• We envision a world in which several different brain preservation procedures, both cryogenic and room-temperature, have been validated as effective (see our Technology Prize for details). This includes validation for cryonic vitrification. While we are very sympathetic to the goals of the cryonics community, they have sadly never been able to make vitrified neural tissue look normal under electron microscopy. As a result, they have never had the support of neuroscientists that their methods would likely preserve memory and identity. Fortunately, after decades of neglecting this issue, they are now making progress toward validation.
• Next, as validation proceeds, we envision that each procedure has been demonstrated to preserve not only the delicate morphology and connections of neurons, dendrites, synapses, and their supporting cells (glia, astrocytes) in a whole large animal brain (the connectome) but also the key proteins, receptors, and neurotransmitters at each synapse (the “synaptome”) and all relevant subcellular structures in each cell body (the neural nucleus, the epigenome) that have been theorized by some neuroscientists to potentially be involved in long-term memory encoding and retrieval.
• Next, we envision a predictive model of long-term memory emerging from basic and computational neuroscience, in one or more model organisms (C. elegans, Drosophila, Aplysia, Danio, Mus, T. guttata, etc.), perhaps in this decade. One way this model might be validated would be to directly observe and predict memory encoding and retrieval in vivo, either in simpler animals (C. elegans) or in the appropriate areas (eg. hippocampus and cortex) in more complex animals. Another might be to infer, with reproducibility, what an animal learned (consolidated via LTP) in particular set of set of long-term neural circuits anywhere in the brain, using a static map of the relevant circuits and synaptic weightings in that organism’s chemopreserved or cryopreserved nervous system.
• Next, we envision hundreds of relevant scientists signing a formal statement we circulate, which says that the use of one or more of these procedures at death “seems very likely to preserve significant information” (unique memories, experiences, and perhaps, full individual identities) of the persons who choose to undergo them.
• Finally, we envision a series of social changes in medical access, ethics, oversight, and affordability, to ensure that citizens of all free societies have the option of exercising the brain preservation choice at death, and a series of personal rights around that choice (see below).

Each of these steps will be difficult, and each will require many substeps. But as long as brain preservation continues to appear scientifically reasonable, we feel morally compelled to pursue the vision, for the benefit of humanity. We hope you agree. If so, here’s a few direct ways you can help.

This is a list of demands of sort, or perhaps a call to arms. It is what we think people who believe in brain preservation should be pushing for—a society in which they and their loved ones have a reasonable chance at reaching the future, and where the main obstacles to achieving that goal are real technical ones, and not legal roadblocks imposed by ignorance, prejudice or superstition. It rejects the current status quo where cryopreservations of doubtful efficacy are performed by unregulated institutions only after the declaration of legal death, and often after hours of postmortem ischemic damage.*

It is our individual unalienable right to choose death, or to choose the possibility of further life for our memories or identity, as desired. Under the appropriate conditions, it must also be our right to choose to undergo an uncertain medical procedure which may indeed shorten our life, but which we believe has the possibility of greatly extending it, in quality as well as in duration. In particular:

1. Every major hospital should be able and ready to perform an emergency brain preservation protocol on a terminal patient if requested by that patient, and should have trained personnel and the associated surgical instrumentation on standby.
2. This protocol should be certified to preserve 99.9% of the neuronal connections in a brain (under ideal surgical conditions), and should allow for indefinitely long storage without decay.
3. The preservation protocol’s efficacy must have been rigorously verified through testing on animals. At a minimum, the preserved animal brain must be stored for several months while being subjected to an accelerated aging environment (e.g. temperature swings), after which the brain is dissected to look for gross structural damage, and, most crucially, a sufficient number of tissue samples must be extracted from various brain regions and volume imaged using an electron microscope to verify intact neural circuits and to statistically ensure that the procedure has preserved 99.9% of the synaptic connections across the entire brain. Application of this protocol must show repeatable quality of preservation and must provide diagnostic checks for efficacy of preservation when applied to human patients (e.g. monitoring of perfusion extent during the surgical procedure, post-preservation MRI imaging of brain, etc.).
4. Legal rights must be secured for persons in storage such that they have many, but not all, of the rights held by living humans in long-term unconscious states today. Specifically:
   1. Persons should be ensured a quality surgical preservation procedure performed by a licensed professional. These rights should be on par with the guarantees against malpractice in surgical procedures today.
   2. Persons should be ensured quality long term storage and protection from harm with no removal from storage due to insufficient funds.
   3. Revival rights must exist such that the revival wishes of the individual undergoing brain preservation can be legally enforced, when technically feasible. This includes the right to partial revival (memory donation instead of identity or self-awareness revival), and the right to refuse revival under a list of circumstances provided by the individual before preservation.
   4. Legal rights should be available to allow persons in storage to retain some monetary and other assets, in trust form, so that they can be retrieved by the individual upon successful revival, or used to aid early revival. The amount of resources that can be held in trust, and how long they can be held, will be a political decision to be decided, and periodically revised, by all governments that allow it.
5. While BPF takes no policy position on physician-assisted euthanasia  (assisted dying), it is currently legal in four countries (Belgium, Netherlands, Luxembourg, Switzerland) and five U.S. states (CA, OR, WA, MT, VT) for uncoerced and mentally competent individuals to undergo medically-assisted death when they seek this outcome and have less than six months to live, as assessed by their physician and/or an independent board. In these jurisdictions, it seems reasonable that such patients should have the legal right to brain preservation, when desired, during the assisted dying procedure. Such Assisted Dying and Preservation (ADAP), the simultaneous application of both assisted dying and brain preservation procedures, is a new category of assisted dying that will clearly require new processes of informed consent and oversight, as additional moral hazards exist for its use. Furthermore, as neuroscientific evidence mounts that at least some useful neural information will be retrievable from scans of preserved brains, the ethics of assisted dying and preservation more than six months prior to expected death, in special circumstances, should also be carefully considered. One obvious ethical argument for such “early ADAP” cases arises when Alzheimer’s, Parkinson’s, metastatic brain cancer, multi-infarct dementia, and other brain-degrading diseases are progressively threatening the patient’s memories and identity. Clearly, the mental state of the patient, the information provided to them, the claims made by any preservation services company, and the procedures of the preservation process must all be subject to regulation and oversight by appropriate ethical, legal, and regulatory agencies, both in ordinary brain preservation (BP) services, available to terminal patients, and in any Assisted Dying and Preservation (ADAP) services offered to the public.
6. If the brain preservation procedure can be made sufficiently inexpensive and reliable, no person should be barred from obtaining a quality brain preservation surgical procedure and quality long-term storage due to lack of funds. It seems very likely that chemical fixation and plastination can be low cost in comparison to today’s more complex medical interventions, such as heart surgery. At present in the United States, approximately 30% of medical costs are accrued during the last year of a person’s life. If those contemplating or choosing brain preservation tend to reduce their use of heroic medical procedures in their final years of life, an argument can be made for social supplementation of its cost. The degree of cost supplementation for the brain preservation procedure will be a political choice that varies from country to country. In the Netherlands, where physician-assisted suicide has been legal since 2002, and where 2.3% of all deaths in 2011 were by patient-elected euthanasia, the degree and circumstances of cost supplementation will likely be different than, for example, the United States. Again, BPF takes no position on physician-assisted euthanasia, we are just recognizing relevant political differences in each country. In any country where a socially significant number of brain preservations are occurring, either at the end of life or by legal physician-assisted euthanasia, it seems reasonable that a strong political argument can and will be made for a right to cost supplementation.
7. Brain preservation should always be a voluntary, freely chosen, and appropriately consented procedure. The right to choose personal death must remain an unalienable human right, as must the right to choose brain preservation, with its potential future benefits, which include life restoration. Given the unknowns about if and when a preserved brain would be revived, brain preservation is analogous to a risky surgery electively undertaken by an individual to cure his otherwise terminal illness (e.g. removal of a brain tumor in which death on the operating table is a real possibility) or to treat a condition which severely reduces his quality of life (e.g. brain surgery to treat severe epileptic seizures). We respect the right of individuals to refuse these current surgical interventions, and we respect the right of individuals to electively undertake them even though they risk death during the surgical procedure itself. We must extend these same basic freedoms and rights to those wishing to undergo brain preservation, in every country of the world.

Footnotes

* Ken Hayworth, personal comment: I have nothing but respect for the research and hard work of these cryonics orgs in the face of abandonment by the larger scientific community and outright attacks by an often irrationally hostile public. But this does not mean we should accept this status quo. We can do better, and owe our best to humanity.