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Bioethicists must rethink the concept of death: the idea of brain death is not appropriate for cryopreservation

Death has historically been believed to be an event that coincided with the onset of clinical death. It is now understood that death is a series of physical events, not a single event, and that the determination of permanent death is dependent on other factors beyond the simple cessation of breathing and heartbeat. We may need to accept the concept of the life cycle assessment introduced by nanotechnology or astrobiology, a process that is often called transhumanism (1). Cryopreservation is the use of antifreezing solutions and proteins or cryoprotectants and cooling to very low temperatures for the long-term storage of human bodies, animals, organs or tissues, typically at liquid nitrogen temperatures (-196˚C). Cryopreservation is not freezing. At these low temperatures, any biological activity, including biochemical reactions that would lead to cell death, is effectively stopped. However, when cryoprotectant solutions are not used, the cells being preserved are often damaged when approaching low temperatures in the freezing process or when being warmed to room temperature. To be biologically useful, cryoprotectants must easily penetrate the cells and not be toxic to them. Cryopreservation is used for embryo storage, for example, when in vitro fertilization has produced more embryos than are needed at a given time. Semen can be successfully used almost indefinitely after cryopreservation, with successful storage reported for as long as 21 years. Oocyte cryopreservation is a new technology in which eggs are extracted, frozen, and stored. They may later be thawed, fertilized, and transferred to the uterus as embryos. As of 2010, there were more than 200 people in cryogenic storage, all of them in the United States or Russia. Most are stored in the Alcor and the Cryonics Institute, but more than ten are in Russia, and two are in Trans Time. All modern cryonics organizations require full payment for all future costs associated with storage ‘‘in perpetuity’’ before patient cryostorage. The costs of cryonics vary significantly, ranging from the basic fee of $10,000 for neuro(head or brain only) cryopreservation at the European cryonics company KrioRus to more than $200,000 for whole-body cryopreservation by Alcor (this value includes overseas and last-minute fees). Alcor’s neuropreservation (head only) is priced at $80,000 (2).