Matt Angle:

Welcome back to Neurotech Pub. Today we're going to be talking about Connectomics and the science and ethics of brain preservation. Connectomics has a broad definition but when we use the word, we're going to be specifically referring to the study of the wiring diagrams of the neurons in the brain and we're going to be talking about electron microscopy as a tool to reconstruct the wiring between all of the different neurons in the human brain which is sometimes called the connectome.

We recorded this episode in two parts. In the first episode, we're going to discuss the ethics of brain preservation and make some assumptions about the quality of brain preservation that's available now or will be available in the future and also make some assumptions about the types of technologies that might be available to recover a connectome or maybe even recover a stored personality or consciousness from a preserved brain. In the second episode, we're going to discuss some of the assumptions that we made in the first episode and we're going to talk about the state of brain preservation technology and the outlook for recovering connectomes from human brains.

Our guests in this first episode include Nita Farahany, a law professor and bioethicist at Duke University, Kenneth Hayworth, a scientist at the Howard Hughes Medical Institute, Janelia Farm Research Campus, and Robert McIntyre, the CEO of Nectome. As a warning to listeners, this episode discusses human brain preservation and contains a brief mention of assisted suicide in a medical setting.

If you're listening to this episode as a podcast, be sure to check out the Neurotech Pub website where you can find show notes and references from the episode.

Well, thank you all for coming. I'm really excited to be talking about Connectomics and brain preservation and what this means in the context of not only understanding the brain but also some people's interest in whether they can preserve their own memories and their own thoughts for the future.

‍

Robert McIntyre:

They're often tied together, the uploading and the preservation, but technically they're not. The real question is–

‍

Nita Farahany:

Right. Yeah. Totally.

‍

Robert McIntyre:

Does the preservation lose something that matters, right? I would argue neuroscience says it doesn't. So neuroscience is either wrong about that or works. And then, there's the question of, "Okay. 80 years from now, what would you actually do to recreate someone?" and–

‍

Nita Farahany:

Okay, by preservation, Robert, you just mean freezing the brain like the cryopreservation of the brain which doesn't necessarily allow you to reboot EEG, neural connections, etc.?

‍

Robert McIntyre:

So by preservation, I'm talking about aldehyde stabilized cryopreservation which is gluing all the proteins together with glutaraldehyde and then vitrification. So you've got a gelled network of proteins and then you turn that whole gel into a glass and then when you look at it under an electron microscope, it's nanoanatomically complete and you could trace everything. From a chemical point of view, essentially all of the proteins in essentially the same place they were when the animal was alive are still retained in place because of the fixation-

‍

Nita Farahany:

But we don't know if it'll reboot.

‍

Robert McIntyre:

It definitely won't reboot because it's glued with fixatives.

‍

Kenneth Hayworth:

Yeah. There's a 100% no reboot on this.

‍

Robert McIntyre:

Yeah. Short of some ridiculous nanotechnology or some nonsense. You're not getting that back. It's glued shut.

‍

Nita Farahany:

I mean, I know about Robert's company and Kenneth, I know about the foundation. Do you guys work together at all? Do you know each other already?

‍

Kenneth Hayworth:

I mean, we're connected on brain preservation but there is a firewall between the Brain Preservation Foundation is a nonprofit foundation that does science advocacy so I'm not exactly sure what goes on day-to-day with Robert besides what he's willing to tell me.

‍

Nita Farahany:

How are the two connected, the Brain Preservation Foundation and Nectome?

‍

Kenneth Hayworth:

Well, I mean, the Brain Preservation Foundation put forward a...this is probably something you should ask me on the call as well, put forward a brain preservation prize that was a challenge to the cryonics community and the general scientific community that went on for several years. Robert won that prize and that's how we met.

‍

Nita Farahany:

Got it. Okay.

‍

Kenneth Hayworth:

And then, he took that winning technique and started a company.

‍

Nita Farahany:

Got it. Okay.

‍

Kenneth Hayworth:

A research company as far as I understand so it's–

‍

Robert McIntyre:

Full disclosure, I actually volunteered for the Brain Preservation Foundation forever ago when I was in grad school but then I quit because I thought I could just win the competition instead.

‍

Nita Farahany:

Got it.

‍

Robert McIntyre:

And so, since then we've been separated but I mean, there's not that many people in this space, so we appear together a lot.

‍

Kenneth Hayworth:

Yeah. I–

‍

Nita Farahany:

Nectome is just research but is not actually offering?

‍

Robert McIntyre:

So Nectome's a for-profit company that's ultimate goal is to develop this into something that would be applicable to humans and I–

‍

Nita Farahany:

But it's not yet doing it on humans?

‍

Robert McIntyre:

That's right. We're not yet doing it on humans, pure research, and I tend to follow Hayworth's... Hayworth's written up this document that says, "What are the standards that a reasonable, actual, legitimate offering to people should meet?" and I follow those. That's my guiding light on this stuff. I hope, eventually, the Brain Preservation Foundation might judge these things but that's still to be decided.

‍

Matt Angle:

Yeah. Nita, can you quickly introduce yourself?

‍

Nita Farahany:

Sure. So I'm Nita and I'm a professor of law and philosophy at Duke where I focus on neuroethics and my research focuses on neuroethics. I was the immediate past president of the International Neuroethics Society. I do bioethics, neuroethics of emerging technology, also from a legal perspective to think about the legal and regulatory and practical issues that arise from it. So I'd say I'm a pragmatic philosopher and ethicist who looks at how do we enable the responsible progress of technology? I'd say my bent is generally on technology is coming and the question is, "How do we enable the responsible progress of it?" not the kind of precautionary, "Ah! Don't allow it to come forward."

‍

Matt Angle:

So maybe Ken, could you kick things off by quickly telling us a little bit about the state of Connectomics today and also how people envision that some of this science could be used for preserving people's memories?

‍

Kenneth Hayworth:

Sure. So the state of Connectomics today, we should start by saying there are several different definitions of Connectomics. The Connectomics that we're talking about today, I believe is the really mostly electron microscopy at a resolution that is able to see every single synapse and trace those synapses back to their neurons, the pre and post synaptic neurons.

And so, that technology has been... The technology to do that level of resolution has existed since the 1950s and '60s but the level of automation really took off about 15 years ago and it's been a whole bunch of different techniques but it is still very, very daunting. So the idea is that some of the "large scale" things that have been done, large scale is in quote, the largest that anybody has imaged to date is a cubic millimeter. So that mouse cortex, that puts it in perspective so that was an incredibly difficult project. Allen Institute did that recently and to my knowledge, they are still probably a few years away from tracing all of that. Maybe Jeremy can say more about that but there are smaller scale projects that are getting real data, real biologically interesting stuff.

One of the ones that I have had a little tiny involvement in is a connectomic reconstruction of the central complex of the fruit fly brain. This is also relatively small, probably 300 by 300 by 300 micron type of a scale. Again, this is a many, many, many year effort. Even though the data is there and the neurons and connectivity has been traced out in these small systems, the neuroscience understanding of how to read off that data is incredibly lacking.

So the best summary is that connectomics, EM scale connectomics, synapse level connectomics is a relatively new technique that allows neuroscientists to look at the synaptic connectivity of small pieces of brain but it is in its infancy in terms of being able to get to larger volumes and it's actually, the data is... It has a tremendous amount of promise but it really takes the rest of neuroscience, as a whole, all the optical techniques and electrophysiology and genetic techniques, all of that come together with the connectomics to actually understand how individual circuits work.

‍

Robert McIntyre:

If I may, could I add a timeline here real fast just to give some perspective? So the very first whole connectome was the C. elegans connectome in the '80s and that's about 300 neurons total. And then, the next completed one that I know of is the fruit fly that's got about 40,000 neurons total and it has about a cubic millimeter and there's about a million cubic millimeters in a human brain and the next biggest project that's... To do a cubic millimeter takes about a year and about a million dollars last time I checked, just to do the scanning. And so, the next big project is to do an entire mouse connectome. Mouse has about a hundred million neurons and its entire volume is about a third of a cubic centimeter. And so, that's about a thousand fold more would be what you need to get to a human brain and it's thought that the mouse connectome will be completed in 5 to 10 years at a cost of about maybe $200 million so that's where we're at right now.

‍

Matt Angle:

Suppose you had everything you wanted, suppose you had a human level connectome reconstruction with the same granularity that you have, Drosophila, the fruit fly today. What happens? Explain to us why. For people who don't work in dense electron microscopy and neural circuit reconstruction, this may seem very niche and it may seem to have no immediate connection to immortality or living in a simulation. Yet, there there's a lot of interest even within the connectomics community about the possibility of turning this data into something really transhumanist. Can you explain what that ambition is?

‍

Kenneth Hayworth:

Well, I think we need to right upfront make it clear that there is synapse level connectomics that is very interesting from a neuroscience perspective. And then, there is some level of detail that maybe 200 years from now, if I had to put a timeline, it would be 100 to 200 years, okay? That's my rough estimate that we might be able to read off a whole human brain at the level that would be required for a whole brain simulation that could bring back memories and personality and consciousness, etc.

So does that technology require that 200 years from now--does that require only mapping the connectome? The vast majority of neuroscientists would say, "No, it would require much more than the connectome." I think that the verdict is still out on that but even if I had to guess, I would say, "Yes, it would probably require more." The connectome is more thought of as a bare minimum. There is no way without the connectome, without knowing what cells connect to what other cells through synapses that you're ever going to get memories and function of the brain.

But once you have that, you probably need much more and we can go into great detail on what might be more. In general, we're talking about there are certain molecules that would probably also need to be imaged at the same time. So I just want to make sure that...because it is very easy to have somebody run off with a, "Oh, connectomics is promising mind uploading tomorrow," and nothing could be farther from the truth. What connectomics is, is it's a really, really cool new technique in neuroscience that is really showing it's another level on a path toward what could, in a few hundred years, amount to mind uploading which I think is the end goal of neuroscience.

‍

Matt Angle:

But today, people are signing up to have their brains frozen with the promise that the science that you have just described–

Kenneth Hayworth:

So we have to be very careful with language, okay? First of all, frozen is...the neuroscience community preserves brains of animals fantastically well and they don't freeze the brains. We–

‍

Matt Angle:

Yeah. Let me be clear. I think for the conceptual purposes like glutaraldehyde or paraformaldehyde-based fixation and freezing the brain are not that conceptually different. I mean, what I'm trying to get at is the idea that there are currently people signing up for services right now to have their brain preserved on the idea that it will be preserved for a timeline of 100 to 200 years.

‍

Kenneth Hayworth:

Okay. So I know that there are cryonics organizations where people sign up for cryonics. First of all, I don't think they promise anything. I used to be signed up for cryonics with the company Alcor and I was so frustrated that they could not show the minimum preservation that I've put forward this brain preservation prize and challenged them to show that their methods preserve at least the bare minimum which is the connectivity of the brain and they failed at that. Maybe they will succeed at some point in the future but they failed at that.

And so, therefore, I withdrew my membership because I didn't know what the heck that they were selling in the first place. But even them, they were not promising anything. They were basically saying, "Look, this is the best we can do and it ain't so great and we don't even know how good it is but what else is there? There's the grave and this." So I take issue if you're saying that somebody is promising that this new technique and selling it to people because I don't think that's true. I don't think that... Robert, are you selling this to anybody? No. Are you promising that they're going to be uploaded in the future?

‍

Robert McIntyre:

No.

‍

Kenneth Hayworth:

No. Exactly. So let's be very careful because we've...look, I get hit all the time on this. I want to have a very serious scientific discussion about what is possible. I mean, the fact of the matter is, look, we are all going to...modern medicine is not saving any of us. We are all on a slow decline to death and there is no solution out there and what is being proposed here is to say, "Look, neuroscience thinks that..."

The best hypothesis of neuroscience is that we are the sum total of the computations in our brain. That's encoded in the synaptic connectivity of the brain, in our memories, and our techniques are really good at preserving brains nowadays, we should definitely go into great detail, and our techniques of imaging brains at the connectomic level but also at the molecular level are getting very, very good. And so, if you look at the, "We're all going to die." What is a slim hope at avoiding that fate? The only slim hope of avoiding that fate is taking the best brain preservation we have today and hoping that neuroscience eventually succeeds in the future and can bring people back. That's my opinion on it.

‍

Matt Angle:

Nita, I'd like to bring you in here for a minute. Let's think from a legal perspective. What happens if you have a brain that is fixed with chemical fixatives, embedded in epoxy, and we all believe, let's just say from a starting point, that we all believe that the fixation, the preservation, and the storage are done correctly so that in fact, all of the information is preserved in this brain that would be required at a later date to turn a person back on. How do we treat that kind of data? How do we even think about that?

‍

Robert McIntyre:

Just to avoid a common problem here, let's assume it's the entire body of the person and not just a brain sitting round.

‍

Nita Farahany:

Why do we need to assume that Robert?

‍

Robert McIntyre:

Because that's what it would practically be and it's just that there are some non-interesting things here, talking about the peripheral nervous system that is a–

‍

Nita Farahany:

Okay.

‍

Robert McIntyre:

Well, it's genuinely scholarly stuff–

‍

Nita Farahany:

So I think I'll answer it how I want to answer it but I will take that as a friendly suggestion that you want to think about whole body preservation. Let me say, Matt, that because, as Ken and Robert would all concede, the possibility of full reanimation of a person, full restoration of consciousness is a really long way off into the future, I would say a lot of the ethical study of what the implications would be are also just emerging. And my own thinking on this is evolving as well.

And so, I would say I'm in the early stages myself of trying to think about all of the possibilities, both legally as well as ethically, as to what it would mean. A starting place as just an interesting question for me is I'm currently serving as a reporter on something called the Uniform Law Commission which proposes in the US, uniform model legislation where uniformity would be valuable and one area where uniformity is quite valuable is in the definition of death.

The UDDA, the Uniform Declaration of Death Act, is being revisited to try to determine in light of both changes in medicine and changes in law and changes in neuroscience, do we need to update what the definition of death is? One way in which we determine death is by brain death, death by neurologic criteria and death by neurologic criteria presumes the irreversible loss of essential functions of the brain. That's a summary of what the UDDA currently requires and how irreversible does it need to be? How permanent does it need to be? If it is something that could come back 100 years from now or 200 years from now, is the person not legally dead or do we say you're good enough dead for legal purposes? It turns out that whether or not you are declared dead based on neurological criteria, it's really important for a whole host of things that we make choices about.

Obviously if you're choosing to be somebody who has your brain preserved, you're probably not an organ donor but can you be an organ donor if there is the possibility of reversing the loss of consciousness or the irreversible loss of brain functions? Can your estate pass to other people? Can we consider all of the things that we fix in law based on your passing and death? Are all of those things up for grabs and in suspended animation as we think about it? I think that there is a finality and a certainty to death that we need in law to make a whole host of choices and this would throw those into questions. So that's just one small area.

It also raises all kinds of questions about the possibilities of asking a person after death what their wishes were. So imagine we're 200 years into the future where you actually could have a restoration of consciousness or even some synthetic version of consciousness. So suppose what you have is you're able to, through the fact that memories are fixed, you could reconstitute what the person was like in the past and using AI, that might help you predict how they would respond to novel situations and they didn't leave a will and you want to know, "Do you really want to cut off your third kid from your will? Because they're not written into your will."

And so, do you query and ask the synthetic consciousness or brain or do you do what we currently do which is we try to make inferences, we try to decide what the person would've thought, or do you make a much more direct inquiry like, "Hey, what is it that you actually wanted to do? Did you really want to cut Billy out of your will or did you really want to leave everything to your new girlfriend that you just met two weeks before you died? Is that really what you hoped for?" All kinds of things that we currently can't do would be open possibilities.

And so, this is just a starting place. We could keep going but as we imagine what the implications are, it throws into question a whole bunch of assumptions we have in law, assumptions we have about how we interact with people and raises all kinds of equity questions. Can only rich people do it? I mean, Altered Carbon was a great series. I'm sure you guys all watched it. I loved it. That really poses this future in which right now, the only people who could afford the brain preservation or whole body preservation to Robert's point would be people who could afford it, who have luxury of excess finances. And so, do we end up with this huge gap in the future that's even wider than today, that only people with intergenerational wealth are really the people who many years into the future continue to have that wealth preservation through this kind of technology. So that's a starting place, Matt. We can go in any direction you want.

‍

Matt Angle:

I love this thread and another aspect of this that I think is very interesting is obviously, if someone goes to sleep and you kill them in your sleep, you've committed murder. If someone's brain dead and you unplug them, you haven't. But it would seem, I think we'd all kind of agree right now when it's a long shot that if someone signs up to have their brain preserved and put on a shelf and then some drunk driver crashes into Robert's shop and destroys a bunch of preserved brains, we would probably say that person did not commit multiple homicides.

‍

Nita Farahany:

Well, I mean, maybe, Matt. Because I mean, there's this whole doctrine of loss of chance. Do you know about that?

‍

Matt Angle:

No, no. I'd be curious to hear about it.

‍

Nita Farahany:

Okay. So what you've just described which is the person for all intents and purposes is dead but they've preserved the possibility of being undead. We'll just be really unscientific about it here, right?

‍

Matt Angle:

Yeah.

‍

Nita Farahany:

So I mean, we're going to call them legally dead but there's a possibility of reversing that in the future where they're restored to life and maybe we have to come up with some new legal category as to what that is and what they have, the interests that they have once they are cryopreserved or I don't know what exact terminology we want to use here, but let's assume they they're preserved. Can we just use that? Is everybody happy with preserved as a word?

‍

Robert McIntyre:

Yeah. Preserved is good. Yep.

‍

Nita Farahany:

Okay. So they're preserved and they have a chance of restoration or revival or whatever we want to call it and the person who crashed into Robert's shop took away that chance.

‍

Matt Angle:

By the way, Robert, we know you don't have a shop and we know you're not–

‍

Nita Farahany:

We're imagining a future where Robert has a shop.

‍

Matt Angle:

But we're just making a–

‍

Robert McIntyre:

Well, yeah. Hypothetical thing.

‍

Nita Farahany:

So in Robert's shop and Kenneth crashes into Robert's shop and as a result, all of the bodies are unable to be preserved any longer like any chance that they have is destroyed. There's a doctrine in US law called Loss of Chance Doctrine and it solves what the problem that you highlighted, Matt, is which is it solves the causation problem, your conduct has to cause the person's death. Well, obviously, your conduct didn't cause the person's death. You can't prove that beyond a reasonable doubt but you could prove beyond a reasonable doubt that you took away their...it's a loss of chance. It's 100% loss of chance of future survival and that might not be murder but nevertheless, you might have a tort suit like a civil damages suit because you had some interest in future revival and how are we going to quantify that and what we're going to figure out the damages are for your loss of chance of life?

Maybe we would look to...this happens in IVF cases. So embryos are preserved and then they totally mess it up, so they haven't frozen the embryo properly, the equipment fails, and so then, several years later, past the time at which the partners could meaningfully get eggs out of the female partner, they go back in to do a frozen embryo transfer and the embryo doesn't thaw because of a mishandling of it. The claim there is a loss of chance of the possibility of having this child and denial of that loss of chance has led to millions of dollars in damages and suits that have happened when the freezers, whatever, the cryopreserve tanks have malfunctioned or the embryologist has done something wrong or the equipment's tube that they put it in has malfunctioned. So there's a precedent for this and I wonder if that precedent would be used in the case where Kenneth crashed into Robert's shop.

‍

Matt Angle:

What happens over time as the probability of revival goes from, I think we'd all admit, small, to everybody's getting revived?

‍

Nita Farahany:

So there are, again, the IVF analogy is a pretty good one which is if you have a frozen embryo that has not been genetically tested, for example, and it's from when the person was 45 years old that they froze the eggs. And so, the likelihood of success is less than 15% because of the likelihood of genetic abnormality and failure to implant is quite high. The damages are much lower than a genetically tested PGT-A euploid embryo which has a 75% chance likelihood of having a successful implantation and live birth and the result is quite different.

I would think the same would be true here which is the closer we get to the possibility of revival, the greater the damages are. Maybe your damages for crashing into the shop are low when we're 100 to 200 years off and the possibility of fully restoring a body and brain and consciousness is really a remote possibility but the closer we get to that, the higher likelihood, I think, that Ken in a lot of trouble for crashing into Robert's shop and we decided that the loss to society was quite profound because of the inventions and the scientific progress that you might have brought to society.

Maybe we're able to bring a criminal suit against you and a criminal suit standing applies when you're talking about a civil suit a private party is suing. So maybe you don't get a wrongful death or in this instance, a wrongful failure to revive suit as the person because they're dead, maybe the estate has or the heirs have that standing but criminal law is brought in the name of the public. And so, the state is the one who prosecutes and they prosecute because of the harm to the public and we could think that there's a harm to the public because of the irresponsible driving, the loss of lives–

‍

Matt Angle: 

Has there ever been a situation where someone was not resuscitated in a situation where they could have been? Like they're in a hospital, they don't have a DNR–

‍

Nita Farahany:

Yeah. So that's where Loss of Chance Doctrine comes in most often, is a medical negligence case where the failure to have done something by a doctor who had a duty to have done so. Their medical negligence can't be said to be the but for cause of the person's death but the medical negligence was the loss of chance of survival that they had. And so, they likely would've died anyway. Their chance of survival was quite low but that chance of survival was lost because of the medical negligence of the party.

‍

Robert McIntyre:

Another way to think about this is the information that's contained in a preserved brain is itself of historical significance and valuable and the destruction of that is somewhat akin to laws that we have for destruction of historical artifacts or destruction of information. So for example, if I own a property and I discover some ancient Indian artifacts on my property, I can't just smash them and destroy them, I need to...I'm actually responsible for the destruction of cultural heritage at that point so you could make an argument even if the–

‍

Nita Farahany:

I'll just say that you're treating it like property then, right?

‍

Robert McIntyre:

Yeah.

‍

Nita Farahany:

That's a good question. You're right that we have analogies in the loss of property or in destruction of property but I think the real question is, "Is preserved brain tissue and preserved bodies, do we think of that as property and tissues or do we think of that as the potential living being?" That's why I likened it to an embryo because the question with an embryo is the potential for life and here, we're looking at the potential for restoration of life and there was this whole debate as to whether or not embryos are treated as a unique and special class distinct and different from property in regular tissue because of their potential. I think that's the kind of analysis that we'd have to do when it comes to something like this is, "Do we treat it like brain tissue that's preserved for research purposes or do we treat it as the potential for restoration of life?"

‍

Robert McIntyre:

Yeah. It's a great way of thinking about it. So I'm just saying, currently, the law does treat–

‍

Nita Farahany:

Now, we would treat it as property because now, we would just treat it as tissue, right?

‍

Robert McIntyre:

Yeah. But even under the definition of property, the information there is still of relevance so–

‍

Nita Farahany:

You can make out a damage case and say it's not just regular brain tissue because of the way it's been preserved, it has preserved a lot more significance than traditional brain tissue would. And so, the value–

‍

Matt Angle:

The destruction of property is the boring issue, right? The more interesting issue is that, people, it used to be they stop breathing and they're dead. Then it was like, "Nah, you should really wait for the heartbeat." And then, it was like, "Nah, you should do an EEG." But now, we're saying, "You know what? Even if the neurons aren't firing anymore, it's really the data." And so, now it's a very interesting thing because suddenly like–

‍

Nita Farahany:

Well, right. But is it past data, Matt, or is it also future data, right? That's part of it. If this is past data, I'm less worried about it and less worried about it from a death perspective.

‍

Kenneth Hayworth:

Unfortunately, everybody is talking about a legal question that does not exist. The current legal system is barring anybody that really needs a good preservation and anybody that really thinks that this is a possibility. I mean, look, I know cancer patients that they're terminal, they're dying, there is nothing that can be done for them, they want a good preservation, and they can't get it because the legal system basically says, "This doesn't make any sense whatsoever." This can't be treated as a medical technique until you actually show somebody coming off the table alive. That is the only criteria that they will say and therefore, if you want a good preservation... I mean, if you want any preservation, you have to be legally dead and essentially tissue anyway. And then–

‍

Nita Farahany:

Well, that's not quite true, Kenneth, because you can be brain dead... Now, maybe that actually is the problem for you which is if you had brain death, then you have quick problems with degradation of the brain tissue to begin with. There's also Normothermic perfusion that people are doing an organ donation. And so, you could have circulatory death and then reperfusion and still have brain function that could be preserved in those instances. So I think it's a little bit blurrier than you're suggesting.

‍

Kenneth Hayworth:

Well, I mean–

‍

Nita Farahany:

Unless, what you're saying is you can't kill a terminally ill person in order to preserve them. Is that what you mean?

Kenneth Hayworth:

Yeah. Well, I–

‍

Nita Farahany:

Yeah. You're right. You can't engage right now in active euthanasia in order to preserve, that is considered hastening their death which is murder.

‍

Kenneth Hayworth:

The other thing though is that the scientific study of this is not considered part of regular medical science. So I mean, look, my–

‍

Nita Farahany:

Connectomics is a part of... I mean–

‍

Kenneth Hayworth:

Well, again, all of neurosciences... Look, there is very little relationship to what we're talking about and connectomics, okay?

‍

Nita Farahany:

Well, let's back up a minute because you actually raised something really interesting which is you can't get what you said as a good preservation because you can't engage in active euthanasia in the US in most jurisdictions, right? So there is some death with dignity movement in the US for terminally ill patients but certainly moving up to well before you get to the point where you've had organ failure and everything else like you have the diagnosis, that's the point at which you want to enter into preservation because that's the point at which you're most likely to have a successful revival in the future. You can't do that.

Active euthanasia, passive euthanasia have been debated for a very long time but there are a lot of really good reasons that we're worried about active euthanasia and that we haven't adopted active euthanasia because of the slippery slope, because who do we trust to actually perform that, because what's the line between murder and active euthanasia like how do we actually regulate that system to ensure that it is done in ways that are safeguarded?

I am somebody who strongly believes in death with dignity and strongly believes in the right to a person to die with dignity and to choose to die through active euthanasia but I recognize that to implement it is incredibly challenging. The practicalities of implementing a system like that to ensure that it's not abused and to maintain trust in the medical system is challenging but that's true across the board. That's not just for preservation. This has been a debate that we've had for–

‍

Kenneth Hayworth:

Yeah. But this–

‍

Nita Farahany:

A very long time.

‍

Kenneth Hayworth:

This substantially ups the ante though because now, you're saying we are not just going to either force you to–

‍

Nita Farahany:

I agree.

‍

Kenneth Hayworth:

Yeah. Exactly. That's–

‍

Nita Farahany:

Yeah. No, I agree which is like if you could choose an earlier point of time which is like I shouldn't have to wait until my organs fail in order to choose to make an autonomous choice to have my brain and body preserved because the best chance I have for revival is if I do that well before the terminal illness ravages my body.

‍

Robert McIntyre:

The worst case here is Alzheimer's because you don't qualify for any death with dignity if you have Alzheimer's. There's just simply no recourse whatsoever.

‍

Nita Farahany:

Yeah. Unfortunately, we're in heated agreement over here. This isn't going to be fun because... But I'll just point out that while I agree it is problematic, I also, from a legal perspective, just understand how incredibly complex it is to implement a system that's safeguards against abuse and misuse of active euthanasia. And so, it's not–

‍

Robert McIntyre:

I mean, anything–

‍

Nita Farahany

To implement.

‍

Robert McIntyre:

Yeah. Although you surely don't mean that as an actual argument for it because anything that's important is often difficult to implement legally like legalizing marijuana or ending slavery or any of these things are complex things to do.

‍

Nita Farahany:

Yeah. This is a little bit more complex because what's the line between murder and active euthanasia and then, where would you draw it, right? I mean, do I have to be terminally ill or can it be that I'm just done and I recognize that, 18 years old, my body is going to be as healthy and vigorous as it's going to get and I'd rather come back 200 years from now and I'd rather make that choice now.

‍

Robert McIntyre:

Yeah. I would challenge that. Why can't you just copy paste the Netherlands' laws? Those work and they've already been done for decades and they're fine. I think–

‍

Nita Farahany:

Robert, what's your moral argument for adopting the Netherlands' approach versus like if you believe that when you have your best chance at preservation, you ought to have the opportunity to do so and you believe that you have an autonomous reason to be able to make those choices? So you're really favoring individual autonomy, why wouldn't you allow the 18 year old who is a legal adult who has decided that they're in the best shape they're ever going to be in, their body is most likely to succeed for the 200 year preservation, and they'd rather live in that future because they want to come back if we have solved climate change but they're not interested in living in this world.

If we haven't solved climate change and if climate change is such that the world isn't going to exist in 200 years, they're not going to worry about it, they're not going to be back but they're just done. They're done with this world. They're done with this world that doesn't care about climate change. They're done with the Trump era. They're just done and they want to come back in 200 years so why can't they?

‍

Robert McIntyre:

Yeah. It's a really interesting question. One intuitive idea about this is originally, the way I was hoping preservation might work is it'd just be a thing you could jump in and you'd go like let's say you were 60 and you thought that the uploading technology would happen in 80 years and you're obviously not going to live long enough to make it. So you'd have this thing that you'd jump into and you'd go in it for five weeks and you'd come out for one week and it would be robust and benevolent enough and benign enough that you could just do that over and over again.

That would be the ideal because then you could still be part of society, you could still vote, you could still manage your affairs, see your grandkids, and you're not around that often but now suddenly, the 20 years you have left between 60 and 80 has been multiplied to 100 years and then you're fine. So I do think that if we had a fully reversible technology that it seems really clear that you can just do that and morally, at least to me, it seems fairly uncomplicated.

‍

Nita Farahany:

Who are you going to let do it? Anybody? I mean, so... Again, if it really worked and if it was really on the horizon, why do I have to wait until I have my 60 year old post-menopausal body as opposed to my vigorous 18 year old body?

‍

Robert McIntyre:

Yeah. See? It seems tough to say. If it's really genuinely universal, it feels like it's less...one thing that is important is we're going to have to deal with this maybe a bit sooner than everyone realizes because in the next, say 20, 30 years or so, essentially every decade, neuroscience is progressing at a vast rate. So right now, the evidence is clear to people like, "Hey, what do you mean? You can do the preservations?"

But let's say, 20 years from now we've got an entire mouse brain, we're actually simulating parts of it and they're working really well, we've extracted 500 bits of memory from various animal models, right? Then, it's more likely. I think that even in the case where you have the first human upload, the first one is going to be like a moon landing project. It's going to cost billions of dollars, it'll take 10 years, it'll take a crew of people to do it.

And so, I could very well see a situation where we've successfully uploaded a person, we know for sure that it works, but it's still another 30 years before that's generally accessible or affordable to anybody. Just like you can't go to the moon but nobody questions whether you can go to the moon or not. So then, at that point, it's definitely a very interesting question.

‍

Nita Farahany:

I got to go because I know that my childcare is running out. Matt, is there anything else you wanted to cover with me before I hop off?

‍

Matt Angle:

Maybe just one more comment which is we're making the perfect transition into the next segment which is we've been talking about this as like, "Okay. How do we think about the brain preservation if we know that at some point in the future it can happen," but how do we think about this especially because you can only get good fixation if you, essentially like anyone who's done animal work knows, you got to do a live perfusion to get a good fixation?

So we've been calling this euthanasia but it's like you have to pump fixative through an alive brain to get a good fixation. So we have people who are alive becoming by what we consider now not alive and that's the only way to do it and we have no idea if they'll be able to be revived. Maybe if you could just give us a closing thought. In the face of such uncertainty, how should we think about the ethics of allowing people to do this?

‍

Nita Farahany:

I think you've got to break it down between a few different parties. One is the person who opts into it, should they have a right to opt into it? So that is a person who's alive, do they have a right to essentially commit suicide? We've had that debate for a very long time, right? Is there a right to suicide? There are states that have suicide as a criminal thing. There are religions that believe that it is a sin to commit suicide. That's an age-old debate that we're not going to solve here today but I'd say first is, does a person have a right to commit suicide for any reason, even if the reason that they are offering is because I want to come back in the future in some different form or in some better world or in some better condition?

The second is, the person who's doing it. So what is the duty of the person who's doing it and do they have a right to do it? Right now, it would be the equivalent of committing murder. And so, the person who is doing it, even if... You can't consent to murder. There is no such thing as consenting to murder within... But I mean, this is... People have written load of articles about this. They've talked about, "Could you have a world in which you consent to murder?" and the answer is, "No, we don't currently allow that." So we'd have to create an exception and say that this is more active euthanasia and that there's some humane basis for doing so and some rational basis for doing so.

And then, the question is, do only certain people qualify? Is it only somebody who's terminally ill? Is it somebody who's young and healthy? Can anybody do it and what are the limitations? And then the last piece of that would be, assume we get through all of those hurdles and we decide that it is both permissible for a person to commit suicide for this reason or for any other reason, that it is permissible for a person to be the person who is doing the preservation, then the question is, how do you do it ethically, right?

Because if a person has to be alive in order to have the perfusay pumped through their body, we have debates all the time about the death penalty and how inhumane it is because people suffer and the fixatives that you have to put in to stop their heart, etc, etc., how do you do it in a way that's humane? Can you do it with just the person being fully anesthetized? Can you induce a coma such that the person is unaware and if they ever do come back, there isn't PTSD and trauma of actually being preserved? These are questions about... These are both questions of science but also questions of morality and philosophy and ethics of how you would do it ethically if you actually got to that point.

And then, what are the ongoing duties of the company that is doing the preservation? These are issues as well. So suppose Robert has a shop that he opens that actually allows people to be preserved and then he declares bankruptcy, is there an ongoing duty and obligation to continue to preserve those bodies? What does that look like over time? What if Robert is dead and the future company and the future shareholders decide they want to pivot into a different direction? Do they have an ongoing duty and obligation to continue preservation and for how long and at what point do they decide that this body is degraded enough or the technology is bad enough or the first few people that we've brought back are zombie-like enough that it's more humane to disconnect these people?

There are all kinds of ongoing issues that will remain if we ever get to that future about the ongoing obligations after we get to the point of preservation. So there are going to be a host of issues that we're going to have to deal with if we ever get to that future. The immediate ones that we'll have to deal with are, "Do you have the right to commit suicide? What is the obligation or right of the person who's doing it? What is the humane way to do so and what are the ongoing duties and obligations of whoever it is that has done the preservation and is the fiduciary who's responsible for those bodies?"

‍

Matt Angle:

Awesome. Thank you so much.

‍

Nita Farahany:

Thank you, guys. I look forward to hearing the episode and I hope to be in touch with all of you in the future. Bye.

‍

Matt Angle:

Absolutely.