The Ethics of Cryonics

by Francesca Minerva

  At the moment, only a few hundred people are cryopreserved, and no attempt has been made to revive any of them so far. This is because the technology required to revive them is not yet available, and we do not know if it will ever be. However, as is often the case, the theoretical discussion of a technological innovation precedes its actualization, and the debate about cryonics and its implications has been going on for decades despite the technology itself being far from fully developed or available. At this point, if concerns raised are outstandingly negative, the development of the technology could be paused or even stopped. This is what happened, for instance, with human cloning technology: when the birth of Dolly the sheep, the first mammal to be cloned, was announced to the world on 3 February 1997, the public soon became preoccupied with the possibility that such technology would someday lead to attempts at cloning humans. Even though there was no short-term plan to clone a human being, the concerns expressed by a large part of the public and by many experts led to a ban on human cloning in many countries around the world (Pattinson & Caulfield, 2004).

  Public Scepticism Towards Biotechnology

  It is not surprising, then, that the debate around the ethical implications of cryonics dates back as early as 1962, when Robert Ettinger—later known as “the father of cryonics”—first presented the idea in his book The Prospect of Immortality (Ettinger, 1962). Since then, the debate has proceeded rather slowly, owing perhaps to its widespread perception as unfeasible and remote—in contrast to IVF and human cloning, both of which have tended to produce more tangible results—but possibly also due to cryonics researchers being stigmatized for their work (Topping, 2016). Just as EC was initially met with suspicion and fear, the prospect of human cryosuspension after legal death is not usually viewed with much warmth and favour. Indeed, if anything, it is generally met with even greater hostility and/or incredulity than IVF was.

  These days, IVF and EC are largely accepted. But when they were first introduced, most people were either sceptical of or outright opposed to the use of such technologies as a means to bring new humans into the world (Singer & Wells, 1983). We will now consider some of the most common arguments used against IVF and many new biotechnologies in general, as they provide a good indication of what arguments might be used against cryonics qua technology that attempts to interfere with something as central to humans as death.

  Against Nature

  One popular objection to IVF , also used against many other new technologies when they are first introduced, is based on the argument that we have a moral duty to follow nature. This argument, in turn, stems from the belief that we can, by observing how things are, deduce how things should be (a textbook case of what is known as the naturalistic fallacy). According to this argument, since humans have always reproduced through sexual intercourse, they also ought to continue to reproduce only through sexual intercourse, because there is something intrinsically good in natural processes.

  Before discussing what is wrong with this type of argument, it is interesting to note that the force of arguments based on “nature” often seems to depend on the perceived “novelty” of a certain technology, that is, on whether and to what extent people are accustomed to it, rather than on whether the technology actually goes against what is perceived to be “natural”. For example, this argument seems to hold much less force now, 40 years after the first IVF baby was born, than it did when IVF was first introduced to the public. These days, the technology has largely lost its novelty in the public eye, and so naturalistic arguments are often seen as outdated. In general, such arguments are often abandoned after some time, as people gradually become more accustomed to the technology in question. Eventually, something newer appears on the horizon, and the original technology ceases to be considered novel and controversial.

  We can see how the same argument could be used against cryonics: to die is part of the natural cycle of life, hence we ought to die; therefore, trying to cheat nature by using preservation in liquid nitrogen to pause the process of dying must be immoral.

  There is, however, at least one major problem with arguments based on the supposed moral superiority of the natural over the unnatural: the difference between natural and unnatural is far less obvious than one might think. As J.S. Mill (1874/2009) explained: “Nature in the abstract is the totality of the powers and properties of all things. ‘Nature’ means the sum of all phenomena, together with the causes that produce them; including not only everything that happens but everything that could happen.”

  If, as Mill suggests, “nature ” is the sum of all phenomena and their causes, then everything—including humans and their technology—must be part of nature. What is produced by humans, and is commonly defined artificial, cannot be produced by anything but natural forces. In other words, what we define as artificial is not the creation of something new, but merely the rearrangement of what is already found in nature, according to nature’s laws: “[T]he role of man is a very limited one; all we do is to move things into certain places. By moving objects we bring separated things into contact, or pull adjacent things apart; such simple changes of place produce the desired effect by bringing into play natural forces that were previously dormant” (ibid.). If everything is necessarily natural, then IVF and cryonics must be natural, too.

  One could reply that “natural” refers to anything that was not created by humans. This presupposes that humans are the only beings in nature with the power to transform what is natural into what is artificial. According to this view, then, things like oceans, supernovae, and the Ebola virus are natural, whereas things such as lasagna, houses, and antibiotics are unnatural.

  The problem with this distinction between natural and artificial is that, when used as an argument to support the superiority of the former over the latter, it necessarily winds down to extreme or inconsistent views. Since even the simplest forms of human technology would be “unnatural” under this definition, living “naturally” would mean eschewing such basic things as clothing, buildings, agriculture, and even simple tool use. One would have to live naked in a cave, eating only wild fruits and seeds and whatever small animals they managed to catch with their hands. Given such extreme implications, it is understandable why supporting a similar view leads almost necessarily to inconsistencies. The same people who would oppose IVF or cryonics on the basis that they are not natural tend, like most of us, to enjoy living in the comfort of their houses and rely heavily on the use of their personal technology.

  Moreover, to say “all that is natural is also good” is plainly false. Tsunamis are entirely natural phenomena, yet we would not say that the 2004 Indian Ocean tsunami, which killed up to 280,000 people, could be considered good.

  Humans Should Not “Play God”

  Another common form of objection to new reproductive technologies, and biotechnology in general, is based on the argument that “we should not play God.” This objection is often applied to human interventions that appear to deviate from the plan or will of some religious deity. Like objections based on the naturalistic fallacy, the “we should not play God” objection tends to get abandoned after enough time has passed and the fear of novelty has faded away. This kind of objection has been used throughout history in opposition to all sorts of things: eyeglasses, contraception, abortion, IVF techniques, euthanasia, cloning, and genetic engineering, to name but a few. Needless to say, tampering with death—as cryonics aims to do—also falls among activities considered to be God’s prerogatives.

  Much like the naturalistic argument, the “playing God” objection is used quite inconsistently by its advocates. Consistency dictates that both objections should also be used against many forms of life-saving medical treatments, spanning from antibiotics to intensive care units (ICUs ); yet proponents of both naturalistic and “playing God” objections are generally silent on such matters.

  Weirdness and Repugnance

  New forms of technology are often seen as “weird”, sometimes even “gross”, p
resenting another class of arguments against IVF and other biotechnology. Such arguments are rarely given on their own but, instead, tend to be paired with arguments of the “unnatural” or “playing God” kind. According to this view, the fact that something “feels” weird or evokes a disgust reaction should be considered symptomatic of it also being immoral. For instance, philosopher Leon Kass (2001) has argued that:[R]epugnance is the emotional expression of deep wisdom, beyond reason’s power fully to articulate it … repugnance may be the only voice left that speaks up to defend the central core of our humanity. Shallow are the souls that have forgotten how to shudder.

  So, consistently with this view, the fact that some people have a yuck reaction to the idea of suspending human bodies and disembodied heads in vats of liquid nitrogen for future revival should be considered proof that cryonics is immoral. But arguments based on gut reactions are hardly a good guide to morality.

  Repugnance can be plainly irrational (I find olive pits repugnant, but this does not make olive pits immoral) and also heavily influenced by cultural influences or individual predispositions. For instance, the idea of transplanting a human heart—commonly portrayed as the seat of emotions—seemed both weird and repugnant when it was performed for the first time in 1967. Similarly, IVF was seen as weird and yucky for at least a decade after its introduction. And yet, few people today consider heart transplants or IVF “yucky”. If we had given in to the gut reactions of the time, hundreds of thousands of people would have died because of diseases curable with organ transplants, whilst many others would not have been born at all because of infertility.

  So if history is any indication, it seems that trusting our gut reactions is not wise. Indeed, if anything, we have learnt that disgust can be a very misleading guide to morality.

  Uncertainty

  Objections to new technologies based on uncertainty are very common. We easily get worried about the possible negative effects of a new technology.

  Perhaps the best example is that of genetically modified organisms (GMOs ). Soon after the first GMO tomatoes arrived on the market in 1994, the new products were met with numerous objections from the public. People were worried about GMOs causing all sorts of diseases, or claimed it was some sort of disgusting “Frankenfood” that would contaminate and then destroy all the natural, nutritious, good old-fashioned crops in the world. More than two decades and hundreds of studies later, it is clear that most GMOs , and certainly those present on the market, are not harmful to human health, have no noticeable difference in taste from other foods, and do not destroy natural crops (Nicolia, Manzo, Veronesi, & Rosellini, 2014).

  Admittedly, though, arguments from uncertainty should not be discarded too lightly, as it is often difficult to predict the effects that a new medical procedure will have on the individuals undergoing it. Caution is always recommended, and adopting the precautionary principle might sometimes be the most rational strategy. Unfortunately, empirical uncertainty can only be overcome through experimentation. For instance, we know now that children born through IVF , with or without EC , are as healthy as children conceived naturally. Of course, given that the first person conceived through IVF , Louise Brown, is only 40, there is still a chance that IVF will turn out to have devastating epigenetic effects that only appear past the age of 40. However, this possibility currently seems vanishingly small, and it appears far more likely that people born through IVF are, indeed, just as healthy as naturally conceived ones.

  Similarly, there is empirical uncertainty about the effects of cryopreservation of adults. We do not yet know whether this process would have any adverse effects or the extent and the nature of such effects. For instance, it is possible that cryopreservation would cause major disabilities, or permanent amnesia. The range of possible side effects is enormous, but it is also possible that cryopreserved people will, just like people born from cryopreserved embryos, turn out to be healthy. Whether or not we should proceed with cryopreservation in spite of this uncertainty depends on whether it is prudent, rational, and ethical to adopt a precautionary principle. Although we will not go into detail about the precautionary principle, it should be noted that if the principle had been rigorously applied to every new technology in the past, we would not have many of those technologies today (including IVF and EC ). Perhaps this consideration is sufficient to justify proceeding with research on cryopreservation despite the risks, albeit with a cautious attitude.

  Other objections to new reproductive technologies were based on uncertainty around the religious issue of when one’s soul enters one’s body, known as ensoulment. According to some religious traditions, notably that of the Roman Catholic Church, ensoulment happens at the moment of conception.5 Given that fertilized eggs and embryos can be cryopreserved for a long time before being implanted and actualizing their potential to become a baby, a dilemma has arisen regarding what happens to the soul during the intervening time between the conception and implantation of the embryo. This question is particularly worrisome when one considers embryos that are conceived and cryopreserved, but never get implanted. Destroying these embryos might be considered morally equivalent to performing an abortion or a homicide, but leaving them in liquid nitrogen for decades or possibly centuries poses difficult questions about the status of their souls.

  Cryopreservation of adults poses a similar problem: according to some religious views, when people die, their soul leaves the body and joins God in Heaven or some other spiritual dimension (if they have behaved well, that is). It is unclear what would happen to the soul if the individual were cryopreserved in view of someday being revived, instead of being buried or cremated. If the soul left the body before cryopreservation, then unless it somehow returns to the body from Heaven once the body is revived, it appears the revived person would find themselves without a soul upon revival.6 If the soul instead remained attached to the body, but it turned out that revival of cryopreserved people is never feasible after all, the cryopreserved individual would be deprived of the chance to spend eternity in Heaven. Immortality, whether preceded by cryonics or not, in general poses some similarly difficult issues (we will return to this in Chap. 4); for example, if the soul is immortal and life on earth is only a brief transition towards spiritual eternity, then physical immortality opens a series of difficult issues.

  Only the Rich Will Be Able to Afford It

  A common concern about the development of new technologies is that since they are usually quite expensive upon commercialization, only rich people will be able to afford them, thereby causing the inequality between the rich and the poor to increase. This was indeed a concern also when IVF was introduced, because it was feared that only rich infertile people would be able to have children, whereas poor infertile people would not have the same option. Since having children is often a profound desire, and some people experience deep emotional distress because of their infertility, it is quite clear why the prospect of IVF raised some serious concerns with respect to fairness. IVF is now often supported by the public health system, and although it is usually not fully covered, it is generally affordable to anyone with the financial means to support a child in the first place.

  But if inequality issues arise when it comes to procreation, they are more powerful when it comes to matters of death. If only the rich can afford cryonics, then being poor will be incomparably more disadvantageous than being rich, as it would suddenly make all the difference between living a normal lifespan and living, potentially, indefinitely.

  One common counterargument is based on the fact that the price of new technologies tends to decrease over time. Computers, for instance, were originally very expensive, but nowadays one can buy a cheap one for a few hundred dollars. It is likely that cryonics, too, would become cheaper over time, following the usual declining cost trajectory of other (bio-) technologies.

  Today, the cost of cryonics is not negligible, and it is surely not affordable by everyone. However, there are insurance companies that cover cryonics
costs for fees between $30 and $100 per month. One cryonics provider, Alcor, offers full-body cryopreservation at a price of $200,000, while their competitor the Cryonics Institute charges around $28,000 for the same deal. Unlike Alcor, however, the Cryonics Institute does not include the cost of transportation to the cryonics facility, which can amount to as much as $90,000 (depending on the distance between the place where the person is declared legally dead and the cryonics facility). So all in all, if one decides not to pay the subscription upfront in favour of a monthly fee to an insurance provider, cryonics can already be afforded by not only the rich, but also people with a middle-class income.

  Of course, people who live around or below the poverty line would not be able to invest $30–$100 in cryonics every month, so there would still be large parts of the population who could not afford it. The fact that so many people in the world still live in a state of poverty is, without a doubt, one of the greatest tragedies of our time; but while it is important to remain vigilant with respect to new sources of inequality and try our best to avoid worsening the current situation, focusing on just one potential source of inequality is not particularly useful. It is true that if cryonics were so expensive to be affordable only to very rich people, so that they would live much longer than poor ones, cryonics would end up increasing the current inequalities between the rich and the poor. However, there are many other factors that increase such inequalities. Compared with the poor, rich people have access to better healthcare and nutrition, and seem, on average, to be healthier overall. Indeed, rich people already live longer than poor people, and cryonics would only exacerbate this inequality without compensating for it in some other way.