This page contains the current draft of Chapter 16 of RAFT 2035. All content is subject to change.
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16. Bubbling under
RAFT is far from being a fixed and complete model. It is expected to grow and evolve in the months and years ahead.
As the ideas behind RAFT have been discussed ahead of publication, a number of other goals have been proposed for 2035, but have not yet been included in the main analysis. Borrowing a phrase from publishers of charts of the most popular music tracks, these goals can be said to be “bubbling under”: they are under the present threshold for inclusion, but have enough interest to be worth listing.
Selected examples are listed below, with a view to versions of these goals potentially being adopted more widely in due course.
A charter for individual liberties?
RAFT emphasises social collaboration, with “no one being left behind” against their will. This includes what can be called a principle of “active neighbourliness”: rather than keeping quiet about impending dangers about to befall someone, or major opportunities they are about to miss, we should find the way to speak up, just as we would ourselves like to be alerted to these dangers or opportunities in an equivalent circumstance.
At the same time, RAFT champions the fundamental importance of human individuality: individual flourishing should not be sacrificed or subordinated to collectivist goals. Society should protect and elevate all members of society. Individuals should never become cannon-fodder in service of some tribal, national, ethnic, religious, or ideological quest.
Balancing the principles of human individuality and active neighbourliness can be challenging at times. Might a new charter of individual liberties help?
This charter would clarify reasons to uphold important rights, as well as reasons why people should accept important responsibilities and limits. The interplay of these points can be subtle.
Merely the fact that someone desires to carry out some kind of medical or lifestyle experiment, and claims to be fully informed about all the risks and consequences, cannot, by itself, convey the right to proceed. That’s because the consequences of the experiment could extend beyond the person directly involved. Financial or social costs incurred by third parties could far exceed what they expected.
However, the positive upsides to such an experiment could, likewise, exceed reasonable expectations. Therefore, care must be taken not to limit experimentation unnecessarily. Care is particularly required not to allow dominant subgroups to exert restrictive viewpoints over a community as a whole, obstructing innovation, where the effect of these restrictive viewpoints is to privilege existing power groups and to preserve the status quo.
In other words, there’s a need to take into account, not only the direct effect of a medical or lifestyle (etc) experiment, but also what are called the “externalities” of that experiment. Failure to do so would be akin to commending a company whose profits depended on them hiding flows of waste pollution they are generating. Another comparison is with overlooking the “moral hazard” that arises from an otherwise commendable act of generosity or forgiveness.
Two terms that are heard in this discussion are “precautionary” and “proactionary”. It is sometimes implied that a one-time choice must be made between these two poles. In reality, both principles are needed.
- The precautionary principle is appropriate when there are credible suggestions of huge negative consequences of some action. We need to beware unintended runaway consequences of well-meaning actions. This is particularly necessary when the distribution of outcomes has “long tails”, in which extreme results will happen more frequently than under an assumption of the normal (Gaussian) distribution. An example of such a distribution is for the number of biological species that can become extinct over a given time period.
- The proactionary principle points out, on the other hand, that abstaining from action can have huge negative consequences as well. To adapt traditional language, there are “sins of omission” as well as “sins of commission”. Rather than any blanket abstention from actions which have associated risks, it is often better to develop plans to manage these risks.
In many cases, a better principle than precaution is reversibility. Action that is risky should be undertaken in ways that allow reversal, in the event that matters develop badly.
Such a commitment to reversibility would require effective monitoring, and avoidance of any inertia that would overwhelm attempts to change course. It also requires the emotional intelligence that is willing to admit and experience failures, and to learn lessons from these failures.
The points mentioned could indeed be included in a charter of individual liberties, to be developed in the years ahead. Such work would dovetail with several of the interim goals already present in RAFT:
- Agreement on the basic elements of a revised social contract in which paid employment loses its prime position (from Goal 3)
- Establish a commitment from all countries in the United Nations to an updated version of the Universal Declaration of Human Rights, which takes fully into account the remarkable transformational nature of the technologies highlighted in RAFT (from Goal 7)
- Agree a statement of the “core values of all UK residents” (from Goal 8)
- Agreement on a replacement for the GDP index, that fully incorporates “externalities” (from Goals 9 and 10)
- Agree basic principles of the design and operation of systems for “trustable monitoring” (from Goal 6)
As well as seeking wide agreement on the desirability of various liberties, it’s also important to develop products and services that makes these liberties possible and, indeed, possible at scale. That’s the subject of the next two bubbling under goals.
Cryonics suspension on the NHS
Cryonics provides a kind of “ambulance to the future” – a future time when bodies can be repaired or even reconstructed, allowing a fresh new lease of life beyond the existing capabilities of medicine. Cryonics will increase the chance of people being able to resume relationships with family and friends, to continue to develop their own skills, and to have more experiences. As such, cryonics can be seen as a potential very powerful technology of liberation.
Cryonics involves the body (or, in some cases, just the head, or the brain) being lowered to temperatures below -130 °C. At these temperatures, biological processes essentially cease.
A group of 68 scientists have signed an open letter on cryonics, at various dates from 2004 onwards:
To whom it may concern,
Cryonics is a legitimate science-based endeavor that seeks to preserve human beings, especially the human brain, by the best technology available. Future technologies for resuscitation can be envisioned that involve molecular repair by nanomedicine, highly advanced computation, detailed control of cell growth, and tissue regeneration.
With a view toward these developments, there is a credible possibility that cryonics performed under the best conditions achievable today can preserve sufficient neurological information to permit eventual restoration of a person to full health.
The rights of people who choose cryonics are important, and should be respected.
Low temperature preservation is already in wide use for early-stage embryos, and for sperm and eggs. These have regained vitality when the temperature has been increased again. Simple organisms, such as the C. elegans worm, have been cryopreserved and then reanimated, and have demonstrated retention of memories of trained tasks at the end of the process.
However, the cost of cryonic suspension is currently upwards of $28,000 (via the American company Cryonics Institute) or $80,000 (via another American company, Alcor). These costs can rise higher to take care of standby costs, and, in the case of Alcor, further again, to $200,000, for the preservation of the whole body rather than just the head.
These high costs reflect the fact that very few people undergo the procedure at the present. Costs could come down significantly if benefits of scale can be achieved. Larger scale operation is also likely to improve the quality of the suspension, so there is less chance of damage being introduced.
The first person to be cryopreserved was Dr James Bedford, a 73-year old retired psychology professor. This took place on 12th January 1967. Despite the early cryonics community forecasting that the idea would soon become more popular, the rate of cryopreservations remains low to this day. For example, Alcor preserved only 10 individuals in 2018, 5 in 2017, 6 in 2016, 10 in 2015, 13 in 2014, 7 in 2013, and 3 in 2012.
However, there are currently many factors that discourage people from signing up for cryonics preservation. These include:
- Problems arranging transport of the body overseas to a location where the storage of bodies is legal
- The perceived low likelihood of a subsequent successful reanimation
- Lack of evidence of reanimation of larger biological organs
- Dislike of appearing to be a “crank”
- Apprehension over tension from family members (exacerbated if family members expect to inherit funds that are instead allocated to cryopreservation services)
- Occasional mistrust over the motives of the cryonics organisations (which are sometimes alleged – with no good evidence – to be motivated by commercial considerations)
- Worries that clients of cryonics organisations will be disproportionately rich, and that these organisations will become obstacles to social change
- Uncertainty over which provider should be preferred.
In principle, strategies are known to deal with each of these factors. As in numerous other fields of life, costs should decline and quality increase as the total number of experiences of a product or service increases. These are known as scale effects.
Hence the desirability of the following goal: cryonic suspension will be offered to all, on point of death, on the NHS, without requiring individual payments. Just as no-one needs to pay to be born, no-one should need to pay to be cryonically suspended.
Other actions that are likely to increase the number of people signed up for cryonics (and thereby reduce individual costs) include:
- Convincing demonstrations of successful reanimation of larger biological organisms or organs
- Changes in the law concerning euthanasia, to allow people who are approaching death to control the time when cryopreservation can start (this is sometimes known as cryothanasia)
- Storage of cryopreserved bodies at locations throughout the UK, rather than travel needing to be arranged overseas
- Involvement of hospital doctors and other staff in the cryopreservation process, rather than a potentially disruptive handover needing to be made to a team of “standby volunteers”.
Another suggestion is that cryopreservation of the brain could be offered by the NHS in return for the other organs in the body being made available for transplantation or scientific research.
Ectogenetic pregnancies on NHS
Whereas cryonics (discussed in the previous section) would provide additional choices over the treatment of people at the end of their natural life, ectogenetic pregnancies would provide additional choices for mother bringing new babies into the world.
The proposed goal is that pregnancy via ectogenesis will be available to all on the NHS.
The rationale for the goal is that many women who currently find themselves unable or unwilling to become mothers by natural gestation will be grateful for the opportunity provided by ectogenesis. Coupled with therapies to regenerate ovaries and reverse the menopause, this treatment will provide additional choice to women, beyond existing options such as adoption.
Ectogenetic pregnancies extend and unify two fields of healthcare that already exist:
- IVF: In-Vitro Fertilisation, in which conception takes place outside of the bodies of the parents
- Hospital incubator care of babies that are born prematurely – babies that would otherwise have been too young to survive.
Ectogenetic pregnancies would remove the need for the growing embryo to be implanted inside the mother in between conception and birth. Instead, growth will take place inside a kind of artificial womb.
An indication of the kind of technology that could one day provide artificial wombs is given in the 2017 Nature article “An extra-uterine system to physiologically support the extreme premature lamb”:
In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic fluid’ circuit that closely reproduces the environment of the womb. We show that fetal lambs that are developmentally equivalent to the extreme premature human infant can be physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support maintain stable haemodynamics, have normal blood gas and oxygenation parameters and maintain patency of the fetal circulation. With appropriate nutritional support, lambs on the system demonstrate normal somatic growth, lung maturation and brain growth and myelination…
Extreme premature fetal lambs can be consistently supported in an extracorporeal device for up to 4 weeks without apparent physiologic derangement or organ failure.
At the other end of the process, scientists in the United Kingdom have (as reported in the Guardian) have kept embryos alive for 13 days after conception:
Researchers at Cambridge University… have kept a human embryo alive outside the body for 13 days using a mix of nutrients that mimic conditions in the womb. The embryo survived several days longer than previously observed and research only stopped because they were approaching the 14-day legal limit for the length of time an embryo can be kept in a lab. In other words, our ethics rather than our technology are now the limiting factor.
The Guardian article continues:
The key to survival through ectogenesis is reproducing the conditions of the womb. As scientists become better at that, the gap between the longest time embryos can survive and the earliest time a foetus is viable will narrow. When the two timescales meet, we will have the technology for a complete external womb.
However, there are still major obstacles to facilitating total extra-uterine development. It will take some time to fully identify and generate all the biologically active molecules that are incorporated into a developing embryo. It will also be a major challenge to develop a system that facilitates the specialised angiogenesis processes that form a working umbilical cord to connect to the surrogate maternal system, delivering all the elements.
Views vary regarding the desirability of this technology – similar to the heated debates that preceded the availability of IVF in the late 1970s. At that time, it was widely thought that excess psychological pressures would apply to the women, families, and children involved. However, society subsequently developed methods to handle these pressures.
To support this goal, further investment of research would need to be prioritised, in order to provide women with the greater freedoms and opportunities the technology would provide. In parallel, discussion should continue about the social and psychological implications of this technology. An example of a short fictional story that can prompt useful reflection on this topic is the video by Rachel Foley, “Technocratic Birth”.
This goal may turn out to be too ambitious for the 2035 time horizon. If further study were to confirm that conclusion, the goal could be revised to the adoption of technology supporting babies that are ever more premature.
By the way, how can we judge how much change it is credible to imagine can take place in a given time period? That’s one of the questions that is included in the FAQ (Frequently Asked Questions) list for RAFT, as contained in the next chapter.