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Day two of the Alcor Conference. The day began with the “Human Cryopreservation and Critical Care Medicine Panel,” including Alcor’s Tanya Jones, critical care physician David Crippen and bioethicist Leslie Whetstine and moderated by Aschwin de Wolf.

[Recap]

The panelists discussed the various definitions death, including legal and biological, and the ethical issues of cryonics. A diagnosis of brain death is required for organ procurement as well as cryopreservation, but determining death is difficult. There are several steps within brain death and it is difficult to determine exactly what part of the process a brain may be in at any particular time. These difficulties and complexities require negotiation between hospital and Alcor personnel, and there are similarities and differences with organ donor requirements.

Alcor prefers the pronouncement of cardiac death over a pronouncement of brain death. Whetstine argued, however, that cardiac death is problematic. If the heart is dead, but the brain is not, and as technologies improve, then this could lead, according to Jones, to a time when the first steps of cryopreservation will transition from an after-death procedure to a medical procedure requiring trained medical personnel.

[Commentary]

The inclusion of a bioethicist in the panel added some drama to the proceedings. Whetstine appeared to be arguing (and this is a vast oversimplification of her argument) that it is okay to declare someone dead if their heart stopped, but it is wrong if you then want to cryopreserve the patient.

So when is a patient dead? When is it okay to cryopreserve them? Right now, Alcor must work within a legal and cultural framework that does not view cryonics as feasible and where the definition of death is changing. Jones said she believes Alcor will need to go on the offensive based on positive results, instead of waiting to be attacked. Whetstine was argumentative, but I found her arguments unclear. She obviously finds cryogenics problematic, but she kept repeating things like “but then they are not really dead” and “that is not death.” She works on the definition of death and believes it needs to be changed.

Some Alcor members were concerned about how their own personal wishes would affect decisions made upon their death. Crippen felt that physicians generally honor their patients wishes, but Whetstine felt patients’ consent should not be part of a declaration of death. Crippen said Alcor members need to get over thinking of consent as something that trumps legal and cultural issues.

Both Jones and Crippen believe that the framework will need to change for cryonics to be more acceptable. Alcor, said Jones, must be open about their arrangements to ensure a more positive future for Alcor.

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Stephen Van Sickle, Ralph Merkle, Michael R. Seidl, and Brian Wowk of the Alcor Board of Directors answered questions from the audience for the last session of the day. The Board addressed questions about the current state of Alcor finances. Alcor is financially stable, with the following sources of income:

• 1/3 membership dues
• 1/3 bequests and estates
• 1/3 grants and donations

At the current number of members (approximately 800) Alcor cannot support all the efforts it needs to support. Employees must wear many hats to cover all the administrative and technical tasks required. Better fund-raising was a popular suggestion for improvement by Board members.

“Alcor will aways muddle through,” said Van Sickle, stressing that this was both a strength and a weakness.

Maintenance costs are expected to remain stable over the next few decades, but operations costs are generally less stable. With more members, Alcor could see economies of scale, but exactly how does Alcor gain new membership? Rudi Hoffman, a certified estate planner who helps people secure the necessary level of life insurance to cover the Alcor fees, suggested using the Internet and mapping, with their permission, local Alcor members so that prospective members can contact them for more information.

Alcor does not intend to open up voting for choosing directors to the membership (this in response to a member question submitted to the conference emcee Susan Fonseca-Klein.)

Van Sickle briefly discussed a wealth preservation trust that would better protect a member’s estate upon their death. Alcor’s lawyers are trying to develop this type of arrangement, but it may take many years before it becomes available as an option.

[Commentary]

A minor few members were relatively emotional about the statement regarding membership voting for directors. Otherwise, it appears (from a show of hands) that most members are happy with the board and how the board continues to choose its own members.

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[Recap]

Does Aubrey de Grey really need an introduction at this point? His public proposal for repairing and reversing the damage of aging, SENS, and his public admission of being an Alcor member were the topics he discussed in “Is it Politically Safe for a Biologist to Support Cryonics Publicly?”

According to de Grey it is an important decision for a scientist to admit to supporting cryonics. A public acknowledgment of their support can affect their professional work. One of the dangers of being a leader in admitting to support is the lessened ability to procure funding. Funding peer review can be more difficult than publication peer review.

A cryonics leader provides public outreach and information. As other speakers have emphasized, legal death is only a convenience that needs constant review as technologies advance. Some people who are legally dead have in fact been revived, and this is something de Grey suggests the public be reminded of. Brain death is itself a complicated concept. Not only can a person be legally dead, they can be legally alive but functionally brain dead, via dementia, for example.

Cryonics supports can also provide ethical leadership. Cryonics supports can help demystify death and cryonics, promote cryonics as life saving, and provide facts for a useful ethical debate. Some people find cryonics “yucky” but a straightforward approach by scientists, rather than anger or ridicule, could be especially effective in demystifying the technology.

Science politics will also be affected by leadership. While mainstream cryobiologists support organ preservation, they do not generally embrace brain preservation. Leaders can point out this apparent discrepancy.

Leaders in this situation may be one of those lucky few who do not have to worry about dangers to their careers, funding, etc. De Grey believes he was lucky to have entered this field and “make trouble” without destroying his career. These lucky few should be able to help each other, until there is a tipping point toward broader support of cryonics.

De Grey believes he made the right decision to go public about his support of cryonics and Alcor membership.

[Commentary]

Leaders are important to any movement, and technologies themselves can be movements when tied to ideas like radical life extension. Cryonics support can be positively affected by people standing up and admitting they support the idea.

But what will be sacrificed when one stands up and stands behind such ideas? How does one talk about cryonics? These are important questions, and I think a review of other movements and how they address their own topics may be helpful.

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Ice cream! Networking! Being nearly run over by busy organizers!

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[Recap]

Another approach to recovery of cryonics patients, or patients prior to requiring cryonics, is regenerative medicine, that is, the ability to use stem cells to rebuild tissues. Michael West from Advanced Cell Technology discussed “Immortal Cells: The Prospect of Regenerative Medicine.”

The biology of aging remains a mystery, and West provided a history of thoughts on aging, including a reference to August Weismann in 1891 who predicted that cell division in somatic cells is finite. His research, however, was ignored. Researchers have since determined the finiteness caused by a “clock” in somatic cells, through telomere shortening on the tips of DNA over multiple cell divisions. The germline maintains telomere length. West and his research team tried to take this ability in germline cells and apply them to somatic cells. According to West “it worked!”

A reservoir of “immortal cells’ turned out to be human embryonic stem cells. These cells, even in the laboratory, will differentiate into a wide-range of tissues. According to West, nuclear transfer does reset the “aging clock,” despite the common belief that research showed this was not to be the case, with Dolly the cloned sheep commonly believed to have been “born old.”

Where is the field of stem cell research currently at? West and his company are working on technology to sort stem cell precursors to various mature tissues.

[Commentary]

Recent research into the environment of stem cells, as opposed to stem cells themselves, suggested you cannot simply inject stem cells into the body, especially an older body, and hope they regenerate and rebuild the necessary tissues. Particular factors in the environment of these stem cells appear to be important for letting the stem cells do what they need to do, according to researchers like Irina Conboy. West said that there are definitely unanswered questions, but so many promising avenues of research that something good will come from this activity.

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[Recap]

Nanotechnology. Once only an obscure buzzword among fringe techno-progressives, nanotechnology has emerged both as a multi-billion dollar industry and a controversial technology that could lead, according to some, to a prosperous future of plenty, or, according to others, the destruction of the Earth. The word has become increasingly tied to modern, market available structures measured in nanometers and included in goods to provide properties not possible with larger scale materials.

Originally, however, nanotechnology referred to something now called molecular manufacturing. These are nano-sized devices, including computing and mechanical, that can, among other capabilities, manipulate individual atoms and perform computation. This technology is an important area of inquiry for those interested in cryonics because it could be the very technology used to restore cryopreserved individuals to life.

Ralph Merkle is a noted expert in the field of nanotechnology. He discussed “Molecular Nanotechnology and the Repair of Cryopreserved Patients.”

His definition for nanotechnology includes the arrangement of atoms in “most of the ways permitted by physical law,” get them in the right place, and decrease manufacturing costs to not much more than the cost of the raw materials and energy. Important to cryonics is the ability to position atoms where needs, in hopes of repairing damage and rebuilding healthy bodies.

This enabling technology is called positional assembly. Diamond is a suggested material for building these tools. By making use of just a select few elements like hydrogen, carbon, and germanium nearly limitless types of structures could theoretically be created. To support this idea, Merkle and Rob Freitas have been exploring minimal toolsets by using simulation software. The nine tools they propose are molecules that can perform particular functions. For example, a hydrogen donation tool could deposit hydrogen atoms where necessary.

Combined with these tools the researchers suggested a selection of reactions to attach and detach atoms where required. Repeating these steps many, many times, you can create new copies of the same tools, as well as hydrocarbon structures.

Beyond these simulations, Merkle recommends more specific proposals to actually begin building these tools and nanostructures by exploring each of the useful reactions proposed in more detail using more detailed simulations, and by conducting experiments based on the simulations.

Eventually, molecular manufacturing is expected to lead to robotic arms, 8-bit computers, and other parts for devices smaller than, say, the mitochondrion. Merkle estimates that a sugar cube-sized volume computer created by molecular manufacturing advances would have more computer power than all the computer power that exists in the world today: “almost a billion Pentiums in parallel.”

This radical reduction in size and increase in ability would lead to nanomedicine and the ability to revive cryopreserved patients, by repairing and rebuilding at the subcellular scale. However, one issue is appropriate funding levels to conduct the necessary experiments and development. If molecular manufacturing is a capability that will take several decades to develop, long-term thinking investors are necessary.

[Commentary]

Fantastic speaker. It is helpful to create a blueprint by which others can design their own experiments.

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It is time for lunch. These breaks, lunches, and dinners are includes in the conference package and sponsored and funded by organizations or wealthier Alcor members. These sponsors have been mentioned between talks.

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[Recap]

Tanya Jones is the COO of Alcor. She has also participated in over half of the members’ cryopreservations. She talked about “Improving Cryopreservation Technology at Alcor.”

The moment the heart stops and legal death begins, Alcor must act quickly to stabilize the brain and body. This is most effective when they are on standby and near the patient. The logistics for transferring human remains to Arizona are extensive, and so Alcor must pay close attention to every detail.

Research will help improve the cryonics process, at every level from standby to stasis. New automation technology called the Whole-body Perfusion System will speed up the process which has until now been mostly manual, while allowing the gathering of new data, automated reports, and improved knowledge. For example, cryopreservation levels were previously eyeballed by one of the technicians. The Whole-body Perfusion System will now monitor these levels, temperatures, pressure, flow, and cryoprotectant uptake and flag alarms.

Other alarm conditions, like bubbles during cryopreservation, that arise will be flagged by the new system, and reports will be generated to document to process.

Another technology being developed is called “Deep Cooling”, a way to cool the patient down to -100 degrees Celsius.

Besides equipment and tool improvements, procedures for training are also being revisited. Worldwide Alcor membership is currently around 800 people, so new technician regions are being setup to get them to the bedside of patients more quickly and efficiently. Training will be improved by bringing people to Alcor for hands-on experience with cadavers or large animal remains.

[Commentary]

It is always great to hear about new technologies being tested or implemented that will improve efficiency, data gathering and report generation. Even the tables and pods have been improved, including fans, ways of making sure the person will fit, and other additions and changes. Other improvements will include better ice baths with improved insulation, potentially keeping a person at 0 degrees for up to five days; tools for drawing out the blood; cooling via the lungs, smaller and more portable perfusion equipment, and new safety features on tools. The stabilization kits used in the field are being revisited and reduced in size so technicians can get to the patients bedside more easily.

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[Recap]

The next speaker from Alcor was Stephen Van Sickle, Executive Director, discussing the “Research Direction at Alcor.”

There was a time when Alcor did not conduct much research, focusing instead on their services and gaining new members. However, eventually Alcor leaders decided that research could definitely help the institution.

Van Sickle said that research is important because it brings in “key personnel” and provides valuable training to Alcor employees. Alcor chooses questions to research that specifically relate to technology and procedures used so that they can be improved.

In years past, Alcor experimented on dogs. Now they are using a rat model system, because of the complexity, time, labor and expense savings compared to the use of dogs. A laboratory has been built around this research direction. One of the complications has been developing equipment appropriate for the size of a rat, compared to established equipment for humans and other organism.

With this rat model, Alcor will begin developing experiments in cryoprotection, ischemia, and hypothermia. For example, Alcor will try to determine the level of cryoprotectants that is most effective for eventual recovery.

Van Sickle emphasized that research in cryogenics will not likely lead to a sudden breakthrough in cryonics and “incremental progress is what is needed.”

Another line of research important to Alcor is how to minimize fracturing during the vitrification process. Fracturing occurs prior to the vitrification temperature, measured by an acoustic sensor placed on the head to listen for fracturing events in the brain. They hope to look at the stresses involved to try to minimize them with future procedures and tecnologies. One possible technique to be tested is warming up the body very briefly during the cooling down process to relieve stresses before heading back toward colder temperatures.

Technology trends and continued research will allow Alcor to better monitor patients during the cryonics process to gain useful statistics. They will test new tools for monitor cryoprotection, like NIR fiber optic spectroscopy.

[Commentary]

There has been a lot of focus in the first few talks about the important of research to Alcor. Instead of simply providing just a body preservation service, they seek to improve the technology while hoping to prove the theory of cryonics. They are now laying the groundwork for the rat model system.

The Alcor philosophy of “slow and steady” progress sounds like an approach anyone doing research should take. Research can be tedious, long, and arduous, but remains absolutely necessary for progress.

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[Commentary]

Break time! Time to mingle, network, eat snacks, or catchup on liveblogging…

The accommodations are very nice here at the Hilton Scottsdale Resort. About 100 people are in the audience, with water, gum drops, and notepads on the tables. Three livebloggers are sitting here at a table on a side aisle: Simone Syed, President of h+ at the University of Arizona, blogging for the Center for Responsible Nanotechnology (CRN); John Schloendorn, LysoSENS researcher, blogging for the Alcor blog, and me.