The Ethics of Cryonics

by Francesca Minerva

  4It should, of course, be noted that views on the eternal life of the soul differ greatly between the Abrahamic religions and Hinduism.

  5By tiredness I mean a sense of psychological or physical exhaustion.

  Part III

  Alternative Uses of Cryonics

  Introduction

  In Part I of this book, we focused on the pros and cons of cryonics as a potential means of giving legally dead people another chance at life. We saw how cryonics holds up to various common arguments against similar technologies that society has dealt with through the years, and we identified some novel issues raised by cryonics in particular. In Part II, we discussed cryonics as a step towards radical and potentially indefinite life extension. We took a critical look at the badness of death in general, and saw how death can be considered harmful to anyone regardless of their age. Building on this conclusion, we then considered the pros and cons of immortality without ageing. We found that, although there are good reasons to believe that an indefinitely long life might be undesirable, there are equally good reasons to think that the current human lifespan is too short, and that we should at least try to extend it.

  In this third and final part of the book, we will focus on the potential use of cryonics as a means of bypassing moral conflicts about two highly divisive medical practices in our society, namely euthanasia and abortion. The profound ethical disagreements about each of these practices arise from the fact that they both cause the death of a human being.

  In the case of euthanasia, the human being in question is a person who is experiencing prolonged, incurable, and unbearable pain, and whose chances of recovery or relief are vanishingly small. People in these situations often find that the value of their life is negative, and that they would prefer to die rather than continue to suffer.

  In the case of abortion, the human being in question is an embryo or a foetus developing in the womb of a woman who is either unable or unwilling to bring that human being into the world, and hence seeks to abort it. Her reasons for doing so might include wanting to spare the prospective child a life in suboptimal conditions, either because she would be unable to provide adequate care herself or because the foetus or embryo is affected by a medical condition that would cause severe disabilities; or she might simply not want to raise a child at that particular time, or at all, and instead devote her time to other pursuits.

  I will argue that cryopreservation could provide a good alternative to both euthanasia and abortion , as it would achieve the desired result in each case, yet eliminate the necessary death of a human being by replacing an irreversible act with a reversible one. Cryonics would thus offer the advantage of reversing the decision to euthanize or abort, if and when circumstances are more favourable. In particular, it would allow a person who would choose cryothanasia (instead of euthanasia) to come back to life in case an effective therapy for their condition were to be found in the future, and it would allow a woman who chose to have a cryosuspension of pregnancy (instead of a termination of pregnancy) to reimplant the foetus if the circumstances that discouraged her from continuing the pregnancy were to improve. In the next two chapters, we will explore arguments in support of the thesis that cryothanasia would be a better option than euthanasia, and that cryosuspension of pregnancy would be a better option than abortion .

  © The Author(s) 2018

  Francesca MinervaThe Ethics of Cryonicshttps://doi.org/10.1007/978-3-319-78599-8_5

  5. Cryothanasia

  Francesca Minerva1

  (1)Philosophy and Moral Sciences, University of Ghent, Ghent, Vlaams Brabant, Belgium

  Abstract

  Most objections to euthanasia are based on the moral principle that killing an innocent person is wrong. This principle also applies to cases wherein people ask (for help) to die in order to avoid unbearable, intractable, and incurable pain. It has been suggested that such patients could be offered an alternative in which they are cryosuspended immediately after their (legal) death has been medically induced. Such “cryothanasia” would allow them to be stored indefinitely with a non-negligible chance of being revived in a more medically advanced future. Since cryonics ultimately seeks to preserve and extend lifespan, these cryothanasia patients would, in effect, be choosing to die in order to (hopefully) live longer in the future. This chapter argues that classical objections to euthanasia, based on the principle that it is always morally wrong to kill an innocent person, cannot be used to oppose cryothanasia.

  Keywords

  EuthanasiaCryothanasiaDeathCryonicsAssisted suicide

  Euthanasia is any medical procedure wherein the explicit goal is to mercifully and painlessly end a patient’s life in order to avoid unbearable suffering brought on by a (usually terminal) medical condition, upon a patient’s request. The term is normally divided into two distinct types of cases. In the case of active euthanasia, a physician carries out the lethal procedure at the patient’s request. In passive euthanasia, medical treatment is withheld or withdrawn from a patient, upon the patient’s request, with the intention of shortening the patient’s life (Giubilini, 2013); When referring to “euthanasia ”, broadly understood, I will also include the practice of assisted suicide, wherein the patient carries out the lethal procedure on themselves, albeit with the help and supervision of a physician who provides the necessary medical assistance (and, of course, always at the patient’s request).

  As of 2018, active euthanasia is only legal in the Netherlands, Belgium, Luxembourg, Canada, and Colombia, whereas assisted suicide is legal in Germany, Switzerland, Japan, and seven US states (Washington, Oregon, California, Colorado, Montana, Vermont, and Washington, DC). Patients in these countries who experience prolonged and incurable suffering can request to hasten their own death in a controlled manner. Such requests are only granted as a last resort after the patient has already gone through all standard treatments for their condition, and there are regional variations around what conditions are seen as sufficient grounds for euthanasia .

  The goal of euthanasia is to stop unbearable and intractable suffering, hence the colloquialism “putting someone out of their misery”. Patients who request euthanasia do so out of an overwhelming desire to be relieved of severe pain—whether physical, psychological, or both—and after concluding that currently available therapies are inadequate. Realizing that continuing their life will almost certainly imply never-ending misery, these patients then opt for death as the only available alternative. The fact that ending their plight at that point necessarily includes ending their life is, by and large, an unfortunate side effect: if it were possible to end the suffering (either physical or psychological) without ending the life, of course euthanasia would not be a rational or an ethical option. So, if there were some way to relieve these patients of their suffering without simultaneously causing them to die, we can reasonably assume that the vast majority of them would consider it a preferable option. It is easy enough to imagine such options coming into existence at some point in the future, and we can draw on historical examples for inspiration. Advancements in medical science have helped ensure a decent quality of life for patients with conditions that, until recently, were seen as more or less synonymous with misery. Minor injuries and infections were often fatal before the advent of modern evidence-based medicine in the late nineteenth century, and those lucky enough to survive were often left with lifelong complications and chronic pain; migraines, cluster headaches, and other neurological pain disorders only became treatable in the early twentieth century; and there were practically no effective treatments for severe psychiatric disorders before 1950. Hence, it is reasonable to assume that among today’s most painful and intractable medical conditions, at least some will become treatable in the future. In other words, at least some of today’s euthanasia patients would find their prospects improved if only they could stick around for a few more years or decades. Of course, this is old news to those who opt for euthanasia . When a patient’s suffering becomes so unbearable that they
consciously decide to end their life, they simultaneously give up on waiting for a better alternative.

  In a paper I co-authored with Anders Sandberg, we discussed what kind of alternative could technology provide to people who find themselves in such a difficult situation (Minerva & Sandberg, 2017). The answer we came up with was cryothanasia: a hypothetical future procedure with the explicit goal of painlessly pausing (rather than ending) the life of a patient who would otherwise satisfy the conditions for receiving euthanasia , in the hope of someday being able to resume their life, cure their condition, and enable them to live a full life.

  By undergoing cryothanasia, a patient practically leaves open the possibility that there will be at some point an alternative to death available to him or her, and therefore the intention behind cryothanasia is not that of ending one’s life in order to avoid suffering, but that of postponing the end of one’s life until suffering could be avoided without procuring death.

  The terminological choice of the word cryothanasia means, from a merely linguistic point of view, the loss of the eu- (“good”) component of the concept of euthanasia , which refers to a kind of death that is good for the patient. Now, the terminological choice might not be seen as very appropriate, given that I have specified that the patient undergoing cryothanasia does satisfy the conditions for receiving euthanasia , and therefore the procedure is meant to be good (eu-) for the patient by terminating a condition of untreatable prolonged unbearable suffering. However, I want to stick with the term cryothanasia (that I chose together with Anders Sandberg) because it effectively conveys another important meaning, namely that the outcome is not death, as the term -thanasia implies, but something different, which is achieved through cryonics rather than by an act of merciful killing. While we could therefore consider other terms such as “cryodeath”, “pseudodeath”, or “cryocide”, as suggested by Ole Martin Moen (2015), I prefer to use the term cryothanasia because its assonance with euthanasia reminds us that it is a procedure that is always done in the interest of the patient undergoing it.

  Apart from the general implications of cryonics covered in the rest of this book, what makes cryothanasia especially interesting from an ethical standpoint is that it appears to circumvent many of the most frequently cited arguments against euthanasia . Perhaps most notably, if one believes that the fundamental goal of any medical practice should be to improve health and extend life, then euthanasia clearly falls outside the domain of morally acceptable medicine (since it aims at killing the patient). But since the goal of cryonics is to greatly improve health and lifespan, and cryothanasia would improve its chances of success, then it becomes very difficult to argue that cryothanasia is impermissible on the same grounds as traditional euthanasia (Shaw, 2009).

  Cryothanasia is ethically different from euthanasia in many other important respects. This leaves objections to euthanasia largely inapplicable against cryothanasia. Hence, valid objections to cryothanasia must rely on some set of reasons that do not concern traditional euthanasia , which I will explore in the latter part of this chapter.

  We can now turn to an ethical analysis of cryothanasia. I will do this in two ways. First, in light of the characterization of cryothanasia and of its differences with euthanasia I have offered above, I will rely on the standard objections commonly raised against euthanasia . As we shall see in the next section, the differences between cryothanasia and (certain types of ) euthanasia which have emerged in this section imply that even if we assume—for the sake of argument—that the standard objections to (certain types of) euthanasia are valid, they do not imply the moral wrongness or badness of cryothanasia, and actually imply that cryothanasia is morally preferable to euthanasia . Second, I will consider a few other possible objections to cryothanasia that are independent from the standard objections to euthanasia, and I will show that even this second group of objections is not strong enough to make cryothanasia a morally impermissible enterprise.

  Objections to Euthanasia Applied to Cryothanasia

  We will now review the most common arguments against euthanasia and the degree to which they also apply to cryothanasia. As we will see, cryothanasia tends to escape such arguments.1

  Deontological

  By “deontological” objections to euthanasia I mean objections that appeal not to the badness of the outcome in itself, but to the intrinsic wrongness of the act itself or of the reasons, intentions, or motivation with which the act is carried out. There are two main types of deontological objections to euthanasia: one based on the moral relevance attributed to the distinction between acts and omissions and one based on the moral relevance attributed to the distinction between intention and foresight, which in turn is grounded on the so-called doctrine of double effect (DDE ). Let us consider these two types of objections in order to see whether they apply to cryothanasia.

  Let us start from a moral distinction that many people draw between active and passive euthanasia. It is held by some that active euthanasia is immoral because it actively causes the death of a person, as opposed to passively allowing a person to die. This objection is based on the belief that acts (or actions) carry more moral weight than omissions. In the context we are examining, this means that causing the death of a person is morally unacceptable, while failing to prevent that same person from dying naturally is morally acceptable—or at least less wrong than active euthanasia.

  Assuming that the distinction between actions and omissions does carry a moral weight such that passive euthanasia is indeed morally different from active euthanasia, the reason why the act in question is considered bad or wrong is that its outcome, namely the death of a patient, is considered necessarily something morally bad. But the outcome is different in the case of cryothanasia and of euthanasia. Whereas euthanasia causes certain death, cryothanasia only results in a possibility of death. Surely, the ideal alternative to certain death would be an act that restores health and allows the patient to keep living right away; but in the absence of such alternatives, reducing a certain death to an uncertain chance of death is an improvement, if only a small one, and indeed something morally preferable on any plausible conception of morality (Shaw, 2009).

  Another common objection to euthanasia is based on the DDE . In short, DDE states that if a certain action has two outcomes, one of which is good (e.g. the end of suffering) and the other one is bad (e.g. death), then the action is only permissible if the bad outcome is not intentionally used as a means for the good outcome, and the badness of one outcome is proportionate to the goodness of the other outcome, and if the action itself is not intrinsically morally wrong. The DDE belongs to the Thomistic tradition and is typically embraced by the Catholic Church . In the case of euthanasia , even though the intended goal of relieving suffering is beneficial, the act of killing is morally bad. Hence, doctors operating under DDE normally do not condone euthanasia (although they may condone what is sometimes referred to as “palliative sedation”, i.e. giving patients doses of sedatives and/or analgesics that would foreseeably hasten death, as the act of administering such drugs to relieve pain is morally neutral and the intention is that of relieving pain, not killing the patient).

  Cryothanasia more closely meets the requirements of the DDE criteria. The action, a hopefully reversible and (hopefully temporary) pausing of life, is arguably not as wrong as the killing of a person even on moral views that consider killing an innocent man always morally wrong. It has two goals, relieving pain and extending life, each of which is beneficial. One could argue that the procedure itself is impermissible because it entails a risk of death, which would be a bad outcome, and the intended benefit does not outweigh the risk of cessation of life. However, even if that was the case, death or risk of death is an unintentional side effect of the procedure, and not—as in the case of euthanasia —the intended outcome. Granted, one could argue that (hopefully temporary) pausing of life is somehow inherently bad, but it is not clear how one would convincingly explain where this inherent badness stems fr
om; it might be wrong to artificially keep a person unconscious because that would temporarily deprive that person of a potentially meaningful life, but it is not clear how this would be different from normal general anaesthesia.

  Thus, we can conclude that the standard deontological objections against euthanasia do not apply to cryothanasia.

  Faith-Based

  Western religions tend to judge euthanasia on a basis similar to that of DDE : they consider the relief from suffering a good thing or at least not a bad thing2 unless it is achieved by killing the patient, which, if the patient is an innocent person (which he or she will likely be), is always morally wrong. In addition to how cryothanasia avoids DDE , as stated above, it is possible to argue that cryothanasia is not about relieving suffering per se, but rather about avoiding death. Although many religious and secular views do place some positive value on death (whether instrumentally, for instance, as a means of getting to the afterlife, or intrinsically) they tend to view premature death as largely negative, and most prohibit seeking death in all but extreme cases (such as martyrdom). Moreover, even if one believes there is something valuable to be learned by enduring terminal suffering, it would nevertheless seem that a person would have the time to learn much more if they were able to live a full life, especially after a brush with death.

  Another religiously based objection argues that life is a sacred gift from God , and that humans have a duty to respect and protect life at all cost. In this view, euthanasia is a sacrilege no matter how badly one is suffering. Cryothanasia, however, seeks to preserve and ultimately prolong life in cases where the only alternative is suffering followed by certain death. Hence, one could argue that cryothanasia not only respects the sanctity of life, but actively demonstrates a profound personal dedication to it. Or at the very least, cryothanasia is not significantly different from all other medical interventions that seek to prolong life, which are normally not condemned by religions (unless the treatment is considered futile) and which indeed are often actively supported by religious doctrines, such as in the case of life-prolonging treatments on a terminally ill patient. There is, of course, still a risk that revival will not succeed, in which case cryothanasia amounts not to a case of euthanasia , but rather a case of inadvertent death during a medical procedure intended to save the patient. The risk would thus be comparable to the risks associated with complex life-saving surgeries or experimental cancer treatments, which are generally considered acceptable under mainstream religious views (Bridge, 2015).