Avoiding Autopsy for Cryonics
A primary focus of cryonics procedures is to maintain the physical structure of the brain as much as possible so that future science has the best chance of maintaining the memory and identity of the cryopreserved person in the reanimated person. Cryonics procedures place much emphasis upon minimizing or eliminating ischemic damage (damage to tissue that occurs after blood circulation stops) and freezing damage (damage due to ice crystals which vitrification is intended to prevent).
Autopsy of the brain, however, is a distinct and devastating form of damage that also greatly worsens ischemia while preventing vitrification perfusion. Autopsy of the neck can be nearly as deveatating insofar as neck autopsy often renders perfusion with vitrifying cryoprotectant impossible. Significant effort should be made by Cryonics Institute Members to prevent autopsy from compromising the value of cryopreservation.
Autopsy is commonly performed (and typically mandated by law) where there is evidence of homicide, suicide, accidental death or death due to contagious disease or unknown causes. The autopsy rate has declined considerably in the past century because cause of death is more commonly known and because people are more likely to be elderly when they die. Determining cause of death is much more likely to be mandated for a younger person because elderly persons are assumed to "die of old age". Increasingly the medical profession has respected the wishes of the deceased and their loved-ones to forego autopsy (if that is their preference), especially on religious grounds.
Orthodox Jewish tradition holds that the human body is an image of God which should not be desecrated by autopsy as if it were an impersonal object, and which should be buried respectfully as soon as possible after death. (Orthodox Jewish tradition opposes embalming for the same reason.) Amish, Hmongs and many Muslims also object to autopsy. According to JOURNAL OF THE ROYAL SOCIETY OF MEDICINE; Sheikh,A; 91(3):138-140 (1998) the majority of Muslim fatwas hold that autopsy is against Islamic religious belief, but a small (and growing) minority say it is permissible.
According to ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE; Bierig,JR; 125(11):1425-1429 (2001) there are at least seven states in the United States where statutes are in place to require a Medical Examiner (coroner) to take account of religious beliefs: California, Louisiana, Maryland, New Jersey, New York, Ohio and Rhode Island. Typically, autopsy will always be mandaged where there is evidence of homicide or a public health risk associated with contagious disease. Religious belief usually can prevent autopsies intended to determine cause of death where death was unexpected, but unlikely to be due to contagious disease or criminal activity.
State of California Government Code Section 27491.43 is instructive: Except where a criminal act or contagious disease is reasonably suspected, if a friend or relative informs the coroner of a certificate of religious belief executed by the deceased which opposes autopsy, the coroner must wait at least 48 hours to be presenting that certificate before performing an autopsy. If presented with the certificate the coroner shall not perform the autopsy. The certificate must be signed and dated in the presence of two witnesses (no mention is made of a notary, but a notary could be one of the two witnesses).
References to other statutes in other states include:
Maryland Health Code 5-310(b)(2)
Ohio Code 313.131
Louisiana (citation not available)
A case might be made for invoking the First Amendment of the US Constitution as a defense against autopsy when there are religious beliefs involved. There is often no need to explain or justify religious belief in the certificate, but it could be prudent to be prepared to do so. Some cryonicists who believe that the word of the deceased might be challenged have joined the pro-cryonics religion Society for Venturism.
Persons living in the United Kingdom might gain some value from the Autopsy Choice website.
Cryonics Institute Members who have religious beliefs that would preclude autopsy can include a signed and witnessed Certificate of Religious Belief and Religious Objection to Autopsy in their executed paperwork. Those living in a jurisdiction having relevant statutes against autopsy violating religious belief and who have religious beliefs against autopsy can make personalized wallet card, bracelets and necklaces that include citations to those statutes (see Emergency Jewelry and Wallet Cards).
For CI Members who do not have religious beliefs that would preclude autopsy, the Cryonics Institute will attempt to use legal assistance to prevent autopsy. Insofar as we only know of a few that have statutes allowing objection to autopsy CI Members who are concerned about the danger of autopsy should hire a local lawyer for legal advice concerning the jurisdiction in which they live and the legal options available to prevent autopsy, religious and otherwise. Even in those states that have statutes, it might be wise to get legal advice concerning how the statute has been interpreted in specific cases.
Coroners or Medical Examiners normally have a great deal of discretion concerning how autopsy is done and whether it will be done. The personality and mood of the coroner — including how he/she responds to cryonicists petitioning against autopsy — are often crucial factors in determining whether an autopsy is performed. It could be useful to know how accommodating your local coroner would be by getting information concerning his or her standards for requiring autopsy, and responsiveness to requests that it be avoided.
[For a legal treatise on the need for legistlation to protect the of the rights of cryonicists, see the Southwestern University Law Review article in a WORD document on the CI website.]