Brain Repair and the Near Future of Death


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James J. Hughes

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Brain Repair and the Near Future of Death

  1. 1. 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
  2. 2. Biopolitical Struggle <ul><li>Radical life extension not just scientific progress </li></ul><ul><li>Also requires legal and cultural evolution </li></ul><ul><li>From bioconservatism to transhumanism </li></ul><ul><li>Human-racism vs. personhood </li></ul><ul><li>Who is a citizen with a right to life?: abortion, stem cells, great ape rights, chimeras, brain death </li></ul><ul><li>Brain Repair will be central </li></ul>
  3. 3. Biopolitical Values Tech must be banned Risks are manageable Sacred taboos, “the natural”, yuck factor Humanism, reason, individual liberty Human-Racism (Deep Ecology) Personhood Bioconservatism Transhumanism
  4. 4. From Human-racism… <ul><li>Human-racism: Human embodiment is the basis of rights-bearing </li></ul><ul><li>Humans have souls or crypto-spiritual “human dignity” </li></ul><ul><li>Universal Declaration on the Human Genome and Human Rights (UN General Assembly, 1998) </li></ul><ul><ul><li>“ 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.” </li></ul></ul><ul><li>Annas/Andrews Treaty: human enhancement should be “a crime against humanity” </li></ul>Embryonic citizens?
  5. 5. …to Personhood <ul><li>Is hairlessness one of the genes necessary for citizenship? </li></ul><ul><li>Persons: “conscious beings, aware of themselves, with intents and purposes over time” </li></ul><ul><li>You can be human and not persons : fetus, PVS, braindead </li></ul><ul><li>You can be a person and not human : great apes, AI, posthumans </li></ul><ul><li>Legal personhood confers the “right to life” and personal continuity </li></ul>
  6. 6. Continuity of Personal Identity <ul><li>Human-racism : identity = body </li></ul><ul><li>H+: identity = memory, personality </li></ul><ul><li>Thought Experiments </li></ul><ul><ul><li>Scoop out my dead brain and keep me on life support </li></ul></ul><ul><ul><li>Scoop out my dead brain and replace it with someone else’s </li></ul></ul><ul><ul><li>Scoop out my dead brain, and grow a new one </li></ul></ul><ul><ul><li>Who would I be legally? </li></ul></ul>
  7. 7. Alcor’s Definition of Death <ul><li>Death: irreversible loss of the structural information which encodes memory and personality </li></ul><ul><li>Alcor Cryonics: Reaching for Tomorrow </li></ul>
  8. 8. Schiavo and Religious Right <ul><li>Christian Right mobilizing </li></ul><ul><li>Abortion </li></ul><ul><li>Assisted dying </li></ul><ul><li>Stem cells </li></ul><ul><li>Schiavo, living wills, PVS </li></ul><ul><li>Artificial reproduction </li></ul><ul><li>Pope Benedict </li></ul>
  9. 9. New BioConservative Alliances <ul><li>Religious Right </li></ul><ul><ul><li>CS Lewis The Abolition of Man </li></ul></ul><ul><li>Neoconservatives </li></ul><ul><ul><li>Fukuyama Our Posthuman Future </li></ul></ul><ul><li>Deep Ecologists, Romantic Luddites </li></ul><ul><ul><li>Aldous Huxley Brave New World </li></ul></ul><ul><li>Left-wing/Feminist Critics of Biotech </li></ul><ul><ul><li>Jeremy Rifkin Algeny </li></ul></ul><ul><ul><li>Gena Corea The Mother Machine </li></ul></ul><ul><li>Pro-Disability Extremists </li></ul><ul><ul><li>Not Dead Yet </li></ul></ul>
  10. 10. Trans- humanism (H+) <ul><li>18 th century rationalism and skepticism </li></ul><ul><li>Dignity and worth of humanity </li></ul><ul><li>Liberty, equality, democracy </li></ul><ul><li>Our capacity for self-realization through reason, without supernatural assistance </li></ul>Transhumanists are humanists who emphasize what we have the potential to become through reason.
  11. 11. H+ = Radical Human Rights <ul><li>Liberal democracy = personhood not race, gender or species as base of citizenship </li></ul><ul><li>Citizens have right to self-ownership, self-determination: Control own bodies & brains </li></ul>John Locke 1632-1704
  12. 12. Secular Bioethicists Moving To H+ <ul><li>Greg Pence , author Who is a Afraid of Human Cloning? </li></ul><ul><li>Greg Stock , author of Redesigning Humans </li></ul><ul><li>Religious Right (Schiavo) and Kassites polarizing, scaring bioethicists </li></ul><ul><li>Forced to defend autonomy & technology against religious thuggery and nonsense yuck factor arguments </li></ul>Arthur Caplan : “…enhancing intelligence or changing personality or modifying our memory, maybe that should be available to everyone as a guarantee of equal opportunity.”
  13. 13. Tech Spurs Ethical Change “ Animal” personhood Humanzees Status of post-humans Genetic enhancement Status of brain damaged Brain repair Status of embryos, fetuses NICU/Artificial Womb Ethical Challenge Technology
  14. 14. Recent History of Death <ul><li>1960s: respirators, organ transplantation </li></ul><ul><li>1968: Beecher paper in JAMA arguing for whole brain death definition </li></ul><ul><li>1981: President’s Commission drafts uniform model (whole brain) death law </li></ul><ul><li>Today: brain death the law in most states, most countries </li></ul>
  15. 15. Unstable Compromise <ul><li>1970s and 1980s debate: </li></ul><ul><ul><li>Heart death vs. </li></ul></ul><ul><ul><li>Whole brain vs. </li></ul></ul><ul><ul><li>neocortical/personhood death </li></ul></ul><ul><li>Whole brain death a compromise because </li></ul><ul><ul><li>The whole brain dead would die in days </li></ul></ul><ul><ul><li>Declaring the vegetative “dead” politically impossible </li></ul></ul>
  16. 16. Whole Brain Death Unravels <ul><li>Diagnostic procedures inconsistent, incoherent </li></ul><ul><li>Electrical activity persists in most “brain dead” </li></ul><ul><li>Shewmon 1999: Whole brain death is “survivable” indefinitely </li></ul><ul><li>Maintaining Schiavos indefinitely untenable </li></ul>
  17. 17. Just Forget “Death”? <ul><li>Fost, Youngner, et al.: forget “death” - when do we turn off respirator and take organs </li></ul><ul><li>Emanuel: choice in the dying zone between PVS and heart death: </li></ul><ul><ul><li>Self/family can choose euthanasia after permanent unconsciousness </li></ul></ul><ul><ul><li>no cremation/burial until heart death </li></ul></ul><ul><ul><li>after heart death treatment must stop </li></ul></ul>
  18. 18. Tech challenges permanence <ul><li>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. </li></ul><ul><li>Alcor Cryonics: Reaching for Tomorrow </li></ul>
  19. 19. Emerging Brain Repair Tech <ul><li>Tech that will be applied to brain repair </li></ul><ul><ul><li>Neuro-protective drugs </li></ul></ul><ul><ul><li>Neuro-genesis drugs </li></ul></ul><ul><ul><li>Neurogenic gene therapies </li></ul></ul><ul><ul><li>Stem cells and tissue engineering </li></ul></ul><ul><ul><li>Neural stimulation </li></ul></ul><ul><ul><li>Neural prostheses </li></ul></ul><ul><ul><li>Nano-neural-bots </li></ul></ul><ul><li>The accelerating convergence of all these </li></ul>
  20. 20. NBIC: Nanowiring the Brain “ Neuro-vascular central nervous recording/stimulating system: Using nanotechnology probes,” Rodolfo R. Llinás, Kerry D. Walton, Masayuki Nakao, et al.
  21. 21. DNR, NBHD & the Probably Dead <ul><li>Do not resuscitate (DNR) orders </li></ul><ul><ul><li>Potentially revivable, but allowed to remain dead in order to facilitate a dignified death </li></ul></ul><ul><li>Non-Heart Beating Donor Protocol </li></ul><ul><ul><li>Being declared dead depends not only on how unlikely it is you can be revived, </li></ul></ul><ul><ul><li>But also on people not wanting to bring you back </li></ul></ul><ul><li>PVS is probabilistic diagnosis </li></ul>
  22. 22. Brain Damaged/Dead as Missing Person <ul><li>Missing persons </li></ul><ul><li>Potentially alive, but legally dead </li></ul><ul><ul><li>time </li></ul></ul><ul><ul><li>evidence </li></ul></ul><ul><li>If they reappear </li></ul><ul><ul><li>Reimbursing those wrongly declared dead preferred to leaving affairs in limbo </li></ul></ul>
  23. 23. Search Parties for the Missing <ul><li>If advance directives and prognosis permit, declaration of death will wait for trial of brain repair </li></ul><ul><li>Otherwise, they will be declared dead. </li></ul><ul><li>But what if brain repair recovers 20%? 10% 1% </li></ul><ul><ul><li>For biocons, success </li></ul></ul><ul><ul><li>For H+ers, failure </li></ul></ul>
  24. 24. Testing for Continuity <ul><li>Below threshold, different person </li></ul><ul><li>Advance directive could give body to future person </li></ul><ul><li>Advance directives and squatter’s rights </li></ul>
  25. 25. Information Loss <ul><li>How much info can be lost before we, and the law, consider the reconstituted mind a new person? </li></ul><ul><li>Alcor on Information Loss </li></ul><ul><li>...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. </li></ul><ul><li>Alcor Cryonics: Reaching for Tomorrow </li></ul>
  26. 26. HETHR Conference <ul><li>Human Enhancement Technologies and Human Rights </li></ul><ul><li>May 26-28, 2006 </li></ul><ul><li>Stanford University Law School </li></ul><ul><li>Rights of transhuman persons </li></ul><ul><ul><li>uploads, cyborgs </li></ul></ul><ul><li>Rights to transhuman technology </li></ul><ul><ul><li>Life extension </li></ul></ul>
  27. 27. For more information on H+ <ul><li>World Transhumanist Association </li></ul><ul><li>Institute for Ethics and Emerging Technologies </li></ul><ul><li> (online magazine & daily news feed) </li></ul><ul><li>Me: </li></ul>