#6: Optional additional stepspost by mingyuan · 2021-02-02T23:57:01.742Z · LW · GW · 2 comments
Introduction do any of this? I have to do all of these things? Standby arrangements Communicating your intentions to your family for relatives incentives Protecting yourself in medical emergencies advance directives (USA) Living Will Durable Power of Attorney for Health Care The question of resuscitation of Religious Belief Objecting to Autopsy (some US states) Communicating your intentions to other parties cryonics with your doctor, attorney, and local coroner or medical examiner your will a video Getting your family members signed up Bringing assets into the future a revival trust Preserving assets Preserving a legal identity storage Cryonics Institute Alcor None 2 comments
The preceding posts cover everything you need to be fully signed up for cryonics. However, there are a lot of additional steps you may want to take to give yourself the best chance at optimal conditions for cryopreservation.
Why do any of this?
As I've emphasized before [? · GW], any delay in your cryopreservation is to be avoided as far as possible – so any social or legal dispute could jeopardize your successful preservation. In at least one case, an Alcor member was dead and buried for two full months before Alcor even knew he had been ill. Needless to say, you don't want that to happen to you – your organs will definitely not be in optimal condition if that happens.
Essentially, you want to put yourself in a social and legal position such that your cryopreservation won't be blocked by distraught or confused family members, medical professionals, lawyers, or coroners. Pursuant to this, you should communicate your intentions clearly to all stakeholders, codify your wishes in legal documents, and not give anyone financial incentive to interfere with your cryopreservation.
Do I have to do all of these things?
I've listed things in order of how important they seem to me – standby is first because, as I've discussed [? · GW], not making standby arrangements is a great way to incur a ton of ischemic damage. I also think everyone should execute healthcare advance directives if possible, and everyone should at least make sure their family is aware of their intentions.
My family and friends are very much onboard with cryonics, so I'm not worried about anyone interfering with my cryopreservation. But it seemed so easy to have people sign Relative's Affidavits that I figured I would do it anyway. I'm not, however, making a video explaining my intention to get cryopreserved – that seemed unnecessary. I'm also young and healthy, and I don't have a relationship with an attorney, doctor, or coroner, so I'm not talking to any of those people.
The final two points – getting your family members signed up, and bringing assets into the future – feel very much optional.
As mentioned [? · GW] in previous posts, signing up for cryonics via CI does not automatically sign you up for standby. If you want standby, you can get a contract with Suspended Animation (see this page on CI's website) or make your own arrangements with a local funeral director or volunteer standby group. Alcor members – especially those located outside of North America – may also be interested in the latter due to the inherent limitations of centralized standby.
If you're interested in making your own arrangements, I recommend seeking out online discussion groups and/or connecting with other cryonicists in your area; I can't personally offer any advice because I've never done this.
Communicating your intentions to your family
Most legal cases involving cryonics are brought by a family member of the patient, who wishes to dispute the cryopreservation. In some cases this is because the patient's children want to inherit the patient's money rather than having it go to Alcor, but it may also be because the family was unaware of or confused about the patient's wishes.
Because your family by default has so much say over what happens to your body and estate after you die, it's important that you explain to them your wish to be cryopreserved. Ideally do this as soon as possible, and not when you're on your deathbed.
Your family may or may not be receptive. If they're not, CI recommends that you "Consider removing hostile or nonsupportive next of kin from control of your estate and your remains legally in advance of your legal death so that hostile people can be disempowered from making decisions you might otherwise disagree with."
Paperwork for relatives
If your family members are receptive, you should have them sign affidavits promising not to interfere with cryopreservation activities upon your death. Alcor's version of this is a Relative's Affidavit; CI's is the Next of Kin Agreement. Alcor says that a Relative's Affidavit "is a very effective way to protect you."
Consider who stands to gain financially from your provider failing to cryopreserve you. For example, if you name a nonsupportive family member as the contingent beneficiary of your life insurance policy, that person will stand to gain tens or hundreds of thousands of dollars by blocking your cryopreservation. Review your will, cryopreservation agreement, life insurance policy, and any other relevant documents to make sure you're avoiding situations like these. You may also want to look into "no contest" clauses.
Protecting yourself in medical emergencies
Max More and Chana Phaedra have already explained this well:
Even if you have no risk of a third party preventing you from being cryopreserved, you may not be in optimal condition for cryopreservation if you do not take care to minimize certain risks. Particularly in certain medical scenarios, you may wish to avoid extreme life-saving attempts or measures that may place you at high risk of prolonged or repeated ischemic insult and brain damage.
This section deals with what you can do to avoid such situations, including executing advance directives, and registering your desire to not undergo an autopsy. Read more on this topic from Alcor and CI.
Healthcare advance directives (USA)
The two advance directives you should fill out are a Living Will and a Durable Power of Attorney for Health Care. The exact requirements vary from state to state; generic state-specific documents can be obtained for free here or here.
Alcor has a Cryonics Medical Power of Attorney form which is valid in most US states; click here for the PDF or here for an editable version (just make a copy of the Google doc). I also found this outdated Cryonics Living Will that might be a useful reference.
After you have executed your advance directives, send copies to your cryonics organization so that they know who has your power of attorney in an emergency. Also give copies to your healthcare provider and attorney.
A Living Will is not actually a will; it's a document that records the kind of medical intervention you want to receive if you are unable to communicate your wishes due to mental or physical incapacity. While hospitals sometimes ignore a Living Will, it's useful to have one because it protects healthcare providers from liability if they carry out your wishes.
In some states it may not be possible to spell out your desire to be cryopreserved in a Living Will; in those cases your Living Will should just refer to your Durable Power of Attorney for Health Care for the details of your wishes. This also ensures that the two documents don't contradict one another.
Durable Power of Attorney for Health Care
Alcor's explanation is good:
In a Durable Power of Attorney for Health Care, which is by far the more powerful of the two documents, you give someone you trust the power to make medical decisions for you in the event that you are incapacitated and unable to make such decisions yourself. This person is your medical surrogate, also known as a health care agent. The surrogate can make health care decisions with the same authority as if you made them yourself, including decisions regarding withdrawal of life support. Therefore you should be extremely careful about your choice. You should also consider naming a secondary surrogate in case your first choice is unavailable.
We offer these suggestions:
- Your surrogate should be younger than you and in good health, to maximize the chance that he or she will outlive you.
- If you wish to be cryopreserved after death, your surrogate should be fully informed about cryonics and very sympathetic toward cryonics.
- Choose someone who is smart, highly motivated, and has good social skills. You don’t want your surrogate to alienate or antagonize medical personnel.
- Although it is common to choose a spouse or close family member as your surrogate, you may choose any other person as well. If you do not choose a family member, that person should not be a beneficiary in your will who might benefit, or appear to benefit, from your death.
- Your surrogate cannot be an officer or employee of your cryonics organization (but may be a member of your cryonics organization).
Note that if you do not choose a medical surrogate, your closest next of kin will have that power by default. Even if you trust this family member to exercise medical judgment wisely, you should still give that person explicit power of attorney.
Hospitals can sometimes ignore a Living Will, but they find it much more difficult to ignore someone with Durable Power of Attorney for Health Care.
The question of resuscitation
Again via Alcor:
On one hand, cryonicists hope that medical staff will not prolong life unnecessarily if this will increase the risk of brain damage. Very often, a patient who is near death may have low oxygen saturation, which could injure brain cells if it continues for a long period. On the other hand, your cryonics organization will want to be nearby to take immediate action after legal death is pronounced. If Alcor has not had time to deploy a team, or if you are in a remote area, you may want medical staff to prolong your life until the team can arrive.
Recognizing this dilemma, you could consider putting a statement in your advance directives such as, “If I am in a vegetative state, I wish life support to continue, but only until the Alcor standby team is on-site and has stated that it is ready. If I experience cardiac arrest after the Alcor standby team is ready, I do not wish to be resuscitated.”
Certificate of Religious Belief Objecting to Autopsy (some US states)
Autopsies are really bad for your prospects of successful preservation, because they not only introduce a lot of ischemic time, but may also directly damage your organs, including your brain.
In California, Maryland, New Jersey, New York, and Ohio, you can file a “Religious Objection to Autopsy", which should significantly decrease the probability of an autopsy being performed on your body. In other states, you will need to rely on your relatives, your cryonics organization, and the person with your Durable Power of Attorney for Health Care to advocate for your wishes.
Communicating your intentions to other parties
Discuss cryonics with your doctor, attorney, and local coroner or medical examiner
These are all parties that may be involved in your death and the execution of your will. You don't need to have long discussions with them where you discuss the philosophical implications of cryonics or whatever; they just need to be aware of your intentions and how that concretely affects them.
Alcor says: "The best way of assuring that your wishes will be honored is to find a sympathetic doctor who has agreed to honor your wishes in advance. At the very least, make sure your doctor has copies of your advance directives, and that your hospital is given copies on admission."
Change your will
If you have made a will, make sure that it doesn’t contain any statements that conflict with your desire for cryopreservation. For example, my mom's original will stated that she wanted to be cremated; something like this could present an obstacle to her successful cryopreservation.
If you don’t have a will, now is a good time to make one. Ideally your will should include a section explaining and affirming your outlook on cryonics and your desire for cryopreservation after legal death.
Make a video
Alcor says that, in case of any dispute, "a video is the best possible evidence that you made a fully informed decision." They encourage you to "make a short video in which you describe your desire for cryopreservation calmly, rationally, and firmly." You should send copies of this video to Alcor, your attorney, and the person who has your Durable Power Of Attorney For Health Care.
They also encourage you to make the video with at least two witnesses present, and to "make a new video at least every five years to reaffirm your preferences and prevent anyone from suggesting that your video was obsolete because you changed your mind after you made it."
Getting your family members signed up
If you've talked to your family members about cryonics (as recommended above) and they seem receptive to it, why not bring them to the future with you? You already know how the signup process works, having gone through it yourself, and family of existing members are eligible for certain discounts from both Alcor and CI.
Even if you don't get along with your family, surely there's someone who you'd like to bring with you. I'm not nearly as passionate about cryonics as the time I've spent on this sequence would suggest, but I do strongly believe that death is bad. If you love people, you probably want them to not die. So I'm really lucky that my mom and sister are signing up with me, and that several other people I know are signed up already.
Bringing assets into the future
Assuming things like currency and physical possessions still exist when you wake up, you probably want to have some of those.
Creating a revival trust
I was not super interested in this myself, not being much one for finances or believing in a future where things are sufficiently similar to now that this will matter, so instead of my usual detailed explanation, I'm going to give you a vetted list of links on this topic.
If you're signing up with Alcor, they have some existing structure in place for this:
- Alcor's Multi-Investor Future Income Trust (minimum of $25,000)
- Alcor's Asset Preservation Trust (minimum of $500,000)
If you're signing up with CI, consider going through ACS – you'll still ultimately get preserved with CI, but ACS will establish and manage a reanimation fund for you.
"ACS is [also] willing to hold money in trust or as a fund for individuals who do not have their primary suspension arrangements with ACS" (source).
Additional information on how to establish a revival trust:
- John Dedon: "Preserving Assets in Trusts for Clients Considering Cryonics"
- John Dedon: "How to Take It With You"
- John Dedon: "Functions of a Trust Protector during Biostasis and at the Time of Cryogenic Revival"
- Rick Durfee: "Cryonics Suspension Trust: The Ultimate Estate Freeze"
- Rudi Hoffman: "The Hoffman Prototype Trust, and Ideas Regarding Cryonics Estate Planning"
Preserving a legal identity
My insurance agent also said that "in order to have an identity in the future, you must have a trust established that preserves some form of your identity (such as a social security identity)." But, he also said some other things about the far future that I thought were pretty confused, so that might be totally wrong. (To be clear he's great at his job; this is not really part of his job.)
See also Christopher Sega's "Possible Legal Rights of Cryogenically Revived Persons."
Alcor and CI both allow you to store personal effects as a sort of rider on your cryopreservation. You can store letters, videos, hard drives, whatever you want.
CI requires members to sign a Memorabilia Storage Agreement and pay $1000 cash upfront, non-refundable.
Alcor offers every member one 10”x12”x15” box for free and charges $250 for each additional box. You can also contribute items to storage for members already under cryopreservation at Alcor. Alcor Memory Boxes are kept in an underground commercial storage facility in Kansas.
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