[ExI] Medical power of attorney for cryonicsts

[spike]

From: extropy-chat [mailto:extropy-chat-bounces at lists.extropy.org] On Behalf Of John Clark
Sent: Friday, December 05, 2014 9:02 AM
To: ExI chat list
Subject: Re: [ExI] Medical power of attorney for cryonicsts

 

…

>>…I could use the advice of a good medical ethicist


>…Why? I'm sure they have opinions, most of them contradictory, but what actual facts do they know that you do not? I think you do yourself a disservice…

Thanks John, this post did dig deeper and contained useful insights.

Regarding medical ethics, this is something I think about a lot.  Back in the old days, a doctor by the name of John Harvey Kellogg was a most innovative sort.  He was the guy who invented corn flakes and a lot of other stuff in the health field from about 1875 to 1930s.  He did a lot of experimental therapies before the days of lawsuits, before hospitals had ethics boards, so doctors were on their own.  When people had very little access to information, the local doctor was revered, the most scientifically literate person in many communities, not just in medicine but in all areas of science.

A perfect example of where Kellogg could have used a good medical ethicist was in his experimental treatments of asthma using radon inhalers.  He killed an unknown number of patients with that, but they generally didn’t perish until several years after the treatments so no cause and effect was established experimentally or observationally.  A medical ethicist would have required Dr. Kellogg to follow up on those patients who received the experimental treatment and the link between radon and lung cancer would have been found earlier than it was.

In Kellogg’s defense, he saved way more patients than he slew, by promoting low-fat diets, exercise, and complete abstinence from tobacco, recreational drugs and alcohol.  No doubt people who followed his advice were healthier.  He was ahead of his time in many areas.  But he did slay perhaps hundreds with the radon.

>…You can't (or at least you shouldn't) spend your life worrying about how true facts you have found might effect very stupid people…

 

Ja, the reason this is different is that I am not offering some diet fad or cosmetic therapy.  If this appears to work but it is hard to tell, and I publicize it, there is a very real risk that the medication doesn’t help at all (the amyloid plaque model very well might be wrong, as Rafal pointed out) but we know it does harm in other ways.  This could be the modern radon inhaler.  I can easily imagine Dr. Kellogg’s patients reporting that they felt better right after he killed them with that stuff, with a death sentence that took several years to be carried out.

 

I have no feasible way to monitor the patient, so it is an open loop from my perspective.  The person who can monitor the patient lacks scientific sophistication and certainly lacks an objective viewpoint from which to evaluate the patient.  There is high risk of false positive reporting.  Understatement: in these cases, false positive feedback is nearly assured.  People cling to hope, even the false variety.  Religion incorporated is my evidence.

 

I read over Rafal’s studies and his commentary, and I am now thinking there is a good chance the beta-amyloid theory is all wrong anyway.  We know we can cure the hell outta mice, and we know that bexarotene does cross the blood/brain barrier in mice, and we know it doesn’t cross very well in humans, we know that Targretin is specifically formulated to minimize barrier crossing, and we know the beta-am in Alz. mice brains is the same gunk that human Alz. patients get.  But the mechanisms for how it is helping the mice is different (we think) from the mechanism which causes neuron damage in humans. But we might be wrong, and I am not a doctor, I’m just an engineer.  I don’t even want to be fooling with this, I really don’t.  I chose to not go to medical school, because I get too tangled up in ethics problems.  I would have gone crazy by now had I chosen that route.  

 

So all I am offering is a way to get more of the bexarotene to cross into  human brains.  This allows a lower dose which (I expect) would minimize the harmful side effects, which are numerous and serious, and need to be compensated in experimental patients, otherwise bexarotene itself can cause symptoms that mimic the disease it is thought to treat.  Now that’s a hell of a note.

 

Regarding very stupid people, I do object to that.  Reason: the models for Alzheimers disease are so damn complicated and cotradictory, they are nearly overwhelming even for the scientifically sophisticated.  If a person feels their brains slipping away, I see no reason to doubt either their intelligence or sincerity if they grasp at any straw, anything.  That isn’t stupidity, it’s well-justified desperation.  I don’t want to offer a straw which is just going to make a bad situation worse.

 

If you were referring to non-Alzheimer’s bex abusers, well, even there, it is conceivable that a smart person will fear the disease so much they will self-diagnose incorrectly that they have the disease.  How many of us here have blanked, or temporarily forgotten a name you knew for years?  It happens, and it has nothing to do with Alzheimer’s.  If a person is like me, where the only thing they perceive in themselves of value is their brain, and they might panic and over-react at temporarily stumbling on the name of a friend.

 

 

 

> If yes and yes, are those results contradictory? 

 

No. John K Clark

OK John thanks.  

Parting shot please, for anyone who gets thinking they are qualified to be a medical ethicist: go hang out at the local nursing home, particularly the memory care specialists.  Go there just one day, just an afternoon, talk, watch and listen.  Talk to the patients and talk to the staff.  If you can spend just a few hours there and come away still feeling you always know the right thing to do, then I want you to be my personal medical ethicist.

spike


 

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