The Lazy Bioethics of Arthur Caplan

Unserious criticism of cryonics

Here is a bold and startling statement: “It is not wrong for people to look for ways to extend their lives nor for other people to help them.” You may not find that statement bold or startling but many bioethicists strongly dispute it.

Plenty of reasonable opportunities exist for criticism of the life extension field. We can readily accept the goal itself as valid and even praiseworthy while being critical of the way in which some treatments are advertised.

The field of bioethics is worthy in principle. In practice many bioethicists are inordinately conservative or authoritarian or plain ignorant in some of their pronouncements. Before I comment on recent comments by prominent bioethicist Arthur Caplan, a little background on my direct experience with another leading figure in the field, Jonathan Moreno, winner of the American Society for Bioethics and Humanities Lifetime Achievement Award.

Cryo-Crossfire

On July 9, 2002, I received a call from Alcor asking if I could hurry over to CNN’s studio immediately to appear on Crossfire. The show had picked up on the widespread coverage of Alcor’s cryopreservation of baseball legend Ted Williams. I was in the Los Angeles area, an Alcor member since 1986, and a philosopher. As such I was well suited to debate Jonathan Moreno on cryonics. The Crossfire hosts at the time were Tucker Carlson and the less well known Paul Begala – Begala being the chief strategist for the 1992 Clinton–Gore campaign.

“This is obviously grotesque and ghoulish and kind of revolting. What is morally wrong with this? Dr. Moreno, you’re an ethicist. Tell us why it’s a wrong thing.” Tucker Carlson.

The show hosts blatantly sided with Moreno. I was there only to be derided and dismissed. Consider this ever-so-slightly leading question by Carlson: “This is obviously grotesque and ghoulish and kind of revolting. What is morally wrong with this? Dr. Moreno, you’re an ethicist. Tell us why it’s a wrong thing.” In the face of continual derision and absurd non-arguments based in utter ignorance, I stood my ground in explaining why cryonics is not “a wrong thing.”

Despite Moreno’s credentials, in this debate he was a clown who clearly knew absolutely nothing about cryonics yet had the arrogance to dismiss and deride it with complete assurance. I have observed the same aggressively ignorant approach too many times since. Moreno made fun of the idea and compared it to trying to jump from here to the Moon. By contrast, I offered rational and evidence-based arguments in the little time allowed. I also called him out several times, identifying his failure to make a rational case.

On the way out of the studio I talked to several people in the crew. All said that I wiped the floor with my opponent. Naturally, fellow cryonicists all agreed. Judge for yourself: The video has not been available for years but you can find the transcript here.

On December 13 of last year I was contacted by reporter Alia Shoaib from Business Insider. Ms. Shoaib seemed reasonably even-handed so I agree to speak with her. Ms. Shoaib also talked to Arthur Caplan of New York University’s Grossman School of Medicine. The resulting article is here and archived here.

This reasonably balanced piece unfortunately starts with a typical headline reinforcing the “cryonics is for the rich” belief: “Billionaire Peter Thiel is one of thousands due to be cryogenically frozen after they die — inside the industry selling life after death.” The title was probably chosen by the editor rather than by Ms. Shoaib. I represented the reasonableness of cryonics while Caplan represented critics. Caplan’s “argument” was disappointingly weak and lacking in nuance.

In fairness, I will say that when I used to read his MSNBC column years ago, Caplan seemed more reasonable than most people calling themselves bioethicists. Most bioethicists apparently see their mission as pontificating their wisdom to a foolish world to explain why we should not try anything new and different. He also has real and substantial accomplishments including helping to found the National Marrow Donor Program, helping to create the system for distributing organs in the U.S., and he was strong voice favoring controversial challenge studies for SARS-CoV2 vaccines.

On the other hand, he has promoted compulsory vaccine mandates for healthcare workers (something that should be left to each institution). He apparently sees no conflict or tension between the bioethicist principle of autonomy and forcing people to submit to vaccination with novel vaccines. Still, he is far from alone in favoring compulsion and the issue is less clear cut than most cases of coercion.

Caplan is an expert bioethicist but he lacks expertise in cryonics or life extension. The article paraphrases me as saying “said that science is progressing in the right direction, but not at the pace he would like. Earlier this year, scientists at The University of Minnesota successfully unfroze rat organs and transplanted them in a historic first.”

It is to the writer’s credit that she included that piece of supportive information. However, the article also says: “a handful of companies worldwide are selling people the dream that death is not final.” While not entirely untrue there is no mention of the fact that the organizations are mostly non-profits run by people who have personally made cryonics arrangements. “Selling” also rather misrepresents the situation since cryonics organizations until very recently have done extremely little marketing – as distinct from public education.

Caplan is quoted as saying: “To me, it's an illusion. It’s a promise. Legit science doesn't think we know what we’re doing.” This is triply wrong or misleading. First, it is not a promise. As anyone who has read cryonics organization literature and their contracts knows, no promises are made. On the contrary, many factors are emphasized that could mean that it doesn’t work for you.

Second, “legit science” does not say anything. Talking of science or “the Science” has become disturbingly common. Science does not speak with one voice. By its nature the scientific method invites disagreement and remains open. Scientific practice these days seems increasingly to forget or ignore that.

Third is the misleading and overly broad assertion that science “doesn’t think we know what we are doing.” Does he mean:

• That cryobiologists are clueless?

• That vitrification does not work. (How does he say this while supporting IVF using cryopreserved embryos?)

• We are unable to scan brains to check the level of vitrification and degree of preservation of neural structures?

• We have no clue about the physical basis of long-term memory?

• Progress in cryopreserving eggs, sperm, embryos, and rabbit and rat kidneys has produced no knowledge? This is remarkable progress to be made in utter ignorance!

Perhaps he is thinking about the repair and revival end of the process. If so, he is making a major yet common error. The fact that we do not have current scientific proof of repair and revival capability does not mean we have no reason to expect it to be achievable so long as repair tools do not violate laws of physics. This brings to mind a cartoon favored by prominent blogger Scott Armstrong in the style of the Goofus and Gallant characters created by Gary Cleveland Myers:

“I worry that while people look to the future and say, well, in the future, they'll be able to solve anything — if you create a bunch of mush when you freeze using today's techniques, nobody's going to be able to solve it even a thousand years from now.”

No one is saying that in the future they will be able to solve anything. That is a mischaracterization. We know that if you are incinerated, leaving only ashes, no physically conceivable method could reconstitute you. (I am leaving aside various extremely speculative and philosophically controversial methods involving simulation.)

Caplan is correct that if your brain is turned to mush, no future technology will be able to help you. That probably applies to some cryopreserved patients. But most patients are not “mush” and describing patients reached quickly and successfully vitrified in those terms contradicts what Caplan knows about cryopreservation. Even in badly damaged patients, considerable structure remains and the original state may be inferable. In better cases, damage is relatively minor and the process of medical technology suggests that repair should be possible at some point.

The cryonics industry relies on the assumption that one day, death will be reversible. Not only would we need to be able to bring people back to life, but we would also have to be able to cure the cause of death — whether that was cancer, old age, or anything in between. Critics say this feels far too fantastical. Caplan believes that even the process of freezing people is a bit of a gamble, let alone banking on the ability to one day bring them back to life.

It is understandable but not entirely true that we would need to be able to cure aging before reviving anyone. That is certainly the expectation of most of us today. But it is possible that we will be able to repair and revive some patients from biostasis before aging is cured. This is more plausible for people yet to go into biostasis. Suppose a fairly young person has an incurable disease. They might be preserved under excellent conditions. The ability to revive them might come before we have overcome aging. This is a minor point but worth clarifying.

It is unclear whether the writer is quoting Caplan in saying “Critics say this feels far too fantastical”. What the critics feel is irrelevant. They should provide sound arguments. Besides, if Caplan supports challenge trials for vaccines why not let people decide about cryonics for themselves?

Biostasis is “a bit of a gamble” in the same sense as agreeing to experimental cancer therapy or unproven heart surgery is a gamble, except that biostasis has less downside and vastly more upside. Any sane cryonicist knows that their prospects are highly uncertain.

“Even if it worked, if you woke up a thousand years later, you're not going to know what is going on. You’re going to be a freak.” (Caplan)

The article supplies my alternative view: “More believes that this is simply another challenge to overcome. He compared the scenario to people waking up after years in a coma or moving to a different country and learning to assimilate to a new culture.” I think we should grant that reintegration may be a tremendous challenge. It may be too much for those lacking an adventurous spirit. Each of us has to decide whether we prefer to accept that challenge or to give up and cease to exist.

If you will be a freak, you may be a freak with many comrades. Freaks form their own communities in which they flourish. Rehabilitation will surely be done in the company of others from the same stretch of years. Since cryonics organizations are responsible for patients, we can expect them to help us ease into the world of the future. Besides, rather than being freaks, we may be regarded as special and fascinating – living time capsules.

Good critics are our friends. At least, that is the way we should see them. By challenging our views they help us examine our assumptions, enabling us to revise our beliefs or continue with increased confidence. Critics who set fire to straw men, make demonstrably false assumptions, and who fail to understand the target of their criticism are not friends to us nor to rationality.