Leveraging Article 115 of the Swiss Criminal Code to Perfect

Cryonic Pre-Treatment

Franco Cortese

International Coordinator, Cryonics Switzerland

CryonicsSwitzerland.com

The State of the Art in Cryonics Pre-Treatment is in Perpetual Stasis

Currently a declaration of death must precede cryostorage preparation for cryonics patients. This involves:

waiting until clinical death

declaring it

transporting the patient’s body to their chosen cryonics facility, and finally

beginning cryostorage preparation (reducing body temperature and cardiopulmonary support, blood washout and replacement with an organ preservation solution, perfusing the body with cryoprotectant and finally cool-down to cryogenic temperatures).

But having to wait until the definitive onset of clinical death, a declaration of death and subsequent transport to a cryonics facility causes a number of imminently-preventable types of damage (i.e. structural damage and informational loss), ultimately reducing the probability (or ease) of eventual revival, and reducing the maximum obtainable accuracy of informational models constructed from future analysis of patients' cryopreserved organs and tissues.

These types of damage and the processes by which they progress are very well-studied, and we know the most optimal way of preventing them: beginning cryostorage preparation prior to the onset of clinical death.

We have the technology and the techniques, today, to preserve significantly more structural information in cryonically-preserved organs and tissues than we actually do preserve today in practice.

We know how to practice much better cryonics than we are currently practicing, and how to significantly increase the probability (or ease) of eventual revival and the amount of structural information we can preserve through cryostorage.

It isn’t even a case of having the technology, but requiring increased funding and research attention to really bring it to form.

We have the technology and we have it in a state sufficient for use today, and the only barrier preventing us from using it is a legislative one.

What’s The Damage?

During the time between clinical death and the beginning of cryostorage, a number of different kinds of damage occurs in tissues and organs. These harmful byproducts and types of damage destroy significant structural information, especially in organs which have a high degree of structural density on the level of cells and cell-populations (e.g. neurons).

This ultimately (1) decreases the probability (or ease) of eventual revival (i.e. by damaging cellular structures and processes) and (2) decreasing the maximum possible informational resolution (or precision) of future models based upon structural data read from cryopreserved tissues in future.

As Ben Best explains:

“If a person is declared legally dead immediately upon cessation of heartbeat & respiration, nearly all of the cells in that person's brain may still be alive. Organ transplantation would not be feasible were it not for the fact that legal death does not declare the death of all cells, tissues and organs -- including the brain.

But within 5-10 minutes without oxygen or nutrient degenerative processes begin in the brain. The main initial degenerative processes, however, are in the circulatory system -- blood agglutination and vascular spasm. Brain ultrastructure can actually be maintained up to one hour without oxygen or nutrient. Attempts to restore blood circulation within even 10-15 minutes can be damaging. In reperfusion injury restoration of circulation after a long delay actually causes the blood oxygen to oxidize tissues rather than revive them.

Within a few hours at room temperature, release of arachidonic acid from membranes and lactic acid produced by anaerobic metabolism (metabolism in the absence of oxygen) increases the acidity of tissues, including brain tissue. Lysosomes (acidic organelles containing hydrolytic enzymes) burst, further degrading tissue. Anaerobic clostridium bacteria (gangrene) accelerates tissue degredation. Within 24 hours at room temperature a dead person's brain will have virtually dissolved. Cryonics procedures must be applied much sooner for there to be a reasonable hope of success.”

– Ben Best in “Cryonics Protocol, A Summary”. Retrieved from: http://www.benbest.com/cryonics/summary.html.

Contemporary Pre-Treatment Strategies

Ischemic damage and reperfusion injury are today minimized largely by pharmacological and methodological means, including the application of antioxidants and methods of slowing metabolism such as lowering body temperature.

There are a number of contemporary strategies of minimizing ischemic damage and reperfusion therapy, but none are incredibly effective. If the legal necessity of having to wait for a declaration of death to begin transportation and preparation for cryonic storage could be avoided or obviated, this would constitute a much more ideal solution.

While today's pre-treatment strategies significantly decrease the damage and informational loss that tissues and organs undergo while waiting for cryostorage preparation, in practice a significant amount of structural-functional damage and informational loss still occurs.

Leveraging Existing Legislative Infrastructure in Switzerland to Perfect Cryonic Pre-Treatment

The problems caused by having to wait for the onset of clinical death is one ubiquitously acknowledged by the cryonics community.

The utility of beginning cryonic preparations prior to clinical death is explicitly recognized by cryonics organizations, who would like to provide the best services to their clients as possible.

"Current legal and medical criteria for pronouncing death are usually irrelevant to the patient’s ultimate prognosis if cryonic suspension is begun promptly and premortem conditions… have not obliterated brain structure. However, in practice the necessity to wait until such criteria are met may result in serious or even irreversible injury in specific cases.”

Source: Alcor. (2000). Cryonics: Reaching for Tomorrow. Retrieved from: http://www.alcor.org/CRFTnew/crft08.htm

One solution proposed by James Hughes, Executive Director of the IEET, is the legalization of assisted suicide to allow for the beginning of cryonics preparation prior to the onset of clinical death (or immediately following it, thereby eliminating the time spent transporting patients' bodies to their chosen cryonics facility:

"I suggest that it could be acceptable to cryonicists that the frozen continue to be defined as dead if assisted suicide can be legalized. Under a liberal assisted suicide policy cryonicists might be allowed to carry out suspension before a declaration of death, preserving the maximum amount of neural information." –

Source: James Hughes in "The Future of Death: Cryonics and the Telos of Liberal Individualism" (Journal of Evolution and Technology, Vol. 6).

Hughes cites data indicating that Americans are increasingly in favor of legalizing assisted suicide, going from under 40% approval (for legal assisted suicide for consenting terminally-ill patients) in 1947 to over 70% approval in 1997.

This is true, but fighting for legalized assisted suicide in North America is still a formidable fight, and not necessarily the solution we should be fighting for.

Source: Benson, John M. 1999. “The Polls: Trends in End of Life Issues,” Public Opinion Quarterly, Summer 63(2):263−268.

One historical case attempting to utilize assisted suicide to significantly improve cryonics pretreatment is in Donaldson v. Van de Kamp*:

“In Donaldson, Thomas A. Donaldson sought the declaration of a constitutional right to premortem cryonic suspension of his body and the assistance of others in achieving that state. Donaldson, a forty-six-year-old mathematician and computer software scientist, suffers from a malignant brain tumor that was diagnosed by his physicians in 1988.

* See: Griffith, D. B. (1992). Donaldson v. Van de Kamp. Issues L. & Med., 8, 105)

This tumor is inoperable and continues to grow and invade his brain tissue. Donaldson's condition will gradually deteriorate into a persistent vegetative state and will ultimately result in death. Physicians predict his probable death by August 1993.

“Donaldson petitioned the California courts, seeking a declaration that he had a constitutional right to achieve cryonic suspension before his natural death. His doctors believe that if Donaldson waits until his natural death to be suspended, future reanimation will be futile because the tumor will have destroyed his brain. In addition, Donaldson's doctors sought an injunction against criminal prosecution for their participation in the suspension, because Donaldson, once suspended, would be considered "dead" under California law...

“The trial court dismissed the complaint for failure to state a cause of action, and Donaldson appealed to the California Court of Appeals. Because the cryonic process would necessarily involve physician-assisted death, or the aiding, advising, or encouraging of another to commit suicide, the appellate court affirmed the ruling of the trial court, holding that Donaldson did not have a constitutional right to assisted death. Additionally, in light of Donaldson's First Amendment challenge to the statute, the court upheld the criminal statute prohibiting the aiding, advising, or encouraging of another to commit suicide."

Source: Pommer III, R. W. (1993). Donaldson v. Van de Kamp: cryonics, assisted suicide, and the challenges of medical science. J. Contemp. Health L. & Pol'y, 9, 589.

This case exemplifies a few things. One is that in special cases, the inability to begin

preparation for cryostorage before declaration of death can cause a disproportionate amount of structural-functional damage and information loss far exceeding that sustained through typical ischemic damage and reperfusion injury. In this case, a brain tumor destroyed not only non-negligible amounts of information and caused non-negligible amounts of damage to tissues and organs, but actually caused unsustainable amounts of informational loss and structural damage causing a vast decrease in the probability (or ease) of eventual revival. So in some cases, the ability to begin cryonic pretreatment prior to a declaration of death is a life and death matter, determining ultimately whether that patient can expect to be revivable or not.

This case also exemplifies the cryonics community's nearly-ubiquitous desire for the availability of legal assisted suicide as a means of improving cryonics pre-treatment, and the fact that some desire it so much to initiate legal action on their own.

But perhaps most importantly, it demonstrates the difficulty in establishing the legality of assisted suicide, and suggests that establishing such legality is the most difficult part of the fight.

Thus, utilizing the legislative infrastructure for assisted suicide (and thereby for cryostorage preparation before post-mortem conditions like ischemic damage and reperfusion injury result) already in place in countries like Switzerland is ultimately an easier solution to implement than establishing legal assisted suicide from scratch in North America.

The Legal Basis for Assisted Suicide in Switzerland

The legality of euthanasia in Switzerland derives from Article 115 of the Swiss Criminal Code:

“Inciting and assisting suicide:

Any person who for selfish motives incites or assists another to commit or attempt to commit suicide is, if that other person thereafter commits or attempts to commit suicide, liable to a custodial sentence not exceeding five years or to a monetary penalty .1

1 Term in accordance with No II 1 para. 3 of the Federal Act of 13 Dec. 2002, in force since 1 Jan. 2007 ( 3535; ). This amendment has been taken into account throughout the Second Book.

Source: Swiss Criminal Code. Retrieved from: http://www.admin.ch/ch/e/rs/311_0/a115.html.

Article 115 has been in effect since 1942, but wasn’t interpreted as a legal basis for organizations providing assisted suicide as a service until the 1980s.

Since then a number of organizations have formed, offering euthanasia as a service to both Swiss and non-Swiss citizens. However, there are as of yet no cryonics facilities in Switzerland.

Our proposed solution: Cryonics Switzerland. CS was founded by Dr. Charles Tandy, Editor in Chief of Ria University Press. Dr Tandy has done extensive scholarship on the topic of cryonics. He founded CS with the long-term aim of establishing a Swiss cryonics facility leveraging the legality of assisted suicide in Switzerland so as to begin cryostorage before or immediately following clinical death (ideally in Switzerland to eliminate ischemic damage and reperfusion injury incurred during the transportation of patients from Switzerland to the cryonics facility they are signed-up with).

Dr. Tandy brought me on board in October 2013 as International Coordinator, and our activities are currently limited to publicizing the idea and seeking feedback from other members of the cryonics, legal and other relevant communities.

However, longer-term plans would ideally involve the official formation of an organization and facility located in Switzerland that provides the dual service of assisted-suicide and cryonic storage, without a legally-necessitated lag-time between clinical death and the beginning of preparation for cryonic storage.

We would, however, welcome analogous initiatives by existing cryonics organizations like Alcor, which would obviate the eventual need for Cryonics Switzerland to found such facilities in Switzerland.

Options for Formation

Option 1:

Establish cryonics facility in Switzerland and use one of the existing assisted suicide services already established in Switzerland.

There are several existing assisted suicide organizations in Switzerland that could be used, including 'Exit', 'Life Circle' and Switzerland's largest assisted-suicide organization, 'Dignitas'.

Option 2:

Provide both (1) means of assisted suicide and (2) cryonic storage facilities.

The most ideal option would be to set up a cryonics service in Switzerland that provides both a means for assisted suicide and that operates cryonics facilities.

This could eliminate all waiting-time between clinical death and the beginning of cryostorage. The other options require a span of time between the onset of clinical death and the beginning or preparation for cryostorage.

Even if a cryonics facility was established in Switzerland, and not an extremely far distance from Swiss assisted suicide facilities, a very short travel time could still incur significant ischemic damage and reperfusion injury. For instance, reperfusion injury can result from ischemic periods lasting as little as 10 minutes.*

* Ben Best (n.d). Ischemia and Reperfusion Injury in Cryonics. Retrieved from: http://www.benbest.com/cryonics/ischemia.html.

Being the provider of the means for assisted suicide is also ideal because it would increase operational autonomy and allow a Swiss cryonics organization to remain independent of extra external services. This is largely an anecdotal point, but the use of external services could become problematic if external assisted-suicide services engage in activities that increase public controversy, thereby increasing the risk of future legislative reform regarding the status of legal suicide.

For instance, the leading provider of euthanasia in Switzerland, Dignitas, has been accused of engaging in a number of controversial practices and activities.

A nurse employed by Dignitas for 2.5 years made a series of accusations (all of which Dignitas denies) that brought Dignitas into some controversy.

The ex-employee claimed that wealthy patients left "vast sums" of money to the owner of Dignitas, Ludwig Minelli, in addition to the standard non-recurring fee of $5,263.16.

The ex-employee also alleged that one incident involving a new type of machine left one patient suffering for 70 hours, which is what prompted her resignation. In September 2007, when Dignitas was evicted and locked out of three Swiss flats, Minelli allegedly provided the assisted-suicide procedure to two German clients in a car instead.

In 2010, 60 cremation urns bearing the Dignitas logo were found in Lake Zurich, after the ex-employee told The Times 18 months earlier that Dignitas had disposed of 300 urns in the lake. This was after another incident in 2008 where 2 Dignitas employees were actually caught attempting to pour the ashes of 20 cremated patients into Lake Zurich.

In addition to these activities, Dignitas has also engaged in activities that, while legal, nonetheless risk increasing public controversy over the issue of legal assisted suicide in Switzerland. One example is filming and televising the death of Craig Ewert and his wife, who died together as per their arrangements as Dignitas clients. The filming and televised broadcast of their death is neither illegal nor immoral, but it does risk inciting public controversy over issues (e.g. televising a real death) that aren’t even at the heart of the issue.

Despite the overwhelming consensus among Swiss citizens supporting legal assisted suicide for both Swiss citizens and foreigners, euthanasia is controversial enough as it is, and doesn't need it's leading Swiss organization adding to the controversy with such activities.

So while it's an anecdotal point, especially considering the consensus approval among Swiss citizens for legal assisted suicide, providing assisted suicide services 'in-house' would eliminate these worries.

Option 3:

Act as a mediating service between existing Swiss assisted-suicide services and existing non-Swiss cryonic storage facilities.

One advantage this option offers is low logistical and operational requirements and low overhead expenses. One disadvantage is that it provides the least operational autonomy, necessitating that we depend upon external services for both cryonic preparation and storage as well as for providing a means of assisted suicide. Another disadvantage is that this option eliminates the possibility of minimizing the travel time and distance between the application of a means of assisted suicide and the beginning of cryostorage preparation.

Overall, we feel Option 1 to be the most optimal. While it is the most expensive option, it allows for maximum operational control. This would allow us to make the means of assisted suicide available at the site where preparation for cryonic storage begins, thereby eliminating all patient-transportation time entirely and hopefully eliminating ischemic damage and reperfusion injury to negligible levels.

Other Relevant Laws & Requirements

There are a number of other laws bearing relevance to assisted suicide in Switzerland that have to be accounted for to ensure that the present proposal doesn’t neglect any other relevant Swiss laws and regulations.

Altruistic Motive

One of the provisions of article 115 is that the motive for providing the means of assisted suicide must be unselfish. Despite the fact that we suggest leveraging existing infrastructure for an as-yet-unacknowledged use (i.e. to vastly improve cryonic pre-treatment), our intended use provides very defensible grounds for altruistic intent, and indeed can be argued to provide more benefits to patients and less ambiguous and qualitative (and thus more defensible) benefits as well.

Because the absence of personal gain is a prerequisite, it is likely ideal for any such organization to be established as a non-profit entity. It is not certain or unambiguous, however, that forming the organization as a for-profit entity would challenge the altruistic-motive prerequisite.

Why This Proposal Constitutes a Defensible Altruistic Motive

The majority of patients who utilize one of the services providing the means for euthanasia do so for “weariness of life” rather than for particular mental or physical, debilitative illnesses or conditions.

The second but less-common case, wherein the patient lists a specific, CDC-recognized disease, illness or condition, is more defensible on the grounds that such conditions are recognized by the wider medical community, are known to cause qualitative suffering, and are typically quantifiable in order to be diagnosed in the first place (this is especially true for debilitative physiological conditions, and less so for some mental conditions wherein the physiological basis or correlates of the condition are still ambiguous). These three aspects make them more defensible as a source of suffering from a legal standpoint.

Likewise, the use of assisted suicide to provide more effective cryonic pretreatment arguably qualifies as a more defensible and less ambiguous altruistic-motive than either of the above cases (i.e. relief from weariness or life vs. relief from recognized diseases and conditions) for similar reasons. The intended use would quantifiably (i.e. demonstrably) improve both the health and physiological state of the patient when he or she is revived from cryonic storage, and increase the likelihood of their being revived at all.

The present proposal provides more benefit than the above cases because it constitutes, ipso facto, the only case wherein the use of assisted suicide could actually benefit the future state of the patient's health, as all other cases involve the permanent cessation of that patient’s life.

The present proposal provides a less ambiguous benefit than the above cases, because ischemic damage, reperfusion injury and their many underlying physiological mechanisms are very well-studied, recognized by the wider community, and quantifiably demonstrable (i.e. so one can “prove” statements about the condition in a more defensible way than one could for some mental illnesses for instance).

The present proposal can also be argued to provide mental benefit as well as more definitive physiological benefits, in that patients would experience significantly less psychological trauma prior to cryonic storage due to the knowledge of a higher probability and easy of eventual revival or informational reconstruction.

It is for these reasons that the intended use of assisted suicide suggested here is more altruistic than the alternative use of assisted suicide as a means to relief from weariness of life or from debilitative diseases, illnesses and conditions.

It is also for these reasons that the use suggested here is more defensible as an altruistic motive. It is more defensible for two reasons:

(1) because it can be cogently argued that the ability to quantitatively and demonstrably improve the patient’s future state to health and physiological condition provides more benefit to patients than the relief from existing ailments; whereas relief from ailments constitutes a negative definition of benefit, the present constitutes a positive definition of benefit;

(2) because the benefits that are incurred are quantitative, and therefore demonstrable and verifiable by a community of experts. This is true ipso facto because relief from present ailments is necessarily non-qualitative, no matter how quantitative the specific ailment Is (i.e. one can’t yet quantify suffering in a way recognized by a community of experts), but the suffering caused by the ailment-in-question is in the case of better cryonic pretreatment less ambiguous and more defensible than the suffering caused by, say, mental illness, because the physiological condition (e.g. ischemic damage, etc) is itself quantifiable and thus demonstrable. So whereas one might conceivably argue illegitimacy on the grounds than a given mental illness does not cause suffering, on the grounds that its debilitative effects on the patient’s physiological system are not yet quantitative and thus not demonstrable and “provable” by a community of experts, one could demonstrably show the debilitative effects ischemic damage and related sources of damage cause.

Patient Must Have 'Legal Capacity'

“Civil Code, Art 16: Legal capacity (Urteilsfähigkeit)

A person is presumed to have capacity to act reasonably, unless he or she is deemed not to have such capacity because he or she is a child, suffers from a mental illness, mental infirmity, drunkenness or a similar condition.

Civil Code, Art 18: Lack of legal capacity (Fehlen der Urteilsfähigkeit)

A person who lacks legal capacity cannot, unless a statutory exception applies, enter into any legal transactions.”

Source: Swiss Civil Code. English translation of the provisions of Articles 16 and 18 taken from: Schwarzenegger & Summers (2005 February 3). Criminal law and Assisted Suicide in Switzerland. Hearing with the Select Committee on the Assisted Dying for the Terminally Ill Bill, House of Lords.

Consequence:

Articles 16 and 18 of the Swiss civil code indicate that patients must have legal capacity when they consent to their wish to undergo assisted suicide, otherwise the legal transaction of a patient consenting to assisted suicide could be made void, and the person administering the means of assisted suicide could be held criminally responsible for the intentional killing of the victim as an “indirect perpetrator” under articles 111-113 of the Swiss Penal Code.

Patients Must Administer ThemselvesPersons and services can only provide the means of assisted

suicide, and not actually apply the means to the patient. The patient must technically administer the means (e.g. legal injection) himself. If anyone except the patient themselves administers (rather than provides) the means of assisted suicide, “the act no longer constitutes an assisted suicide in the sense of Art. 115 Penal Code. It is rather a case of direct active euthanasia, which is an intentional killing request according to Art. 114 Penal Code.11.0” (Schwarzenegger & Summers 2005).

Thus the legality of the present proposal could be voided if it is not the cryonic patients themselves administering the means of assisted suicide.

Laws on Administering Pharmaceutics and Narcotics

“Law on Pharmaceutical Products, Art 26: Basic principle relating to prescribing and dispensing (Grundsatz für Verschreibung und Abgabe)

The prescribing and dispensing of pharmaceutical products must be carried out in accordance with the acknowledged rules of medical and pharmaceutical science.

A pharmaceutical product may only be prescribed, if the state of health of the consumer or patient is known.”

Article 26 of the Swiss’ Law on Pharmaceutical Products’ indicates provisions that must be followed in administering pharmaceutical products, such as pharmacological means of assisted suicide and the provision of pharmacological agents for cryonics pretreatment.

“Narcotics Law, Art 11: (no title)

1. Medical doctors and veterinarians are obliged to use, dispense and prescribe drugs only to the extent that is necessary according to the acknowledged rules of medical science.2. The same applies for the use and dispensing of drugs by dentists.”

Article 11 of the Swiss Narcotics Law also bears relevance to the legality of assisted suicide. Commentary by Schwarzenegger & Summers on its relevance to the legality of assisted suicide in Switzerland illuminates its relevance to the present proposal:

“In cases, where a terminal illness is diagnosed, the acknowledged rules of the medical sciences permit the prescription of deadly barbiturates to eliminate pain. Thus, the prescription of barbiturates is not in violation of Art. 26 of the Law on Pharmaceutical Products and Art. 11 Narcotics Law.

“If no serious anamnesis (medical examinations) of the person seeking assisted suicide is done, the medical doctor will face punishment according to the Law on Pharmaceutical Products and the Narcotics Law. Additionally, his or her licen[s]e can be revoked under the Cantonal Health Legislation.”

This commentary by Schwarzenegger & Summers indicates that a basis for doctors providing deadly pharmaceuticals is established (and thus that a legal basis for the provision of deadly pharmaceuticals as a means of assisted suicide is provided) and that as per Article 26, provision 2 of the Swiss Law on Pharmaceutical Products, a medical examination of the cryonics patient will be necessary to prove that the patient’s state of health was known by doctors at the time the pharmaceutical (in this case death0inducing pharmaceuticals) was administered.

What are the Prospects for this Legislation’s Longevity?

How likely is this legislation to be in place in time for a cryonics facility to be set up in Switzerland?

The legislation has been around since 1942 (though it has only been used as a legal basis for offering the provision of the means of euthanasia since the 80s, i.e. on the order of 30-40 years), and today remains non-controversial to citizens.

A referendum to outlaw assisted suicide took place on May 15th 2011, and of 278,000 voters in the Canton of Zurich, 85% rejected the referendum to ban assisted suicide for both Swiss and foreign citizens, while 78% rejected the initiative to limit it exclusively to Swiss citizens. Thus voters are overwhelmingly in favor of both keeping the legislation and of keeping its present scope (i.e. applicability to both Swiss and foreign citizens).

And we can suspect that a sudden increase in the proportion of foreign citizens using one of the assisted-suicide services available in Switzerland would not prompt legislators or voters to change their position greatly, as 60% of patients using Dignitas are German citizens, which suggests that already large proportion of the patients who use Swiss assisted suicide services are non-Swiss citizens (and thus that voters had already taken into account high proportions of non-Swiss citizens using such services when casting their ballot).

The Swiss government also rejected proposed regulatory reforms to limit the services to Swiss citizens earlier in 2006, which suggests that widespread support for the legal use of such services by non-Swiss citizens is not a short-term trend of public opinion, but a position that has been the norm for a number of years.

Thus it looks as though this legislation is highly likely to be in place for the foreseeable future, and that the likelihood of setting up a dual assisted-suicide and cryonics facility (or one of the other alternative operational strategies mentioned previously) only to then find the legislative basis for doing so swept out from under us is rather low. We can safely expect this legislation to remain, and we can be confident enough in that conclusion to warrant forming such a facility in Switzerland.

Cryonics Switzerland

Cryonics Switzerland welcomes your suggestions, questions and comments, which can be send to cetandy@gmail.com or francocortese1@gmail.com.

Please visit CryonicsSwitzerland.com for more information and ongoing updates.

About the Presenter

Franco Cortese: International Coordinator: Cryonics Switzerland

Assistant Editor: Ria University Press

Research Scientist: ELPIs Foundation for Indefinite Lifespans

Affiliate Scholar: Institute for Ethics & Emerging Technologies

Chief Operating Officer: Center for Interdisciplinary Philosophic Studies

Ambassador: The Seasteading Institute,

Fellow & Secretary: Brighter Brains Institute

Futurists Advisory Board Member & Life Extension Advisory Board Member: Lifeboat Foundation,

Columnist: H+ Magazine,

Columnist: Immortality Institute (a.k.a. LongeCity),

Ambassador: Longevity Intelligence Communications,

Activist: The International Longevity Alliance,

Reviewer : Global Futures Intelligence System at The Millennium Project.