Brain Repair and the Near Future of Death

James J. Hughes Ph.D.

Author Citizen Cyborg Executive Director, World Transhumanist Association & Institute for Ethics and Emerging Technologies Public Policy Studies, Trinity College, Hartford CT

11/2/2005

Institute for Ethics and Emerging Technologies

Biopolitical Struggle

Radical life extension not just scientific progress Also requires legal and cultural evolution From bioconservatism to transhumanism Human-racism vs. personhood Who is a citizen with a right to life?: abortion, stem cells, great ape rights, chimeras, brain death Brain Repair will be central

2 11/4/2005

Institute for Ethics and Emerging Technologies

Biopolitical Values
Transhumanism Personhood Bioconservatism Human-Racism (Deep Ecology)

Humanism, reason, individual liberty

Sacred taboos, the natural, yuck factor

Tech must be banned

Risks are manageable

11/4/2005

Institute for Ethics and Emerging Technologies

From Human-racism

Human-racism: Human embodiment is the basis of rights-bearing Humans have souls or crypto-spiritual human dignity
Embryonic citizens?

Universal Declaration on the Human Genome and Human Rights (UN General Assembly, 1998)

The human genome underlies the fundamental unity of all members of the human family, as well as the recognition of their inherent dignity and diversity.

Annas/Andrews Treaty: human enhancement should be a crime against humanity

11/4/2005 Institute for Ethics and Emerging Technologies

to Personhood

Is hairlessness one of the genes necessary for citizenship? Persons: conscious beings, aware of themselves, with intents and purposes over time

You can be human and not persons: fetus, PVS, braindead

You can be a person and not human: great apes, AI, posthumans Legal personhood confers the right to life and personal continuity
11/4/2005 Institute for Ethics and Emerging Technologies

Continuity of Personal Identity

Human-racism: identity = body

H+: identity = memory, personality

Thought Experiments

Scoop out my dead brain and keep me on life support Scoop out my dead brain and replace it with someone elses Scoop out my dead brain, and grow a new one Who would I be legally?
11/4/2005 Institute for Ethics and Emerging Technologies

Alcors Definition of Death

Death: irreversible loss of the structural information which encodes memory and personality
Alcor Cryonics: Reaching for Tomorrow
7 11/4/2005 Institute for Ethics and Emerging Technologies

Schiavo and Religious Right

Christian Right mobilizing Abortion Assisted dying Stem cells Schiavo, living wills, PVS Artificial reproduction Pope Benedict

8 11/4/2005 Institute for Ethics and Emerging Technologies

New BioConservative Alliances

Religious Right

CS Lewis The Abolition of Man

Neoconservatives

Fukuyama Our Posthuman Future

Deep Ecologists, Romantic Luddites

Aldous Huxley Brave New World McKibben Enough

Left-wing/Feminist Critics of Biotech

Jeremy Rifkin Algeny Gena Corea The Mother Machine

Pro-Disability Extremists

Not Dead Yet

11/4/2005

Institute for Ethics and Emerging Technologies

Trans-humanism (H+)

18th century rationalism and skepticism Dignity and worth of humanity Liberty, equality, democracy Our capacity for self-realization through reason, without supernatural assistance

Transhumanists are humanists who emphasize what we have the potential to become through reason.
Institute for Ethics and Emerging Technologies

10

11/4/2005

H+ = Radical Human Rights

Liberal democracy = personhood not race, gender or species as base of citizenship

Citizens have right to selfownership, selfdetermination: Control own bodies & brains
John Locke

1632-1704
11 11/4/2005 Institute for Ethics and Emerging Technologies

Secular Bioethicists Moving To H+

Greg Pence, author Who is a Afraid of Human Cloning?

Greg Stock, author of Redesigning Humans Religious Right (Schiavo) and Kassites polarizing, scaring bioethicists Forced to defend autonomy & technology against religious thuggery and nonsense yuck factor arguments
11/4/2005

Arthur Caplan: enhancing intelligence or changing personality or modifying our memory, maybe that should be available to everyone as a guarantee of equal opportunity.

12

Institute for Ethics and Emerging Technologies

Tech Spurs Ethical Change

Technology
NICU/Artificial Womb

Ethical Challenge
Status of embryos, fetuses Status of brain damaged Animal personhood Status of post-humans

Brain repair
Humanzees Genetic enhancement
13 11/4/2005

Institute for Ethics and Emerging Technologies

Recent History of Death

1960s: respirators, organ transplantation 1968: Beecher paper in JAMA arguing for whole brain death definition 1981: Presidents Commission drafts uniform model (whole brain) death law

Today: brain death the law in most states, most countries

11/4/2005 Institute for Ethics and Emerging Technologies

14

Unstable Compromise

1970s and 1980s debate:

Heart death vs. Whole brain vs. neocortical/personhood death

Whole brain death a compromise because

The whole brain dead would die in days Declaring the vegetative dead politically impossible
11/4/2005 Institute for Ethics and Emerging Technologies

15

Whole Brain Death Unravels

Diagnostic procedures inconsistent, incoherent Electrical activity persists in most brain dead Shewmon 1999: Whole brain death is survivable indefinitely Maintaining Schiavos indefinitely untenable
11/4/2005 Institute for Ethics and Emerging Technologies

16

Just Forget Death?

Fost, Youngner, et al.: forget death - when do we turn off respirator and take organs Emanuel: choice in the dying zone between PVS and heart death:

Self/family can choose euthanasia after permanent unconsciousness

no cremation/burial until heart death

after heart death treatment must stop
11/4/2005 Institute for Ethics and Emerging Technologies

17

Tech challenges permanence

The pronouncement of death is thus an arbitrary (if admittedly very practical) medical and legal construct, which amounts to a statement saying in effect: Your affliction has exceeded our current level of medical skill and we are currently powerless to restore you to function; therefore we give up. Alcor Cryonics: Reaching for Tomorrow

18

11/4/2005

Institute for Ethics and Emerging Technologies

Emerging Brain Repair Tech

Tech that will be applied to brain repair

Neuro-protective drugs Neuro-genesis drugs Neurogenic gene therapies Stem cells and tissue engineering Neural stimulation Neural prostheses Nano-neural-bots

19

The accelerating convergence of all these

11/4/2005 Institute for Ethics and Emerging Technologies

NBIC: Nanowiring the Brain

Neuro-vascular central nervous recording/stimulating system: Using nanotechnology probes, Rodolfo R. Llins, Kerry D. Walton, Masayuki Nakao, et al.

20

11/4/2005

Institute for Ethics and Emerging Technologies

DNR, NBHD & the Probably Dead

Do not resuscitate (DNR) orders

Potentially revivable, but allowed to remain dead in order to facilitate a dignified death

Non-Heart Beating Donor Protocol

Being declared dead depends not only on how unlikely it is you can be revived, But also on people not wanting to bring you back

PVS is probabilistic diagnosis

21

11/4/2005

Institute for Ethics and Emerging Technologies

Brain Damaged/Dead as Missing Person

Missing persons Potentially alive, but legally dead
time evidence

If they reappear

Reimbursing those wrongly declared dead preferred to leaving affairs in limbo

11/4/2005 Institute for Ethics and Emerging Technologies

22

Search Parties for the Missing

If advance directives and prognosis permit, declaration of death will wait for trial of brain repair Otherwise, they will be declared dead.

But what if brain repair recovers 20%? 10% 1%

For biocons, success

For H+ers, failure
11/4/2005 Institute for Ethics and Emerging Technologies

23

Testing for Continuity

Below threshold, different person Advance directive could give body to future person Advance directives and squatters rights

24

11/4/2005

Institute for Ethics and Emerging Technologies

Information Loss

How much info can be lost before we, and the law, consider the reconstituted mind a new person? ...even if today's patients do make it there, it is possible (and with sub-optimal suspension even likely) that they will wake with varying degrees of amnesia. In particularly bad cases, cell and tissue repair technology might only result in revival of a biological twin of the suspended patient. Alcor Cryonics: Reaching for Tomorrow

Alcor on Information Loss

25

11/4/2005

Institute for Ethics and Emerging Technologies

HETHR Conference
Human Enhancement Technologies and Human Rights May 26-28, 2006 Stanford University Law School Rights of transhuman persons

uploads, cyborgs Life extension

11/4/2005 Institute for Ethics and Emerging Technologies

Rights to transhuman technology

26

For more information on H+

World Transhumanist Association transhumanism.org Institute for Ethics and Emerging Technologies ieet.org Betterhumans.com (online magazine & daily news feed) Me: director@ieet.org
11/4/2005 Institute for Ethics and Emerging Technologies

27