopreservation process itself, it would be instructive to critique reports of past cryonics cases performed only by morticians without today's bedside teams. What was the E-HIT (equivalent homeothermic ischemic time) when the mortician was called after someone legally died, then packed them in unstirred ice with no cardiopulmonary support? What anticoagulants or ischemia-protective medications were administered? What perfusate did the mortician have, and what happened when it was perfused by an unsterile high pressure embalming pump?

With great irony, it is actually a sign of progress in cryonics that cryonics procedures are now being held to the standards of mainstream medicine. Twenty five years ago, there were raging debates about whether the kind of mortician response I describe above was completely sufficient for cryonics. Really.

I'm sorry that you had a bad experience working at SA under different management four years ago. I'm sorry that you worked with some difficult people. I've read your accounts of not purchasing commercial level detectors, and of building ramps instead of purchasing lift gates for cryonics transport vehicles, etc. I sympathize because I too have had the experience of people in cryonics sometimes underestimating the difficulty of building things rather than buying them. In my experience, these miscalculations occurred not because of personal profit motive, but because of the universal tendency of cryonicists to underestimate the difficulty of tasks, myself no exception. A belief that cryonics could work may be the ultimate example of that.

Re:

"If it were not for a handful of six-figure salary-and-benefits packages, being paid to unqualified persons, who have wasted decades trying to reinvent these procedures, cryonics might be a lot further along."

I can tell you that there is absolutely no one at Alcor who fits that description. Alcor employs approximately 10 people on a salary budget of $500K. There is very little room for waste.

I respect your knowledge of clinical perfusion as it pertains to certain specific aspects of cryonics, and I hope you respect my knowledge of the cryobiological aspects and other technical issues after 24 years of scientific and personal interest. As an Alcor board member, I have nothing to gain by promoting or tolerating any culture of waste or procedural negligence. I'm sorry that has become your perception of the entire field of cryonics because of your negative experiences for a short time with certain people years ago.

It is ridiculously absurd for Dr. Wowk to write that it is his "understanding" that I, (a person who has probably written millions of words about cryonics), "have no personal interest in cryonics." Dr. Wowk doesn't know me, and his sources of information, about me, are most likely lacking in credibility. (I'm sure Dr. Wowk is smart enough to have been able to recognize the MANY lies that have been told about me, by some of the people he frequently works with, in cryonics.)

Historically, cryonics organizations have focused on attempting to train laymen to perform procedures normally performed by vascular surgeons and perfusionists. If there have been recent efforts to retain qualified professionals, (as an added expense, rather than as replacements for unqualified persons), I think it most likely due to persistent, harsh criticism.

On the rare occasion a medical professional, (someone who has had the potential to bring other professionals into the field), has expressed an interest in cryonics, what was the result? What happened when Larry Johnson brought up the issue of OSHA violations, at Alcor? Did his superiors ask him to remedy the situation, or did they ask him to shred documents and delete computer files, related to his complaints? Does Dr. Wowk really know the truth, regarding the nature of the responses to my complaints, at SA? If I thought he did, I would be forced to think very poorly, of Dr. Wowk. Personally, I don't think Dr. Wowk really knows what goes on, on a daily basis, at some of the organizations he defends.

Whether intentional, or unintentional, Dr. Wowk's expressions of sympathy toward me, for trivial matters such as those related to the equipment at SA, appear to be an attempt to paint me, (once again), as nothing more than a disgruntled former employee. I assure Dr. Wowk I am not capable of carrying a personal grudge, to this extreme. (Dr. Wowk might also consider that the person who offended me most, left SA quite some time ago, and that I don't have any reason to have a personal grudge against anyone at Alcor; I don't even know any of their staff members.)

Dr. Wowk maintains there is no one at Alcor, with a six-figure salary-and-benefits package. I doubt that's true. According to Alcor's 2008 Form 990, Tanya Jones, (who was listed as the Executive Director/CEO/President/COO), was paid a total of $89,424, that year. Does Dr. Wowk think that doesn't come in, at six-figures, when the benefits are added? Does Ms. Chapman not earn a similar salary? (Keep in mind the actual cost of an employee also includes things such as office space and equipment, so any unqualified person, sitting at a desk, forty hours a week, accomplishing basically nothing, is a tremendous burden on their organization. Also consider that at least two of Alcor's allegedly underpaid staff members live at the facility, and there must be some value placed on their living quarters and utilities.)

Dr. Wowk does not deny that there are a number of six-figure salary-and-benefits packages, within the three LEF-funded organizations, (Suspended Animation, Critical Care Research and Dr. Wowk's organization, 21st Century Medicine). When I left SA, I was being paid $75K a year, plus benefits. I left behind three co-workers, known to have base salaries of $79K, $77K, $60K, along with three other employees who most likely had very similar salaries, and a consultant who was allowed to bill for 160 $50 hours, per month, plus expenses, which included a subsidized apartment. Catherine Baldwin was added to the SA staff, not too long after my departure, and I'm quite sure her salary and benefits add up to six figures.

The Curtis Henderson case report was a perfect example of one of LEF's highly-paid employees attempting to deceive the public, in regard to SA's capabilities. Catherine Baldwin's report was filled with medical terms, (some used improperly), and she referred to herself as a "surgeon," when she is not even a physician. I don't know how ANYONE, (Dr. Wowk included), could interpret such a report as anything other than intentional deceit. A layperson, not pretending to be a medical professional and misrepresenting the capabilities of her team, would have produced a very different report.

Quite some time ago, someone at CI asked Catherine Baldwin to admit SA's website was not a true representation of their capabilities. Allegedly, Ms. Baldwin DID admit that was true, saying the website was a representation of what she hoped SA would be, in the future. She is said to have added that she was not responsible for the content of SA's website. I found that pretty interesting, because I have an email, from Catherine Baldwin, (carefully preserved in my webmail), in which she clearly states that, while she was paying someone to design SA's site, she would be solely responsible for the content.

Several highly-paid people, connected to LEF, have engaged in many lies, in attempts to misrepresent their true capabilities and to discredit their critics.I disagree that Dr. Wowk has "nothing to gain by promoting or tolerating any culture of waste or procedural negligence." I think Dr. Wowk probably has HUGE professional and financial incentives, to defend the LEF-funded organizations and Alcor.

Until SA and Alcor either make the capabilities of their personnel, and the quality of their services, extremely clear to the public, I will not stop writing about what I believe to be gross misrepresentations of their services. Hypothermic medical procedures have played a huge role, in my life, and I'm not willing to sit by and watch a bunch of quacks make a mockery of something quite meaningful to me, especially in light of the fact that these companies charge exorbitant prices for their foolishness, and encourage people to leave trusts and bequests, to cryonics organizations.

Did the person who left the $7M bequest Alcor recently announced know the truth, regarding Alcor's personnel and capabilities? Or, did he/she read Alcor case reports filled with medical terminology and references to laypersons as "surgeons" and "perfusionists" and grossly overestimate Alcor's capabilities? One has to wonder. (By the way, someone tells me that bequest was originally $15M, is that true?)

It is ridiculously absurd for Dr. Wowk to write that it is his "understanding" that I, (a person who has probably written millions of words about cryonics), "have no personal interest in cryonics."

You've said elsewhere that you have no personal interest in cryonics for yourself, and that you don't believe cryonics will work. You imply that you don't believe it will work because it's not being done competently. However if the Mayo Clinic started offering human cryopreservation tomorrow, you would still believe that cryonics couldn't work. The reason is that if you believe that 10 minutes of surgical time vs. 90 minutes of surgical time is the difference between success or failure of cryonics, then you must surely believe that poisoning a brain with cryoprotectants and fracturing it during cooling utterly dooms it. However that is what happens with the best cryopreservation technology that exists today, no matter who does it. The success or failure of cryonics ultimately depends upon a type of information preservation that is outside the ken or even conception of mainstream medicine, and one that you yourself don't subscribe to because your criticisms are never with reference to it.

On the rare occasion a medical professional, (someone who has had the potential to bring other professionals into the field), has expressed an interest in cryonics, what was the result? What happened when Larry Johnson brought up the issue of OSHA violations, at Alcor?

Johnson's claims are presently subject to an active defamation lawsuit. Numerous medical professionals have done work with Alcor at various times, including nurses, clinical perfusionists, a neurosurgeon, two doctors who served as CEOs, and two full-time paramedics hired after Johnson. None of them behaved as Johnson did.

Your consistent defense of Larry Johnson is incomprehensible to me. This is a man who absconded with photographs of human remains, and sold them on the Internet and bookstores. He violated personal privacies in the most horrible ways that had nothing to do with any wrongdoing. He told vicious lies about matters of which I have personal knowledge. He was shown to have falsified death threats, violated court orders domesticated in three states, found in contempt of court, and is now subject to an arrest warrant in Arizona.

Dr. Wowk maintains there is no one at Alcor, with a six-figure salary-and-benefits package.

I didn't say that. I said there was no one at Alcor who fit the description of having such compensation and wasting time reinventing wheels. It should be clear from the salary budget at Alcor that not many people make large salaries. There is certainly not the salary budget for the full-time cardiovascular surgeon and clinical perfusionist whom you seem to be saying Alcor should hire.

I disagree that Dr. Wowk has "nothing to gain by promoting or tolerating any culture of waste or procedural negligence." I think Dr. Wowk probably has HUGE professional and financial incentives, to defend the LEF-funded organizations and Alcor.

Forget defending, what about tolerating? Cryonics is something you criticize as a hobby. For me, cryonics is a matter of survival. It's my body those things will be done to, any my belief (correct or not) that how things are done matters to my survival. You've said that you don't believe anybody's survival actually depends on cryonics because it won't work.

Regarding my financial incentives, a few facts: I have 23 years of education, three college degrees, including a PhD, and 20 years of experience doing and publishing scientific research. My salary before benefits is five figure, and way below what it would have been had I stayed in the medical field in which I did graduate studies, and not foolishly and idealistically changed fields to do research related to cryonics. I received $700 from Alcor in 2010 for work I did on a cryonics case, and that's it. My employer receives a negligible portion of its funding from sales to cryonics organizations, and no grants from them. My employer prefers that I not make public posts about cryonics, and so do the people who fund them, believing its not a good use of my time. They are probably right. Not following those preferences is actually contrary to my career interests.

As to my motives for defending cryonics and those who do it, you overlook the most obvious ones that have nothing to do with money. First and foremost, after 24 years of advocacy and other work to advance the idea, I care about it being presently fairly and accurately. In that respect, I am as passionate as you are about areas of cryonics that you don't believe are being represented accurately. For both of us, that has nothing to do with money. Second, there is pride involved. When I am a director of Alcor, and among those ultimately responsible for it, it's hard not to take unfair criticism personally. Finally, once again, it is a matter of survival, not just of myself, but many other people who for better or worse I've convinced to sign up for cryonics over the years. If exaggerated, misrepresented, or out-of-context criticisms of cryonics lead to outlawing of it, or severe restrictions on its procedures imposed by people with no understanding or personal value of it, that would be a disaster.

Dr. Wowk is being dishonest, in his representation of my opinions of cryonics. I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work." In fact, on numerous occasions, I've clearly stated cryonics has a basis in reality, based on existing conventional medical procedures, in which people are cooled to a state of death and then revived. Many times...many, MANY times...I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

However, I have also stated, on an equal number of occasions, that I don't believe the scientists of the future will be able to repair the damage being inflicted on cryonicists, by a bunch of unqualified, overgrown adolescents, who want to play doctor with dead people, while pretending to be surgeons and perfusionists. I'm sure Dr. Wowk's lack of understanding, as to why I defend Larry Johnson, can't be any more perplexing to him, than his defenses of Alcor and SA, or people like Harris and Platt, are, to me.

How many cryobiologists does Dr. Wowk think he can get, to support his opinions of the activities of Alcor and/or SA? The response to cryobiologist, Dr. Arthur Rowe's, remarks, regarding cryonics organizations not being able to "turn hamburger back into a cow," was clever, but ridiculous, at the same time. Yes, some of the molecules of the hamburger would be incorporated into the body tissues of the cow that ate it, but the original cow would still be quite dead. Being clever, in defending the cryonics organizations, isn't enough. The organizations are not going to be able to carry on the way they have been, much longer.

Dr. Wowk tries, yet again, to dismiss me as someone not serious about this matter, calling it my "hobby." I assure Dr. Wowk I am quite serious about not allowing people to bastardize procedures, near and dear to my heart, while pretending they are delivering some sort of futuristic medical care, with price tags up to $200,000, coupled with requests for trust funds and bequests, without objection. It seems more of a con game, to me, than a serious effort to make medical history.

Dr. Wowk fails to notice the situation IS ALREADY "a disaster," and always has been. If it were not for all the foolishness that has gone on, there would be no threat of regulation. Instead of debating with me, perhaps Dr. Wowk should start writing letters, directed at Alcor and SA, encouraging them to clean up their acts, before someone does it for them.

If Alcor and SA want to provide the public with FULL DISCLOSURE, regarding their capabilities and personnel, I'll limit my criticisms. But, for so long as cryonics organizations spew out reports I feel are clearly intended to deceive an unsuspecting public, I will feel obligated to inform people of the true nature of the situation.

Dr. Wowk is being dishonest, in his representation of my opinions of cryonics. I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work."

You've been saying it by implication. See below.

In fact, on numerous occasions, I've clearly stated cryonics has a basis in reality, based on existing conventional medical procedures, in which people are cooled to a state of death and then revived. Many times...many, MANY times...I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

There is no present technology for preserving people in a "fairly pristine state" at cryogenic temperatures. Present cryopreservation technology even under perfect conditions causes biological effects such as toxicity and fracturing that are far more damaging than the types of problems you've expressed concern about. Even if the hypothermic phase of cryonics were done perfectly, with completely reversibility, what happens during the cryothermic phase is so extreme as to make the damage from poorly-executed blood washout insignificant by comparison.

If you believe that for cryonics to work, preservation must be so pristine that the number of minutes taken for a femoral cannulation can determine whether cryonics succeeds or fails, then you necessarily believe that cryonics today cannot work no matter who does it. That's because enormously worse damage is unavoidably done during cooling to liquid nitrogen temperature.

Cryobiologists wouldn't be impressed if the Mayo Clinic did cryopreservations. Who does cryopreservations is just window dressing as far as cryobologists are concerned. They know that technology for preserving people or human organs in a reversible state (as reversibility is currently understood in medicine), doesn't exist. Most cryobiologists would regard the idea of repairing organs that had cracked along fracture planes as preposterous, as I'm sure you do if you believe that 300 mmHg arterial pressure or one hour of ischemia is fatal to a cryonics patient.

In summary, the force with which you believe that departures from clinical ideals in the hypothermic phase of cryonics are fatal necessarily means that you believe the cryothermic phase of cryonics today is fatal no matter who does it. As a cryobiologist, I'm telling you that the damage of cryothermic preservation is that bad independent of who does it. The technology for "fairly pristine" just isn't there.

It seems more of a con game, to me, than a serious effort to make medical history.

Maybe you are projecting here about why you took your job at SA four years ago (the medical history part, I mean). I don't care about making history, I care about surviving history. As far as cons go, there has never been a bigger money losing pit for individuals than cryonics. Anyone who bothers to look will see that money Alcor receives is either spent on legitimate activities or set aside to ensure continuity of patient care, and long-term survival of the organization. I don't have to tell you how modest compensation is at CI. Saul Kent often observes wryly that cryonics is the most famous least successful idea in history. I'll add to that, least personally rewarding. In what other fields do sincere people have the opportunity to be mercilessly pummeled as dishonest, incompetent, ignorant, unethical, con men while making below-market pay in most cases, and not seeing any results of their work for centuries, if ever? Although it's not my thing, cryonics would be great for S&M types.

I just want to make sure I have this straight…

Is it Dr. Wowk’s position, the vitrification solutions are so very toxic, it’s acceptable to subject Alcor and Suspended Animation’s clients to additional injury, via grossly incompetent personnel, when delivering those solutions? Wouldn’t it make more sense for organizations advertising the possibility of future resurrection, (and charging up to $200,000 for their services), to provide the best possible care? Shouldn’t they be doing as little harm, as possible?

Dr. Wowk’s attitude seems to be, “Oh shucks, we’re filling them so full of highly-toxic solutions, it doesn’t matter what else we do to them. We might as well throw in some warm ischemia, some inappropriate perfusion pressures, or maybe even massive boluses of air.” Is that the mentality??? Personally, I don't think there's much chance of success, with that attitude. If the damage is as extreme, and as unavoidable, as Dr. Wowk writes, maybe they should just straight-freeze their clients, until they can offer something better.

Dr. Wowk attempts to trivialize the mistakes I've been criticizing, by making reference to “one hour of ischemia.” The truth is, most, (if not all), cryonics suspendees have likely been subjected to much more serious abuse. The last SA case report was that of historical cryonics figure, Curtis Henderson. Mr. Henderson’s groin was prepped, for cannulation, at 6:50am, but the washout was not started, until 12:11pm. That means it took SA about FIVE HOURS longer than it should have, to perform the cannulation. Even then, it was not the SA team that accomplished the cannulation, but a local funeral director. If this is the treatment an historical cryonics figure gets, what does the Average Joe get?

What was most offensive about the Henderson case, was Suspended Animation’s published case report, in which Catherine Baldwin referred to herself as a “surgeon,” and spewed forth more than enough medical jargon, (some of which she used, improperly), to make the average layman think her team was comprised of knowledgeable and competent medical professionals. I think Ms. Baldwin’s report was, quite clearly, a blatant attempt to deceive the public and to defraud SA’s potential clients. I think this is a very well-established pattern, at organizations, such as Suspended Animation and Alcor, and I think anyone who spews forth that amount of deception, when trying to sell some very expensive services, should be arrested.

Once more… If Alcor and SA want to provide the public with FULL DISCLOSURE, regarding their capabilities, (or lack thereof), and the qualifications of their personnel, I'll limit my criticisms. But, for so long as cryonics organizations publish garbage I feel is clearly intended to deceive an unsuspecting public, I will be inclined to expose them.

Dr. Wowk writes: “As far as cons go, there has never been a bigger money losing pit for individuals than cryonics. In what other fields do sincere people have the opportunity to be mercilessly pummeled as dishonest, incompetent, ignorant, unethical, con men while making below-market pay in most cases, and not seeing any results of their work for centuries, if ever?”

While cryonics endeavors may not have been lucrative, for Saul Kent and Bill Faloon, I think the business of cryonics has been quite lucrative, for many, especially the LEF-funded employees. I’ve never seen so many overpaid, underqualified people, accomplishing so little of significance.

Is it Dr. Wowk’s position, the vitrification solutions are so very toxic, it’s acceptable to subject Alcor and Suspended Animation’s clients to additional injury, via grossly incompetent personnel, when delivering those solutions? Wouldn’t it make more sense for organizations advertising the possibility of future resurrection, (and charging up to $200,000 for their services), to provide the best possible care? Shouldn’t they be doing as little harm, as possible?

My position is to do the best you can within available resources, and that criticisms should be in-context and constructive. As far as available resources go, of the $200K of Alcor's new 2011 whole body minimum, $110K is set aside to fund long-term storage, leaving only $90K, the majority of which is consumed by costs that already exist without employing a full-time cardiovascular surgeon (leaving aside the issue of how such a person would maintain his/her skills). This itemized analysis

http://www.alcor.org/Library/html/CostOfCryonics.html

http://www.alcor.org/Library/html/CostOfCryonicsTables.txt

shows those costs as $37,000 in 1990, or $60,000 2009 dollars, neglecting overhead and advances in technology since then. However people cryopreserved in 2011 will mostly not be people who signed in 2011, but people who signed up in 2000 or even 1990, sometimes with much lower funding than current minimums.

Dr. Wowk’s attitude seems to be, “Oh shucks, we’re filling them so full of highly-toxic solutions, it doesn’t matter what else we do to them. We might as well throw in some warm ischemia, some inappropriate perfusion pressures, or maybe even massive boluses of air.” Is that the mentality???

If that was the mentality, then there would be no efforts at field stabilization. Patients would just be packed in ice without any cardiopulmonary support or field perfusion, and sent off to their cryonics organization as is now done for CI members without SA contracts. Obviously I think field procedures are important, and that good-faith efforts must be made to do them well with resources available. However, with the possible exception of air embolism (which can interfere with later cryoprotective perfusion), problems in field care of cryonics patients don't have the same prognosis significance in cryonics that they would have in hypothermic medicine.

Dr. Wowk attempts to trivialize the mistakes I've been criticizing, by making reference to “one hour of ischemia.” The truth is, most, (if not all), cryonics suspendees have likely been subjected to much more serious abuse. The last SA case report was that of historical cryonics figure, Curtis Henderson. Mr. Henderson’s groin was prepped, for cannulation, at 6:50am, but the washout was not started, until 12:11pm. That means it took SA about FIVE HOURS longer than it should have, to perform the cannulation. Even then, it was not the SA team that accomplished the cannulation, but a local funeral director.

That field case report is here.

http://www.cryonics.org/immortalist/july10/henderson.pdf

Let's look at it. A contract surgeon was on standby with the rest of the team from June 21 to 24 before having to leave because of work obligations. A second contract surgeon was to arrive on the afternoon of June 25. As luck would have it, the patient suffered cardiac arrest the morning of June 25, showing that cryonics field work is more like battlefield medicine than an elective procedure. The people on scene, with the assistance of the mortician, did the best they could. Note that cardiopulmonary support and rapid cooling was performed, bringing the patient's temperature down to approximately +20 degC, descending to +12 degC during the surgery, which greatly mitigated the biological effects of the surgical delays. Note also the surgical error that the mortician himself made.

What was most offensive about the Henderson case, was Suspended Animation’s published case report, in which Catherine Baldwin referred to herself as a “surgeon,” and spewed forth more than enough medical jargon, (some of which she used, improperly), to make the average layman think her team was comprised of knowledgeable and competent medical professionals. I think Ms. Baldwin’s report was, quite clearly, a blatant attempt to deceive the public and to defraud SA’s potential clients.

I did a text search of the above document, and I can't find where Ms. Baldwin represents herself as a credentialed surgeon. I don't think it's fair to represent a sincere attempt to report what was done in the interests of transparency as a "fraud." Wouldn't someone whose intent was fraud write a wonderful case report, superficial case report, or none at all? Saul Kent is ironically an extremely strong supporter of writing and publishing case reports in cryonics, including disclosure of problems.

I think allegations of "fraud" and "abuse" are inappropriate in the context of the good-faith efforts being made, in the context of the biological significance of most field problems in cryonics relative to hypothermic medicine, and especially in the context of the alternative of just packing warm patients in ice and shipping without cardiopulmonary support or medications. There's also the context of nobody else caring to help or pay for what the infrastructure to support full-time cardiovascular surgeons at this stage of development of cryonics would really cost.

There's another point that should be obvious, but perhaps not to those not familiar with cryonics procedures. The reason the patient cooled from approximately +20 degC to +12 degC during the long surgery was because HE WAS PACKED IN ICE. That's the same treatment he would have gotten for those five hours had SA not been there.

Before and after those five hours, the patient's treatment was enormously better than it would have been had SA not been there. Prompt cardiopulmonary support (CPS) and ice bath cooling after cardiac arrest supplied oxygenated blood and medications to the brain, and accelerated the initial phases of cooling compared to just packing on ice. After the surgery was finally completed, perfusion allowed cooling the rest of the distance to 0 degC in mere minutes. So,

What happened because SA was there, was:

Fast cooling during CPS / Slow cooling in ice / Fast perfusion cooling to 0 degC

What would have happened if SA wasn't there, was:

Slow cooling in ice / Slow cooling in ice / Slow cooling in ice .....

The criticisms that have been made about this case seem to imply that SA harmed this patient, or engaged in some kind of malpractice. But the patient objectively benefited from the procedures done (based on the temperature descent profile) despite the misfortune of his legal death occurring between the presence of the two contract surgeons.

I believe this is also likely true for the other SA cases that have been criticized; that the patients benefited from the presence and rapid response of a stabilization/transport team despite mistakes made. They would have been much worse off if just packed in ice and shipped by a mortician 1970s-style. However there is no criticism from recent critics when THAT happens in cryonics. There are no allegations of incompetence, malpractice, or demands that people be regulated or arrested. It's only when groups of people try to do better than just packing in ice that the fire and brimstone rains down.

The only logical inference from this would be that critics want regulation to prohibit anyone from having field cryonics procedures (or any cryonics procedures?) other than simple packing in ice unless those procedures are delivered by certified perfusionists and cardiovascular surgeons, guaranteed. As a practical and financial matter in the current state of development of cryonics, this would be tantamount to legislation that nobody in cryonics gets any field stabilization, or even cryoprotective perfusion were such regulations to extend into cryonics facilities.

I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

Can you please clarify whether you mean a state obtainable by present technology or some hypothetical future achievable state? The way you phrase it this could be taken either way.

However, I have also stated, on an equal number of occasions, that I don't believe the scientists of the future will be able to repair the damage being inflicted on cryonicists, by a bunch of unqualified, overgrown adolescents, who want to play doctor with dead people, while pretending to be surgeons and perfusionists.

It sounds like you think cryonics could work in the present day, but only if performed by trained, licensed medical professionals. If that is the case, would you sign up for cryonics if they started offering it in your local hospital tomorrow?

The response to cryobiologist, Dr. Arthur Rowe's, remarks, regarding cryonics organizations not being able to "turn hamburger back into a cow," was clever, but ridiculous, at the same time. Yes, some of the molecules of the hamburger would be incorporated into the body tissues of the cow that ate it, but the original cow would still be quite dead

Could you provide a link? I don't recall reading this response. Dr. Rowe's assertion always seemed to me to be rather ridiculous to start with because it does not address the structural preservation levels possible with vitrification (as opposed to freezing).

I assure Dr. Wowk I am quite serious about not allowing people to bastardize procedures, near and dear to my heart, while pretending they are delivering some sort of futuristic medical care, with price tags up to $200,000, coupled with requests for trust funds and bequests, without objection.

Most other medical professionals (aside from yourself and Larry Johnson) seem to completely ignore cryonics. Which is part of the problem. If you want to stir up interest in the scientific and medical communities in making sure this is done right, more power to you. But it has to be done one way or another.

I would like to ask Dr. Wowk to show me where Larry Johnson "was shown to have falsified death threats," and where he "violated court orders in three states."

During this discussion, Dr. Wowk has identified himself as being on the Board of Directors of Alcor, so I assume he can be considered to be representing them, here. Alcor has accused Mr. Johnson of many wrong-doings, but I do not believe he has been "shown to have falsified death threats."

In addition, it's my understanding the agreement, in which Mr. Johnson was not supposed to publicly comment about Alcor, was supposed to work both ways. Is that correct, Dr. Wowk?

As for violating court orders, I believe the State of Arizona has ruled that Mr. Johnson violated a court order, but are the States of Nevada and New York like-minded?

Forget defending, what about tolerating? Cryonics is something you criticize as a hobby. For me, cryonics is a matter of survival. It's my body those things will be done to, any my belief (correct or not) that how things are done matters to my survival. You've said that you don't believe anybody's survival actually depends on cryonics because it won't work.

And this can't just be because current organizations are not competent. If she were committed to being signed up for a hypothetical future ultra-competent organization the moment someone puts one together, it would do wonders for her credibility as far as I a concerned. At present she gives me the impression of a nosy outsider who feels the need to offer condescending advice and harsh socially stigmatizing criticisms to a marginalized group she neither likes nor identifies with.

Before you extrapolate from yourself - are you sure that you're even a sufficiently typical cryonics advocate, let alone a typical enough example of a disinterested third party?

I thought he meant credibility with cryonics advocates.

Yes, and I'm pretty sure I'm a typical enough example of a cryonics advocate for this to be a generalizable issue. If she isn't planning to sign up it really does at least communicate that she thinks it can't work -- that it's just an expensive funeral no matter who does it -- under present technological constraints.

Now, it's possible to think it can work and not plan to sign up. If you think it is too expensive of a trade-off on the risk-reward scale, or if you have an irrational fear of it. But Melody hasn't attempted to communicate either of these things. Her sole motive is supposedly her moral outrage at the horrible people in existing organizations perverting the sacred practices of medicine. Well if that's true, it should predict that once those moral outrages are resolved she plans to sign up -- that she believes in cryonics as an idea.

The explanation that makes the most sense is Melody is interested in something that is not fundamentally cryonics at all -- hypothermic hibernation for living patients, for example. She may call it cryonics, but it doesn't involve future-technological repair, clinically dead patients, long periods of time, etc. -- it is a fundamentally different concept with superficial similarities and much common ground basic science.

I second your suggestion, though not necessarily your impression. If she would not sign up with such an organization it doesn't mean she can't be an objective observer, but it does make it less likely.

Honestly, the fact that she's not signed up makes her far more credible in my eyes. Has no one here heard of consistency bias? Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works. For someone without a horse in the race to look at cryonics and have a low opinion of it does provide me information.

it provides me no information that he thinks cryonics works.

I don't think cryonics "works." I think it's worth doing. That's not the same thing. I've explained that cryopreservation causes damage that is severe by contemporary standards. It cannot be reversed by any near-term technology. Nobody should confuse cryonics with suspended animation or established hypothermic medicine.

The purpose of cryonics is to prevent "information theoretic death," or erasure of the neurological information that encodes personal identity. Any evaluation of the effects of procedural details on cryonics patient prognosis must be with reference to that.

Unfortunately none of the recent criticisms of cryonics procedures address the issue of information preservation, which is what cryonics is all about. The criticisms that I've seen have all been with reference to what effect various procedural problems would have had on living patients expected to spontaneously recover at the end of hypothermic medicine procedures. The information preservation significance of a delay in cannulation for someone who already suffered a "fatal" period of cardiac arrest before cryonics procedures begin, who may be transported across the country on ice, who will be exposed to hours of cryoprotectant perfusion, their brain dehydrated, possibly decapitated, and then major organs fractured by thermal stress during cooling, has not been discussed. Yet that is the real context of cryonics. Cryonics is not someone having aneurysm surgery.

To be clear, this bad stuff is going to happen no matter who does the procedures. It's intrinsic to present cryopreservation technology. The scientific reality is that for a cryonics patient, as distinct from a hypothermic medicine patient, the composition and concentration of what cryoprotectant ultimately gets into tissue is enormously more important than how long cannulation for field blood washout takes, or who does it, within reason.

Getting back to the question of whether cryonics "works," it was actually Ms. Maxim who took exception to me saying that she didn't believe cryonics could work. She said:

I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work."

I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

There are two possible interpretations of this. Either she believes that cryonics done by the right people today could result in a "fairly pristine state," and cryonics could work. Or she believes that the unavoidable cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures in multiple organs, likely including the brain, that is intrinsic to today's cryopreservation technology is not a sufficiently pristine state to permit later revival. In that case, the entire debate over procedural details and who does them is academic. The technology isn't good enough to work for anyone.

Dr. Wowk has stated that he needs cryonics to work, and so it provides me no information that he thinks cryonics works.

I don't recall making any context-less statements that cryonics works. Obviously I think that cryonics is worth doing, but that's not same as thinking it "works."

I explicitly stated that the damage done by the best cryopreservation technology is severe by contemporary standards. It's not compatible with revival by any near-term technology, no matter who does it. Nobody should be under any illusions that human cryopreservation by available technology is easily reversible.

The goal of cryonics is to prevent "information theoretic death," or erasure of the neurological basis of human identity. Any criticism of cryonics procedures, and the extent to which procedures impact the prognosis of cryonics patients, must be with reference to that. That has been absent in any of the recent criticisms of cryonics related to qualifications of personnel. Recent criticisms of cryonics cases have been with reference to what would have happened to living medical patients had the same case problems occurred (i.e. they might have died). The criticisms have not been with reference to the biological impact on someone who's already suffered a "fatal" period of cardiac arrest before the hospital even let cryonics procedures begin, and who is going to be perfused with cryoprotectants for hours, dehydrated, and then cooled to a temperature that results in thermal stress fractures through all major organs of the body, likely including the brain. In such circumstances, ultimately getting cryoprotectants into tissue is enormously more important than how long cannulation for field blood washout takes, within reason.

Regarding what Ms. Maxim believes about cryonics working, it was Ms. Maxim who took exception to me saying that she believed cryonics won't work. She said:

I have never said I "don't believe anybody's survival actually depends on cryonics because it won't work."

I have CLEARLY stated I believe someone preserved in a fairly pristine state might be revived.

There are two possible interpretations of this. Either she believes that cryonics today done by the right people could result in a sufficiently pristine state, in which case she believes that cryonics today could work. Or she believes that the cryoprotectant toxicity, long cold ischemic times, and thermal stress fractures that are unavoidable with today's technology are not sufficiently pristine to permit revival. In that case, the entire debate of qualifications of personnel and procedural details are academic to whether cryonics today does anybody any good because the technology is intrinsically not good enough to work.

My objection is not so much that she isn't signed up but that she has no plans to sign up, even when her moral outrage issues are resolved. So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it's not simply a criticism of the cryonics industry, but of cryonics itself.

What makes it suspect to me is that she argues as though it is a criticism only of the current cryonics industry and yet makes no defense whatsoever of the general notion of cryonics (except a very vague version that sounds more like long-term hypothermic hibernation). Most critics seem to support some kind of future advancement suspended animation -- but that's a very different idea from cryonics from a service (and technological) perspective.

So if it is to be considered as a criticism at all (and your comment seemingly supports the notion that it is), it's not simply a criticism of the cryonics industry, but of cryonics itself.

So? Why is her opinion on the technical feasibility or personal desirability of cryonics at all relevant to her claims of organizational or technical incompetence on the part of current cryonics organizations?

Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim? (for example, "a vascular surgeon that takes 30 minutes to cannulate a femoral artery is unqualified to perform surgery", with all the technical word's accuracy limited by my memory and my time writing this post- I am not a doctor)

If so, then something is rotten in the state of Denmark, regardless of who pointed it out originally.

Only accepting criticisms from true believers is a common cult failure mode, which I would strongly warn you against. It seems like someone on the cryonics side ought to double-check a few of her specific claims; does a case report she claims suggest incompetence contain the text she says it does? Do independent medical experts (just email twenty professors at universities, you ought to get at least one response) agree with a simplified version of the claim?

Yes. This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal ("it's just motivated cognition", "she has no plans to sign up") which really obviously dodges actually addressing the claims. Which are natural human reactions, but that doesn't make them good ideas.

Yes. This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal of the claims ("it's just motivated cognition", "she has no plans to sign up"). Which are natural human reactions, but that doesn't make them good ideas.

Is this reaction evidence against cryonics?

Against the technology, no (I'd say obviously not). Against the organisational robustness of present-day cryonics? I'd say it could well be. I suspect Charles Platt would agree.

(voted up as good question)

Upvoted. Did you check out the analysis by Freitas as well? Here's a link with some additional commentary by Dr. Wowk: http://www.imminst.org/forum/topic/45324-alcor-finances/

By the way, many of your posts are both enlightening and smile-inducing... and yet, I think I mocked you in the past (I think it was at Pharyngula). Since I suddenly feel guilty about this, I ask that you give me a downvote for atonement.

Again, why does it have to be evidence against cryonics instead of, say, Alcor or SA or CI? She's not discussing the theoretical desirability or practicality of cryonics.

The theoretical desirability and practicality of cryonics is what matters at this point. It's what the real controversy is about. If the given organizations are incompetent, they can be replaced with better ones. Or the people in them can be replaced. But, supposing that is necessary, we would need new people to replace them with. People who actually care about cryonics. Melody is not contributing to that cause, in my estimation. Rather she seems to be contributing to, and playing upon, the existing cocktail of mockery, misunderstanding, and marginalization that has plagued cryonics for years.

The theoretical desirability and practicality of cryonics is what matters at this point. It's what the real controversy is about.

Upvoted. But I'll still talk about organizational matters below :)

The thing I like about Mike Darwin is that he offers technical criticisms of cryonics organizations without resorting to threats of strict regulation. Of course, I understand there are people who do not think highly of Darwin, and condescendingly claim we are being duped by this "dialysis technician" (who then conveniently leave out that he received additional training from Jerry Leaf). Perhaps those people should inform David Crippen MD that he has been duped by Mike. David is with the Department of Critical Care Medicine at the University of Pittsburgh Medical Center, and Mike must have lied about his credentials when submitting to his book "End-of-Life Communication in the ICU: A Global Perspective"

Mike also probably lied to get into this debate too: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414041/

;)

With that in mind, since I deeply care about useful external criticism (as opposed to mainstream medicine's silent apathy... because they are still stuck at the starting line by thinking that immortality is some separate magical state of being...), I want Melody to continue with her more technical critiques. However, I do want her to drop her threats of strict regulation, unless she can find many people who have gone through all of the paperwork of signing up and suddenly proclaiming, "Oh my god. You mean to tell me that Atul Gawande is not going to be at my bedside?" I understand the need in politics to sometimes play hardball, but this is different.

I encourage Less Wrong users to look at the language being employed here. Dr. Wowk is saying things like "Mayo clinic" from a life-saving perspective. Melody is saying things like "last wishes," and emphasizing licensed embalmers. I do not feel comfortable with such language being floated around regulation that its (potential) members don't want. At all. If any Less Wrong users do want such regulation without even having the intent of utilizing cryonics, then.... well.... shoo, go away.

This is precisely what I would have thought advocates needed to be researching, and I'm amazed there's so far just been defensiveness, circling of the wagons and ad hominem dismissal....

As I've tried to explain, the entire line of criticism is based on a false analogy of cryonics to hypothermic medicine.

OF COURSE, if cryonics were an elective procedure in which a patient were to be cooled to +18 degC and heart stopped for brain surgery, you wouldn't use paramedics, scientists, or contract cardiothoracic surgeons who may or may not able to show up to do the surgery. OF COURSE, you would use a Certified Clinical Perfusionist to work alongside the surgeon, no exceptions. OF COURSE, any less qualified people are bound to make mistakes, and have made mistakes, mistakes that could be fatal in a mainstream medical setting in which someone was expected to be warmed right back up from +18 degC and woken up at the end of the procedure. OF COURSE, anyone with common sense (no independent medical expert needed) would say that! But that's not what cryonics is, or could be with any near-term technology.

Cryonics doesn't stop at +18 degC. The hypothermic phase continues down to 0 degC, and then the cryothermic phase down to -196 degC, doing injuries far beyond reversbility by mainstream medicine. Cryonics is an information preservation excercise at liquid nitrogen temperature, not an attempt to recover people in real-time from minor cooling in clinical settings. The procedures during the hypothermic phase aren't even the same in many major respects, but I won't bother getting into that.

Isn't anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures?? What medical standards or established specialties exist for that?

Isn't anyone else struck by the bizarreness of malpractice allegations that need to be vetted by hypothermic medicine experts for procedures that end with decapitated heads and brains likely fractured at liquid nitrogen temperatures??

No, why do you ask?

Be honest. Was your one-liner typed with the full understanding of his points on hypothermic vs. cryothermic phases? Or were you just participating in the Less Wrong zombie ritual of linking to other posts? Whatever the case, bring me the down votes on a silver platter :)

Mostly the latter. I see someone use the absurdity heuristic, my conditioning kicks in, and I link to the post about it.

As for the "hypothermic vs cryothermic" criticism, well, no, I don't see the difference. The less the damage that's done to our decapitated, frozen, fractured heads between clinical death and freezing, the easier it will be to recover the person from the corpse. As far as I can tell, an extra 30 minutes of decay at room temperature really could end up making a significant difference.

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.

the cryonics cause

Politics is the Mind-Killer.

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.

"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:

  1. SA underdelivers and overcharges for services, ("incompetence") while representing itself in a disingenuous and probably legally prohibited way.

  2. 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:

  1. SA underdelivers and overcharges for services, ("incompetence") while representing itself in a disingenuous and probably legally prohibited way.

  2. 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'.

In other words, we change the subject to:

while representing itself in a disingenuous and probably legally prohibited way.

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."

Someone who wouldn't use a service but criticizes it is more likely to be criticizing it because they don't like the idea rather than because they have concluded it's done poorly based on evidence. Obviously it doesn't make it certain that that's the case.

I disagree that Dr. Wowk has "nothing to gain by promoting or tolerating any culture of waste or procedural negligence." I think Dr. Wowk probably has HUGE professional and financial incentives, to defend the LEF-funded organizations and Alcor.

This is a specious argument. Plausible motive for defending organization X does not imply plausible motive for promotion/tolerance of supposed practice/culture Y within organization X.

Brian has actually provided a very solid motive for himself and other Alcor board members to oppose waste and procedural negligence. They are signed up for cryonics themselves. If there is too much waste or procedural negligence, they and people they care about could be harmed or killed.

lsparrish writes: "Brian has actually provided a very solid motive for himself and other Alcor board members to oppose waste and procedural negligence. They are signed up for cryonics themselves."

Luke may not know I was encouraged to sign up, while I was working at SA, to appease Saul Kent, so that I could be eligible for the management position. The person encouraging me knew I was not interested in being cryopreserved, at the time. In other words, I was encouraged to trick Saul Kent, the man responsible for funding our very-generous paychecks. I was even told Mr. Kent could, most-likely, be convinced to fund my insurance policy, if I were willing to sign up. Contrary to what, the very naive, Luke Parrish believes, being signed up is NOT "solid motive" for insuring the quality of cryonics services. (I do not mean to cast doubt on Dr. Wowk's sincerity, but only to point out the obvious flaw in Luke's logic.)

For anyone who is interested, I was not interested in my own cryopreservation, due to the gross inadequacies of the protocols, the equipment and the personnel. I don't believe anyone who has been cryopreserved, thus far, will ever be revived. I am not inclined to pay $60,000 for a quack like Catherine Baldwin, to make sure I am REALLY dead, by keeping me at relatively warm temperatures, while she bumbles around, for many hours, trying to perform a vascular cannulation. Nor am I inclined to pay $200,000, to Alcor, for what I consider to be grossly-inadequate services. It seems the people in control of cryonics organizations greatly-underestimate the amount of education and training required, to be a REAL vascular surgeon, or perfusionist. It is absurd, for cryonics organizations to think they can train laymen to perform the tasks of these professionals, by practicing on pigs in the back of a van, or even through their very infrequent human cadaver experiences.

SA and Alcor, can each afford to fund the salary of at least one full-time staff member competent in performing vascular cannulations, and one full-time staff member skilled in perfusion. That they do not do so, is only reflective of their extremely poor leadership. Of course, if they were to hire such medical professionals, for their staff, there would probably be a repeat performance of what happened, when I was at SA. The professionals would want to change things, which would set in motion tremendously-subversive efforts, on the part of the unqualified status quo, to maintain their positions and salaries. Either that, or they will hire medical professionals, who don't believe, for one second, that cryonics will ever work, but who are happy to "go along, to get along," since they see no harm in botching surgeries on the already-dead. Again, it all boils down to a leadership issue.

Finally, don't expect me to respond to the posts of Luke Parrish, with any sort of regularity. I have no time for someone, whose greatest contributions to these discussions are fantasies of how scientists of the future are going to repair the damage being done, by the crackpots of the present, or who has a habit of spewing forth uninformed criticisms of the critics of cryonics organizations. Besides, there's little hope of having a rational discussion with a boy who thinks a hydrogen atom, drawn on a piece of paper, is a real hydrogen atom. http://cryomedical.blogspot.com/2010/10/too-much-fantasy-not-enough-reality-in.html

For those of us who don't have any experience in this area, approximately how much would hiring "one full-time staff member competent in performing vascular cannulations" cost? How much would hiring "one full-time staff member skilled in perfusion" cost?

Alcor already employs a full-time paramedic with surgical training in large animal models to do vascular cannulations when it is possible to do so in the field. Cannulations at Alcor are typically done by either a contract neurosurgeon or a veterinary surgeon. I've written further details about who does surgeries at Alcor, and who has done them historically, here:

http://www.imminst.org/forum/topic/44772-is-cryonics-quackery/page__p__437779#entry437779

It's misleading for people to keep saying that Alcor sends out "laypeople" to do vascular cannulations.

The standard being applied to Alcor in recent criticisms is not just that people doing the cannulations be competent, or even have a medical credential, but that they should be the same professionals who do vascular cannulations for elective surgeries in tertiary care hospitals, i.e. cardiovascular surgeons. According to this website

http://www.studentdoc.com/cardiovascular-surgery-salary.html

the lowest reported salary for a cardiovascular surgeon is $351108 per year. According to this website

http://www.bestsampleresume.com/salary/perfusionist.html

the average salary of a clinical perfusionist is $122,000 per year. The sum of these two figures is approximately equal to Alcor's entire staff budget. Notwithstanding, a clinical perfusion credential was listed as a desirable qualification in Alcor's last clinical cryonics job ad. No perfusionists responded.

Surgeons and perfusionists employed full-time by a cryonics organization might only do a couple of cryonics cases per year, quickly losing their clinical-level skills, and employability outside of cryonics. The perfusionist making all these recent criticisms against cryonics, and insisting that full-time cardiovascular surgeons and perfusionsts be hired (not just contract ones), herself never had the opportunity to work on even one cryonics case during her entire employment at SA four years ago. Cases are that infrequent.

Dr. Wowk is misrepresenting the situation, yet again. It is not misleading to say Alcor has allowed laypersons to have performed vascular cannulations. Not only have they done so, but they have falsely referred to such people as “surgeons,” and even "Chief Surgeon," in their public reports, (something that is a violation of Arizona law). If they want to send a layman to do a surgeon's job, FINE...but, let them so note, in their case reports, and on their website!!!!!

Dr. Wowk also distorts the truth when he writes that recent criticisms (mine, I assume) call for cardiovascular surgeons, at a price of $351,108 dollars a year. Personally, I think if SA tried hard enough, for Ms. Baldwin’s salary, they COULD convince a retired vascular surgeon to move to Florida and do their few cases a year, but MANY times I’ve also suggested other persons, familiar with vascular cannulations, (such as embalmers, scrub techs, or physician assistants). The average embalmer’s salary, in Florida, is $43,171, as per this site: http://www.cbsalary.com/state-salary-chart.aspx?specialty=Embalmer&cty=&kw=Embalmer&jn=jn013&tid=2523&sid=FL , Does Dr. Wowk think a skilled embalmer wouldn’t love to have Ms. Baldwin’s six-figure salary-and-benefits package, and an easy caseload? Wasn't it an embalmer, not even employed by any cryonics organization, who had to perform the cannulation, for the Henderson case, because Ms. Baldwin could not do so, even in five hours time???

Dr. Wowk pretending SA and/or Alcor would have to pay $122,000, for a perfusionist is equally absurd, and has already been proven to be untrue. I am a perfusionist, and I worked at SA. My salary was $75,000 a year, and if it would not have been for the unprofessional and unethical activities, it would have been the highest-paying, least-demanding, job I had ever had! (Perfusionists who make the kind of salary Dr. Wowk quotes, work in demanding positions, doing MANY scheduled cases, AND getting called out in the evenings and on the weekends, on a regular basis.)

I could come and go, from the SA facility, as I pleased, and do whatever I wanted, as long as I did not complain about any of the totally absurd projects, (for which one of Dr. Wowk's peers was earning a whole lot of money!). As Dr. Wowk points out, I never even had to do a case. Who is Dr. Wowk trying to fool??? Many people would love to have a high-paying job, in sunny Florida, with so little to do, and so much freedom!!!

There was no supervision, at SA, for the most part. Some people punched in, and then left the building; some people played on the Internet, all day. If the surf came up, in Delray, some of the employees grabbed their surfboards, and left. When Bary Wilson (SA's manager, for a short time), complained about not being able to complete projects, because no one was ever there at the same time, (even in the middle of the day), they banded together and got rid of him. It was a total, and absolute joke, and not one meaningful thing was being accomplished. (Bill and Saul seem to be clueless, as to how much they have been taken advantage of.)

Dr. Wowk's facility might be doing some valid research, but the "research" at SA consisted of things like seeing how many tens of thousands, or hundreds of thousands, of dollars one could spend on "reinventing the wheel." Want to buy a reasonably-priced, professionally-built cooldown and transport box, from a company that had specialized in cryogenic containers, for many years? Forget it. SA's answer to something like that was to run out to Home Depot for materials, and engage in endless email discussions, (with Dr. Wowk, and others), in regard to the project.

Dr. Wowk is just making excuses, including those about professionals losing their skills, due to the low frequency of cases. People who have been performing cannulations, or perfusion, for many years, don't just forget how to do those things. Even if their skills get "rusty," they would certainly be preferable to laymen, who have only practiced on a few pigs, in the back of SA's van. It's insane, and I don't understand how any reasonable person could defend such activities. It seems dishonest for Dr. Wowk to pretend money is the primary issue, here, when most, (if not all), of the salaries at SA, are significantly more than salaries earned by paramedics, nurses, and other medical professionals.

Finally, Dr. Wowk misses the key point…that being HONESTY. If SA is going to send golf pros, metal fabricators, and other laymen to perform their procedures, THEY SHOULD JUST SAY SO, ON THEIR WEBSITE, AND IN THEIR CASE REPORTS. Not disclosing that information, and writing case reports in a manner intended to deceive the public into believing their cases are being performed by competent medical professionals is DISHONEST. Dr. Wowk wrote, (in another post), that SA’s manager, Catherine Baldwin, did not refer to herself as a “credentialed surgeon.” Does Dr. Wowk think the readers of lesswrong are unintelligent??? I'm sure most intelligent people are able to ascertain that, when someone fills a report with medical jargon and refers to “surgeons” and a “backup surgeon,” their intent is to deceive the reader into believing qualified medical personnel were present. It's ridiculous for him to maintain that it was acceptable for Ms. Baldwin to refer to herself as a "surgeon," because she did not place "credentialed" in front of it.

Do what you want, at Alcor and SA, Dr. Wowk, but at least be honest about it!!!

I'm sure most intelligent people are able to ascertain that, when someone fills a report with medical jargon and refers to “surgeons” and a “backup surgeon,” their intent is to deceive the reader into believing qualified medical personnel were present.

The other explanation would be that she was honestly concerned for the image of the company and did not think things through as to whether this would be deceptive or not.

Assume good faith. Why not? Most people are neither particularly malicious nor particularly stupid, but are subject to the same standard cognitive biases that every other human is.

Besides, there's little hope of having a rational discussion with a boy who thinks a hydrogen atom, drawn on a piece of paper, is a real hydrogen atom. http://cryomedical.blogspot.com/2010/10/too-much-fantasy-not-enough-reality-in.html

(Edited in response to downvotes.)

Consider this. You are attacking me based on a misunderstanding of something I said on another forum, on an unrelated topic. I think this is questionable debate ethics at best.

In a nutshell, my position in the argument you reference is that a description is a real entity, and in Robert's hypothetical example he described something exactly equivalent to an atom at a moment in time. At the level of abstraction he was talking about, the atom was a real atom to the exact same degree and for the exact same reasons that a physical atom (in a given instant of time) is a real atom. Your comment about atoms exploding and undergoing fission because of the paper being torn makes no sense in the context of the argument I was making. The paper is not a part of the framework in which it makes sense to think of the atom existing, nor is the atom undergoing time in the same framework as the paper.