GESTIÓN EN SALUD PÚBLICA: BioEdge: A cool idea for an afterlife

domingo, 13 de agosto de 2017

BioEdge: A cool idea for an afterlife

BioEdge: A cool idea for an afterlife

Bioedge

A cool idea for an afterlife

by Michael Cook | 12 Aug 2017 | 2 comments

“To die in order to live” is one of the commonplaces of Christian piety. So it was a bit jarring to stumble across a similar sentiment in an article in the journal Bioethics by utilitarian bioethicists. In discussing the ethics of cryopreservation, Francesca Minerva, of the University of Ghent, and Anders Sandberg, of the University of Oxford, recall that two cryopreserved people “wanted to die in order to live”.

It is in this spirit that they defend the possibility of euthanasia followed by cryopreservation, a procedure they call “cryothanasia”:

It achieves the positive goal of euthanasia (ending suffering) without its negative instrumental side-effect (permanent cessation of life). Even if it turns out to cause information-theoretic death, the intention is clearly to extend life.

They argue that objections to euthanasia should not apply to cryothanasia. The first objection is the “weirdness argument”. Weird it is, they admit, but we already allow weird practices like circumcision or refusing blood transfusions.

The most powerful objection, however, is that cryopreservation simply will not work. The likelihood of success is probably very low, Minerva and Sandberg acknowledge, but a tiny chance of extending one’s lifespan for many years sometime in the future would make it worthwhile.

Essentially, cryothanasia for a person near death is a gamble of a small number of Quality Adjusted Life Years (QALYs) versus a low-probability gain of many QALYs. Traditional cryonics is a gamble of zero QALYs versus a potential gain. Whether cryothanasia is rational depends on whether the ratio (remaining QALYs)/(potential QALYs) is less than the estimated probability of success.

The ethics of cryopreservation reprises Pascal’s Wager about the existence of God, as bioethicist David Shaw argued a few years ago. Ultimately, he contended, it makes sense because "for atheists who don't believe in an afterlife, cryonics represents the only chance of life after 'death'".

Sunday, August 13, 2017

In a recent article in the American Journal of Bioethics, bioethicist Art Caplan and three colleagues call for a complete overhaul of the venerable Belmont Report (see below). This is the 1979 US government report which set out three famous principles which have governed human research ever since: respect for persons, beneficence, and justice.

Most government reports are already gathering dust within a few months after their publication. But the Belmont Report’s influence has been enormous, as it shaped the bioethical framework for clinical and research decision-making in the US and many other countries as well.

Caplan & Co make a good case for revising the standards in the light of experience and changing times. But it comes at an awkward moment: the Trump Presidency. What kind of commission would Mr Trump create to study this issue? Perhaps a noisy and truculent one, a bull in the bioethics china shop. Be careful what you wish for?