No Patient Left Behind

BY MATILDA AHMED

Cryogenics used to be a thing of fiction novels, scoffed at when discussed in any realistic manner. Today, the reality of cryogenics is becoming more apparent with each passing year of research and with each advancement toward clinical trials.

Cryogenics is the practice of freezing a body to such a low temperature that cell function is suspended, but can be revived at a later time. This practice has been used on hundreds of “patients” in the past fifty years — in other words, there are hundreds of bodies that are medically pronounced dead yet still suspended in laboratories in the hope that they may one day be revived. These cases are considered ideal cryogenics cases because the patients themselves decided, prior to their death, that they wanted to undergo the process instead of a burial.

The ethical issues regarding this practice can be divided by its two scenarios: ideal and non-ideal cryogenics cases. Non-ideal cases made their debut in a study performed in the spring of 2014; they deal with patients who are not yet dead, but are dying. These patients are typically suffering from fatal injuries but could potentially be saved had the doctors more time to perform the necessary surgeries, hence the use of cryogenics to suspend the bodies’ cell functions and energy expenditures.

The process calls for induced hypothermia to offset damage by heavy blood loss and low oxygen levels. The patient lingers in limbo between life and death while doctors work to keep them alive. Then, the patient is hooked up to machines to restore blood and circulation while simultaneously warming up the body for revival. Successful trials have been performed on pigs — promising, but not certain.

The concerns of this practice are multifaceted and many are unsure how to address the qualms that are presented. Foremost, an issue of equality obviously presents itself in the ideal cases. While most insurance companies claim to cover the cost of cryonics after you pass away, it hikes up your insurance cost significantly as you age. The initial cost for the procedure normally ranges from $80,000 to $200,000 — depending on which body parts are frozen — and an additional charge is incurred with each passing year that the body is maintained in liquid nitrogen. A divide between the “haves” and “have-nots” emerges, especially for those who cannot afford insurance in the first place (about 30 million Americans, according to the 2014 Census). Further highlighting the problem presented by cryogenics are the results of recent studies showing that wealthy individuals are not the ones who usually opt for the procedure. Many that inquire about it are middle-class individuals who had worked hard throughout their lives and discovered the procedure later in life, calling it a “second chance.” However, the procedural cost increases with age, thereby marginalizing who can be given another chance at life (theoretically) and who cannot.

More recently, the focus of concern has been shifting toward the non-ideal cases because the patients themselves are in no condition to give consent for the process. Informed consent is indisputably one of the most important aspects of performing any experimental trial on human beings. Is it the doctor’s or the family’s right to make the decision? When do they make the call for suspending animation? None of these questions have concrete answers and consequently, a slippery slope arises within the subject of medical ethics.

Technically, under the FDA, informed consent is exempt in these cases because there is no other alternative for the patient. Even with modern technology such as ventilators and IVs, survival rate of those with severe wounds is less than 10 percent. However, with suspended animation, it is possible that many more lives could be saved if applied to both military and civilian use, which may very well justify the overlooked consent aspect. Thus, the overarching purpose of medical research and technology of preserving life wherever it can be preserved is on the precipice of being fulfilled. Trials for humans have been approved and will be underway starting this year. Though the results will take years to compile, the future holds the possibility of leaving far fewer patients behind than we ever have in the past.

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