I have three primary goals in this course. First, to provide a quantitative and conceptual framework for analysis of population at various levels of organization including the individual, cohort, family, kin and world community. Second, to foster abstract and integrative thought on population topics of national and international concern including actuarial, gerontological, growth and family. Third, to provide students with a sense of place, belonging and continuity in the population of which they are a part. The course is based on the use of conceptual, schematic or, at times, mathematical models. I organized the course around six more-or-less hierarchial topics.

Individual

Cohort

Family

Kinship/Race

Population

This course is centered around the field of demography which is the study of populations and the processes that shape them. The field is concerned with four aspects of population: Size--the number of individuals in the population; Distribution--the arrangement of individuals in space at a given time; Structure--the distribution of the population by age, sex and other compositional traits; and Change--the increase or decrease in number, distribution or one of its structural units. The first three aspects--size, distribution and structure--are considered population statics while the last aspect--change--is considered the population dynamic. The most important variable in demography is age. This aspect is important for basically two reasons: i)age is related to biological and physiological state; and ii)age is the most important source of variation in vital rates. For example, death rate are 100-fold higher at age 70 than at age 10.

THE LIFE COURSE

Life is a developmental process from birth to death. The development of humans is highly complex and the position reached by an individual of a given age is the outcome of many interrelated processes and events both inside and outside of the individual. Graduation, marriage, entry into the labor force, divorce, death of spouse, migration and major personal injury or illness are a few illustrations of life events. The main questions demographers have about individual life experiences include what causes life events to occur and how these events shape people's lives. The study of patterns, causes and consequences of life events is necessarily multidisciplinary. Demographers have formalized the study of individuals and refer to it as life course analysis. Life course analysis is oriented to the process of the changes from birth to death. Life course and biography can be used interchangeably.

Life Course: Classification by age.
The classification of individuals by age is useful for a number of reasons including: i)age is one of the most important variables in demography; ii)age is a universal property of all individuals and therefore they can easily be subdivided into common groups; iii)individuals of similar ages often share common interests, health problems and behavior; iv)the linkage of events at earlier ages with events and patterns at later stages is useful for prediction; and v)age is used as a proxy in legal, civil, and religious contexts (driving, voting, retirement, marriage, etc.) and .

Life Phase	Age Interval	Duration	Example Event(s)
Prebirth Zygote Embryo Fetus	Conception 1 day-2 mo 2-9 mo	-- 2 mo 7 mo	Genetic union Development Growth
Preadult Infant Toddler Preschool Childhood Adolescent Pre-adult	0-14 mo 14-24 mo 2-5 yrs 6-12 13-17 18-21	>1 yr <1 yr 4 yrs 7 yrs 5 yrs 4 yrs	Crawl; Walk Pre-school Elementary Jr & High School College; career
Adult Young Adult Middle Age Senior Young-old Middle-old Oldest-old	22-35 36-55 56-65 66-85 86-120+	14 yrs 20 yrs 10 yrs 20 yrs 35+ yrs	Marry; first job, kids Child rearing; mid-level first grandkids; job seniority retire; illness infirmity

A biography is characterized by the following characteristics of life history events:

1. Types--job changes, births, marriage, divorce, moving
2. Number or frequency--how many of each
3. Sequence--the order
4. Timing--at what age/stage in the life course events occurred

In general, many aspects of one's life can be considered as either an event or an interval between events. Events themselves can be classified as one-of-two types. The first type is non-repeatable and represent events that can occur only once such as death. The second type of event is repeatable and represent events that can occur more than once in a lifetime. Examples include childbearing, moving, changing jobs or marrying. Repeatable events raise questions such as: how often does a given event occur in a lifetime; when do the events occur; do they occur in a given sequence; what is the average duration between two events; is there any regularity in the temporal pattern? All repeatable events can be viewed as repeatable events by specifying order. For example, a woman can have her third child only once, make her second career change only once or move for the fifth time only once. Life events are viewed as outcomes of two underlying processes: substantive including biological, psychological and social; and random (chance). The key parameters are the transition rates from one life event to another. An individual in life course analysis is defined as a carrier of attributes. Attributes can include a wide range of traits such as the following: educational, marital, maternal or paternal, professional and health. Attributes may be categorized on the basis of whether they are invariant or variant. Examples of invariant attributes include gender, year of birth and endowment (e.g. ethnicity). Examples of variable attributes include marital status, location (geographic) and profession or rank.
Many changes are gradual such as a change in health status while others are marked by sharply-defined events such as marriage or childbearing. The life course can be subdivided into changes in the status along several different categories of attributes. This series of events of the same type such as marital, educational, professional, medical, maternal or residential are referred to as careers. Careers may be parallel in that several are active simultaneously or sequential in that once usually does not start until completion of another (eg. professional career after the educational career). The onset of a career is called the event origin. For example, a first marriage is the event origin of a marital career.
These data can be used to chart each of her six careers over her life course as given in the graph. They can also be used to summarize each aspect of her life in a life course summary table. An example summary of her maternal career is given below:
There the general points in the overall life course analysis include:

• Life cycles can be disaggregated into separate careers which consist of similar life events
• Each career can be characterized by events and intervals between events
• Simple life course charts and summary tables characterize various aspects of a person's life history or biography.

Classification by life cycle type

1. Abbreviated--dies before age 20
2. Spinster/bachelor--survives to 20 and never marries
3. Barren--marries but remains childless
4. Dying Parent (single parent producing)--spouse survives to age 57; Dying Parent (orphan producing)--spouse dies before 57
5. Divorced--divorces with or without children and either remains divorced or remarries
6. Typical--survives to age 20, has children and survives with spouse to age 55.

Exter, T. 1986. How to think about age. American Demographics 8(#9):50-51.
Pressat, R. 1970. Population. C. A. Watts & Co., Ltd, London.
Preston, S. H. 1982. Relations between individual life cycles and population characteristics. American Sociological Review 47:253-264.
Ryder, N. B. 1965. The cohort as a concept in the study of social change. American Sociological Review 30:843-861.

BIOETHICS

Many bioethical issues arise at the end points of the life course. For example, issues centered around birth include: i)in vitro (test tube) fertilization and frozen embryos--are they property? who "owns" them or has custody? ii)designer children--purchasing eggs and sperm from "superior" gene pools; iii)surrogacy--who is the mother? rent-a-womb issues where poor women use their wombs to gestate. iv)abortion--should abortion be legal? if so, at what point in the developmental continuum should abortion not be legal?
Some issues centered around death and morbidity include: i)premature babies--should heroic efforts be made to keep them alive even though they may be retarded? ii)alcoholic mothers and drug addicts--should the mothers who harm their developing babies be held accountable for their neglect and abuse? iii)euthenasia--should doctors be allowed to assist terminally ill people in suicide? iv)the terminally ill--should hundreds of thousands of dollars be spent to keep people alive a few more days, weeks or months? v)brain dead--should people who are brain dead be kept on life support systems indefinitely? if not, at what point should they be removed? These issues are important today and will become increasingly important in the future. Today many hospitals employ bioethicists and have standing committees whose purpose is to deal with decisions involving bioethical considerations.
Bioethics is defined as the systematic study of human conduct in the area of the life sciences and health care, insofar as this conduct is examined in the light of moral values and principles. Involves moral, ethical, philosophical, biological, theological, legal and medical considerations. Two perceptions for consideration in most areas: i)Human being--member of the species Homo sapiens; ii)Person--a rational and self-conscious being. All persons are human beings but not all human beings are persons.
Types of Persons: i)Possible--couple contemplate having a child; ii)Potential--embryo or fetus; and iii)Actual--real person such as a newborn or an adult.

BIRTH AND REPRODUCTION

Abortion is defined in medical terms as "the expulsion of the human fetus prematurely, particularly at any time before it is viable".

Two General Abortion Models:

• Model 1: Restrictions for sake of child (Pro-Life)
• Model 2: Availability for sake of women's freedom (Pro-Choice).

Roe vs. Wade (1973)--a woman has the right to an abortion on demand during the first trimester of pregnancy because her control of bodily privacy, according to the Supreme Court, outweighs the value of the early fetus. The pregnancy is divided into three phases (3-month trimesters):

Trimesters:

• First Trimester--During the first trimester the state must leave all questions concerning individual abortions entirely up to the woman and her physician;
• Second Trimester--During the second trimester the state may intervene to regulate abortions only in ways relevant to the health and safety of the woman; and
• Third Trimester--During the third trimester the state may legally ban abortion if it so chooses, except for cases in which the life and health of the mother are at stake.

DECISIVE MOMENT THEORIES:

DEVELOPMENTAL CONTINUUM. According to Wennberg (1985), C. Everett Koop's argument goes something like this: "My question to my pro-abortion friend who will not kill a newborn baby is: 'Would you kill the infant a minute before he was born, or a minute before that?' You see what I am getting at. At what minute can one consider life to be worthless and the next minute consider that same life to be precious?". This argument suffers from what logicians refer to as the fallacy of the continuum which can be used to show, for example, that there is no difference between night and day. If the moments are split fine enough, the light intensity between any two given moments is indistinguishable.

1. Conception. Point here is that abortion is not permissible since conception is the moment of creation of issue of concern.
2. Implantation. About a week after conception the zygote implants in the uterine wall and is viewed as having a firmer hold on life than the free-floating zygote.
3. Appearance of Human Form. The appearance such things of arms, hands, fingers and facial features eventually give the developing fetus the appearance of a small child.
4. Point of Viability. The argument here is that the fetus can survive independently of the mother's body.
5. The Beginning of Brain Development. The scientist measures the definitive end of human life by the end of human brain function. Why not use the onset of that same function? Therefore in terms of brain function is a reversibly comatose individual the same as a 6 week old fetus? The fundamental difference is this: the fetus has the right to the prospect of a first time personal existence while the reversibly comatose individual has the right to the prospect of a continued personal existence.
6. Birth. It should be what you are, not where you are that determines whether you have a right to life since birth only marks the change of location from inside to outside the mother's body. Birth involves a change in location from inside to outside the mother's womb and termination of an intimate physical connection. But it does not alter the nature of the fetus itself.

• In many cases of abortion, the death of the fetus is precisely what the woman is seeking;
• It is the death of the fetus rather than the mere removal of the fetus from her womb that secures the benefit for the woman. So that is would seem that the appeal to a right to bodily self determination is frequently no more than a pretext for securing the death of the fetus;
• When medical technology gets to the point that it can produce an artificial womb, we will be faced with a more pressing question, "Does the woman have a right to the death of the fetus?"
  Do potential persons have the same right to life as actual persons.? Why is the potential possessed by the fertilized ova confer a right to life but the potential possessed by the unfertilized ova does not?

SURROGACY

Surrogate motherhood is more of a social solution to infertility than it is a medical technology.

Types of Surrogacy:

1. Genetical (traditional) surrogacy. Woman may be artifically inseminated with the sperm of a man who intends to be the rearing parent of the resulting child. The Baby M case involved genetical surrogacy.
2. Gestational surrogacy. A woman may be the recipient of a transferred embryo and carry to term a baby to whom she is genetically unrelated. A physician administers hormones to the genetic mother to stimulate multiple egg production and to manipulate her menstrual cycle so that it coincides with the surrogate's. Problem according to some is it goes to the heart of one of the strongest objections that we should not use women as fetal containers. The desperately poor may be exploited as womb providers. Hospital boards may be concerned that if you are 39 years old, successful and very busy, you might want to rent someone's womb as a convenience.
   In October, 1993 a South Dakota woman gave birth to her own grandchildren as a surrogate for her daughter. In August, 1990 a Venezuelan couple became parents of four children after hiring two gestational surrogates to gestate embryos they had created in vitro fertilization. Four embryos were implanted in each of two women who served as the surrogates. One woman gave birth to three children and another gave birth to a single child. Sweeping problem is who are the parents? Does the surrogate have visitation rights?
   About 4,000 surrogate mother arrangements have been concluded to date. Typical contract: i)$10,000 to surrogate mother; ii)$20 to $30,000 living expenses, medical expenses and attorney's fees; iii)impose restrictions on surrogate's personal habits during pregancy such as smoking, alcohol, exercise and mandatory amniocentesis.

CRYOPRESERVATION

Fertilized human eggs in the early stages of embryonic development can undergo a process of freezing in liquid nitrogen called cryopreservation. The ethical and legal ramifications are as vast as are the biological possibilities (Lieber 1989). Are the embryos alive? Are they property? What should be done with them after the parents no longer care about having children?
A Knoxville couple created nine in vitro embryos in 1988 by mixing the husband's sperm with eggs removed from his wife. Two were implanted but failed to develop. The remaining seven were frozen for later use after developing to four to eight cells each. One year later the husband sued his wife for divorce, asking the court to prevent any use of the embryos without his consent. He argued that he should not be forced to become a parent against his wishes. The initial ruling was to grant custody of the embryos to the ex-wife, the judge calling them "children in-vitro" since he issued that life begins at conception. However, this was later overturned after a higher court awarded joint custody of the embryos.

Reproductive and Parenting Possibilities Resulting from Frozen Embryos

1. Timing of Pregnancy--the quality of eggs produced by a woman aged 25 is higher than those produced at older ages, particularly by women in their late 30's and early 40's. Therefore a woman could produce several dozen embryos shortly after she is married and implant them at suitable times until menopause and not worry as much about genetical abnormalities. Furthermore, an older woman, having completed a successful career in her 20's, 30's and 40's, could hire a gestational surrogate and raise a child in her retirement.
2. Gestation by Kin--kin such as daughters or granddaughters could thaw out one of their progenitor's embryos and gestate it, thus producing a sibling or even an aunt or an uncle.
3. Embryo Adoption--a woman may produce dozens of eggs that can be fertilized, frozen and stored. When she is finished with childbearing she could donate them to prospective adoptive mothers. These mothers would only gestate and give birth to the child though would not be genetically related {Could unwittingly marry your genetic twin. Thus need system of recording and tracking people who mature from thawed embryos in order to prevent incest}. A bioethical problem that concerning both frozen eggs and sperm regards property laws. For example, Edward Hart sired Judith Hart, conceived three months after he died from cancer. However, the laws of Louisiana and the Social Security Administration say she is not his legal daughter. Edward Hart stored in 1990 soon after his cancer was diagnosed and before undergoing the chemotherapy that was expected to render him sterile. After he died his widow used the stored sperm to conceive Judith. She now has gone to the U.S. District Court in New Orleans to have 3-year old Judith declared Edward Hart's legitimate child. If she wins Judith will be entitled to $700 per month in Social Security survivors' benefits (Sacramento Bee, Jan. 16, 1995).

CLONING

The prospect of cloning human embryos conjures up visions of a Brave New World, in which masses of identical people become automatons functions for the benefit of the state (Kolberg 1994). What we are talking about is mass producing humans.

Parenting possibilities for cloned embryo:

1. Person who donated the biological material
2. Person who gave birth to the baby
3. Person who raises the child
   The embryo could have a single parent if the mother were cloning herself. Or it could have two natural parents if the father were cloning himself. If another female is cloned then an embryo could have a father and two mothers. Alternatively, if another male is cloned, then the embryo could have a mother and two fathers.

Two Types of Cloning

1. Embryo splitting—separate when in 4, 8 or 18-cell stage
2. Nuclear transplantation—remove nuclear DNA from adult and insert into de-nucleated egg.
   In November, 1993 researchers at George Washington University Medical Center in Washington, D.C. split single human embryos into identical copies. They used in vitro (petri dish) fertilization to create 17 human embryos in a laboratory dish. When the embryos had grown enough to contain two to eight cells the separated them into 48 individuals cells. Two of the separated cells survived for a few days in the laboratory, developing into new human embryos consisting of 32 cells each. On February 27, 1997 a stunning announcement appeared in the British journal Nature. For the first time ever, a mammal—a lamb named Dolly—had been successfully cloned from an adult cell. She resulted from the fusion of a nucelar-free unfertilized egg with a donor cell obtained from the mammary gland of a 6-year old ewe. The lead scientists were Ian Wilmut and Keith Cambell at the Roslin Institute in Edinburgh, Scotland.

Reproductive Possibilities Resulting from Cloning

1. Parents could have one embryo implanted in the mother's womb and store its identical sibling indefinitely. The spare embryos could be implanted later, allowing parents to create an entire family of identical children of different ages--sequential identical twins.
2. Spare embryos could be sold to families who would be able to see from an already born child how their embryo will turn out. Could rich couples bid on frozen embryo clones of Michael Jordan, Elvis Presley, Albert Einstein and Elizabeth Taylor?
3. A woman conceived from a split embryo could give birth to her own twin. Or a man could contract with a gestational surrogate. What would it be like to see an 18 year old version of yourself (your child) when you are 55? What would it be like, as an 18-year old, to have your parent be your identical twin?
4. The advantage of cloning is that cloning is much more efficient than storing non-identical embryos, because conception has to be accomplished only once.

DEATH

As Dworkin (1993) notes, it is a platitude that we live our whole lives in the shadow of death; it is also true that we die in the shadow of our whole lives. Death has dominion because it is not only the start of nothing but the end of everything, and how we think and talk about dying--the emphasis we put on dying with dignity--shows how important it is that life ends appropriately, that death keeps faith with the way we want to have lived. We worry about the effect of a person's last stage on the character of his life as a whole, as we might worry about the effect of a play's last scene on the entire creative work.

There is the story of the poor man who, in 1890, sold his body to an institute in Sweden for research purposes, to commence upon his death. When he regained his wealth, he tried to buy it back, but they wouldn't let him. In fact, they fined him for having two teeth missing--he'd diminished the value of the product (Hitt 1990).

From a clinical perspective death is a useful and convenient shorthand term to denote a disintegrating biological process in which we may recognize a beginning and an end, with striking changes in between. There is really no moment in time at which it occurs. The moment of death is a legal fiction and the biological truth is quite different. Biologically we die in bits and pieces so the moment of death can only have any scientific meaning if we use this phrase to describe the time when we can state, with reasonable certainty, that an irreversible disintegration process has begun. Prediction is implicit in this diagnosis. Traditionally both law and medicine have held the position that death is a single event in time, not a continuous process or series of phenomena.
In a Virginia case, Tucker versus Lower, in a wrongful death suit, a man that was charged with murder but whose victim was brain dead, alleged that the victim was in fact not dead at time that his heart and kidneys were removed. That is, the murderers were the medical personnel moved the organs.
"The only reason for declaring people dead is that they're dead. Leon Kass drew a distinction between the death of an organism as a whole and the death of the whole organism. Throughout human history, death has never been defined as the death of the whole organism, because life continues in the body's parts--the hair and the nails, for example, continue to grow. But brain death entails the death of the organism as a whole, a state that modern technology merely obscures by keeping the heart and lungs pumping and the body warm.
Dworkin (1993; pp11-12) considers two broad conceptual approaches around which debates about life and death issues are framed:

1. Derivative. Presupposes and is derived from the concept that all human beings including fetuses and individuals in persistent vegetative state have rights and interests. Thus someone who objects to abortion or to "pulling the plug" believes that government has a derivative responsibility to protect the rights and interests of fetuses and unconscious "vegetables".
2. Detached. Assumes that human life has an intrinsic, innate value; that human life is sacred just in itself; and that the sacred nature of a human life begins when its biological life begins, even before the creature whose life it is has movement or sensation or interests or rights of its own. Thus someone who objects to abortion or to "pulling the plug" in this case believes that government has a detached responsibility for protecting the intrinsic value of life.
   In 1989 the Supreme Court of Missouri decided that the parents of Nancy Cruzan—a young woman who had been injured in a car crash that left her in a persistent vegetative state—had no right to order a hospital to withdraw the feeding tubes that kept her alive. The court said that Missouri was entitled to keep Nancy Cruzan alive out of respect for the sanctity of life. The concept upon which this decision was based was that, even though remaining alive was against Nancy Cruzan's best interest, it is intrinsically a bad thing when anyone dies deliberately and prematurely; this argument based on the intrinsic value of human life does not depend on any assumption about a patient's rights or interests.

EUTHANASIA

Should the law allow doctors to kill terminally ill patients who are in great pain and who plead to die? Should it allow relatives of patients who are unconscious "vegetables" (persistent vegetative state) to decide that life-support machines should be shut off?

Euthanasia--act of painlessly putting to death persons suffering from incurable and distressing disease. Suicide ends the living process; euthenasia ends the dying process (Fadiman, Harpers Magazine, April, 1994, p74).

Euthanasia—originated in Greece from two Greek words
eu=good; thanatos=death; thus euthanasia literally means "good death"

Contrast the two different scenarios of dying for the elderly in the 1940s versus the elderly in the 1990s (from R. Cranford 1996).

Dying in the 1940s
An elderly female, in her seventies, is dying at home. She is dying in the home she has lived in for the past 30 years. Friends and family gather at her bedside--sad at her passing away, but remembering the good old days when she was lively, healthy, and full of life. Several generations of family are present: children, grandchildren, perhaps even great grandchildren. Over the last few years, the patient's health has dwindled. She is afflicted with arthritis and a heart problem. Her mind is not quite as sharp as it used to be. But no one really questions what she is dying of, including her physician; she is dying of old age, of natural causes. The family physician, who has known her, her husband, and many of the other family members for several decades, comes to the patient's home each day: seeing the patient, examining her heart and lungs with his stethoscope, sitting at the bedside while concerned family members look on. The doctor tells the family the obvious, "There is really nothing we can do at this stage. She is just dying of old age." The family is sad, but understands. During the patient's last few days, she is surrounded at the bedside in her home by her close family, friends, and a family practitioner who knows her and her family's values well.

Dying in the 1990s
An elderly female, in her late eighties, has been readmitted to an acute care hospital for the sixth time in the last 15 years. The patient has resided in a long-term care facility for the last seven years after the family was no longer able to care for her at home. She has had multiple small strokes, at least one heart attack, and two episodes of pneumonia--all of which were vigorously treated at the time by specialists in neurology, cardiology, and infectious disease. Prior to this most recent illness, the patient's memory had seriously deteriorated, and she no longer recognizes her children. Because of her rapidly deteriorating mental and physical condition, she has been admitted to a medical intensive care unit attended by specialists in the fields of cardiology and neurology. This is the first time these specific specialists have ever seen this patient. They know nothing about the patient's previous personal history or life style. The specialists talk to the family whom they have never met before. In the medical record are listed numerous specific medical diagnoses: arterioscl , cerebrovascular and coronary artery disease, emphysema, mild peripheral vascular disease, and probable Alzheimer's disease or multi-infarct dementia. No mention of old age or natural causes. Finally, after several days in the intensive care unit, the patient has a cardiac arrest, but the patient is not resuscitated because the family and doctors have agreed to a DNR (Do Not Resuscitate) order.

The Neatherlands is the only country in the world where euthansia is legal; or more precisely, not prosecuted. The requirements for doctors who assist in dying to prevent prosecution (Royal Dutch Medical Association) include (from Admiral 1996):

1. The request to die must be the voluntary decision of an informed patient.
2. The request must be considered by a person having a clear and correct understanding of his or her condition and other possibilities. The person must be capable of weighing these options and must have done so.
3. The desire to die must be of some duration.
4. There must be physical or mental suffering which is unacceptable or unbearable.
5. Consultation with a colleague is obligatory.

Contrast euthanasia with the following scenario (from Cassell 1996):

Discontinuing ventilation in a patient who has end-stage disease is a decision that physicians have to make all the time. In a patient who is conscious, the primary symptom is not pain. Probably the most frightening symptom of terminal illness is suffocation--dyspnea, air hunger--and the best treatment for it is morphine. One of the reasons for morphine's effectiveness is that is suppresses the drive for air, so in fact the patient lives a shorter period of time because he or she is not struggling to stay alive. In that patient to whom we give morphine once we discontinue the ventilator, how is it possible to say we are not intending that person to die? What kind of an illusion is this? Do we really believe that the patient's demise is just an unfortunate side-effect of the dyspnea? Using this construct reinforces our own denial and makes it possible for us to continue to practice medicine thinking that we are not dealing with death, and confronting this most challenging and sometimes personally threatening fact of human mortality.

CRYOBIOLOGY

Cryobiology refers to investigations conducted well below normal body temperature; cryogenics refers to the technology of low temperature experiments; cryonics pertains to all disciplines and programs centered on human cold storage. Would not mean biological life is extended; only chronological life Methods for biologically delaying rate of living:

Whose Life Is It? In the fall of 1990 a Silicon Valley mathematician, Thomas Donaldson, suffering from a brain tumor petitioned Superior Court in Santa Barbara for the right to have cryonics technicians freeze his head before he is pronouced legally dead. He wanted his head quick frozen using cryonic suspension. The $45,000 procedure is allowed after a natural death. But if Donaldson waited until then, "there would be no point in being revived". He said that under the current, stupid criteria, my brain could be entirely destroyed before I'm declared death. He believes that scientists eventually will be able to safely remove the tumor, then use his cells to create another body. He views this as the only alternative to death.

1. Hypothermia--cooling below body temperature but well above freezing;
2. Hibernation--state of greatly reduced body temperature and reduced metabolism
3. Freezing--entire body frozen

Questions: i)Does anyone own him? ii)Is he legally dead? iii)What happens to property?

The human body is composed of 75% water. Since water expands when frozen, body cells will burst if left unprotected upon freezing. Therefore, the perfusion method of internment--as opposed to embalming--is the key to cryonic suspension. The entire purpose of perfusion is to prevent ice crystals from forming inside the body cells (Smith 1983).

SUGGESTED READING

Dworkin, R. 1993. Life's Dominion. An Argument about Abortion, Euthenasia, and individual freedom. Alfred A. Knope, New York.
Kass, L. R. 1983. The case for mortality. American Scholar 52: 173-191.
Silver, Lee M. 1997. Remaking Eden: Cloning and Beyond in a Brave New World. Avon Books, New York.

Had Mr. Glover Died?
In the mythical case of In re Glover, heard before the United States Supreme Court, the problem present to the Court involved was whether or not Ralph Glover had died. If he had, his four children by his first wife and two other children by his second wife (both wives had died previously) would inherit the entire estate. Yet, if he were declared not dead, the trustees of the Glover Foundation would continue to receive all corporate revenues of those enterprises forming the Foundation. Mr. Glover, a sixty-two year old man, in total possession of his faculties, discovered that he had contracted an inoperable cancer of the pancreas-which had spread to his liver. Accordingly, he directed his physician to inject his body with the chemical, dimethylsulfoxide (DMSO) and then become artificially frozen. DMSO allows itself to bind to intracellular water thereby allowing below zero degrees centigrade exposure of the body without the formation of ice crystals and, furthermore, allowing cell structure - except for its actual physical state - to remain unchanged. A subsequent coordinated quick-freeze process permits the body temperature to be lowered well below the freezing point of water and remain in that frozen state, with a suspension of all vital functions. Mr. Glover's suspension had been supervised by a medical team acting upon instructions by Mr. Glover, himself. He directed that he remain in suspended animation until the time a cure for his cancer was discovered; thereupon he was to be thawed and restored to full life.
Acting on a suit maintained by Mr. Glover's chauffeur, seeking a declaration that Glover was in fact dead and that his bequest of $1,000 should be paid to the plaintiff, the New York Surrogate Court indicted the team of physicians who had supervised the suspension process. They were subsequently found guilty of willful homicide for their act of injecting a noxious drug into Mr. Glover's system. The Glover Foundation objected to any probate consideration being advanced since they contended Glover was still alive. By a four-to-one decision, the New York Court of Appeals affirmed the lower court. A relative (son-in-law) of Mr. Glover's sought, under the authority of a local ordinance requiring performance of an autopsy on persons suspected of having died violent deaths, to have such an autopsy performed. A temporary injunction was granted, however, on behalf of Mr. Glover's son who challenged the right of the city to order the mutilation of a corpse--especially since it was questionable whether a corpse was available.
Other heirs of the Glover estate maintained an action for medical malpractice against the physicians who performed the suspension as well as the hospital where the procedures was effected. Although winning a significant award, it was being contested by the doctors' medical liability company on the grounds that the "heirs" had a recognizable right to sue for an adult who not only was alive, but, when revived and restored to consciousness was, himself, capable of testifying whether he had, in fact, suffered an injury by that procedure undertaken by the physicians. The State Attorney General also charged the two physicians in question with promoting "a vile and pernicious doctrine" - condemned domestically and abroad, especially in the Nuremberg trials - that terminally ill patient could not have their lives taken under the guise of mercifully ending their suffering states.
Not only did a number of members of the New York State Bar Association seek a vote of censure of the law firm which drew up the contract under which the surgical intervention of suspension was performed by the physicians for Mr. Glover, on the grounds that the contract was "grossly immoral and fraudulent," they also sought a judicial opinion regarding whether the contract was fraudulent as to its statement of purpose. This tack was taken on the grounds that the contract implied human immortality and was, therefore, totally inconsistent with and contrary to the State Blasphemy Act passed in the early history of the state and never repealed. Thereupon, the Society for the Advancement of Atheism requested permission to present a brief amicus curiae showing the Act was in contravention to the First Amendment to the Federal Constitution.
Various state tax commissions, where Mr. Glover owned property, sued for the distribution of the estate's assets, arguing that recognition of the continued existence of Mr. Glover, alive or dead, would be an invasion--albeit a novel one--of the Mortmain laws since a corporation controlling real, as well as personal, property was preventing the states in question from receiving a reasonable payment of taxes due and owing. Creative federal bureaucrats sought to void the Glover Foundation's tax exempt status, arguing that, under present laws governing charitable trusts, no trust would be operating solely for the purpose of maintaining an individual's life.
The Glover Foundation then sought the removal from their posts of the two physicians who both assisted and supervised in performing the cryonic suspension and were responsible for maintaining it. The trustees of the Foundation asserted that the physicians in question had no legal right to act as Ralph Glover's agents, especially since they were now convicted felons. The original contract entered into by Ralph and the physicians, and drawn by Glover's attorneys, to act for Ralph also directed that they use the net profits of the Glover enterprises, which comprised the Foundation, be given over to cancer research. These two beleagued physicians, Doctors Green and Hankey, were intent on executing the contract into which they entered with Ralph Glover. Accordingly, they were suing to block a ruling given by the New York State Board of Health that, consistent with local ordinances, Ralph Glover be buried or cremated. The physicians also sought - unsuccessfully - to have a declaratory judgment issued by the Food and Drug Administration that the drug, DMSO, was both harmless and incapable of causing death in the dosage used for Mr. Glover's suspension. As noted, this action was unsuccessful owing to the fact that the Food and Drug Administration was--as a branch of the Executive--unwilling to exercise its powers of intervention before the judicial branch of government had made a final determination.
A minor legatee sought, and obtained, an injunction against any actions designed to thaw or resuscitate Mr. Glover. Her position was that, having a vested interest in the estate, it was an unreasonable jeopardy of that interest to allow such an act until a final adjudication was made regarding the matter. One of Glover's daughters sought - to have a legal guarding appointed for her father since, she argued, in his present state he was either incapable or incompetent to manage his own affairs. The counter argument was a classic one: Why would a dead man need a guardian?
All these various cases were consolidated. Among various amici curiae allowed to participate, the briefs of the Society of Experimental Biologists and the American Cryologic Association were of considerable importance. The Society's position was that a judgment against the physicians would reverse advancing developments in organ transplantation simply because of a pervasive fear that would grip those physicians being called upon to assist this important work. The Association put forward the argument that considering the freezing or cryonic suspension of living persons as murder would be an intolerable invasion or compromise of one's personal autonomy which allows one to act toward his body in any way so desired.
The Chief Justice ordered the appointment of a Special Master whose duty was to inspect Ralph Glover's body and determine whether it was alive or dead. The Master assembled a group of medical experts to assist him and their findings were: The electroencephalograms taken showed no brain waves of the type normally recorded for living persons; the electrocardiograms showed no evidence of heart muscle current (yet, it was carefully noted that at low temperatures, such as those at which Mr. Glover was being maintained, little, if any, electrical conductivity would be present); neither pulse, heart beat or respiratory movements were observed. These specific findings, however, carried little weight because of previous studies which showed the difficulty of ascertaining when life departed when one's metabolism was close to zero; no oxygen level determination could be observed because of the fact that the blood system was frozen; the state of the blood vessels as viewed by the eye grounds was also impossible since the lenses were clouded and a state of opacification of both the aqueous and vitreous humors was recorded; a condition which should have occurred within a few hours after an actual death - namely, a total absence of lividity of dependent tissues - was not found. And, finally, to add further confusion and uncertainty to their findings, the Master and his team examined a small section of skin, taken from Mr. Glover for biopsy. When unfrozen and examined microscopically, it disclosed a cloudy swelling of the cells which, while a common sign of death, is also a condition present in "cachectic" or "wasting states" like those found in various forms of advanced cancer.
One conservative (i.e., "old fashioned") Associate Justice of the Court, who found it difficult to understand or accept new theories or processes, determined a writ of habeas corpus should issue. In this way, Mr. Glover would have to be unfrozen. And, should he be found alive after revival, "all the cases fall out." Yet, "if he's permanently dead (what an expression!) judgment will be easy in every case." The most junior member of the Court cautioned against issuing the writ, noting its issuance was limited to those cases where a determination was to be made whether an inferior court, acting without jurisdiction or in excess of authority, improperly detained an individual. The Chief Justice, nevertheless, pressed his opinion that Mr. Glover be thawed - with the express purpose of such act being to discern his actual intention concerning the alleged contract with the physicians, Doctors Green and Hankey, who performed and maintained the cryonic suspension. It was speculated that since Glover wished the suspension to be maintained until a cure for his cancer could be found, this was tantamount to establishing a trust in perpetuity and thus void.
Justice Freundlich opined that an order to thaw would be direct interference with the terms of the doctors' contract with Mr. Glover and that such action could be pursued only if the contract was either contrary to public policy or violated a specific statute. "Otherwise we are, in effect, condemning Glover to a real death - if he's not dead already." An equally argumentative point was injected by yet another Associate Justice who observed that, since the two physicians had already been found guilty of criminal homicide, to order the thawing of Mr. Glover would be a recognition of the fact that the corpus was, indeed, revivable and, thus, the physicians were not guilty of homicide. (The Justice continued by noting that if the Court "felt" Glover were alive, there was no need for the thaw order.) Although exonerated on charges of criminal homicide upon Mr. Glover's revival, the supervising physicians would be subject to suits for breach of contract and for damages which would be maintained by Mr. Glover and the Glover Foundation, respectively. "If the man is dead, they are incriminating themselves by their failure to resurrect him," observed the perspicacious, yet nevertheless contentious Justice.
The final disposition of this case was determined by an Act of God. Several days after the Justices' Conference, New York City suffered a power outage - no electricity for some fourteen hours. As judicial "luck" would have it, the vault where Mr. Glover was being cryonically suspended at the Glover Memorial Hospital apparently had no emergency sources of reserve power and, thus, all forms of animal life in the freezers "died". Fortunately for the Court, it was allowed to sidestep all the other issues raised and simply hold, unanimously, "That Ralph Glover died by an act of God on an indeterminable date." The previously consolidated cases were severed and returned to the lower courts for resolution.

AN ANCIENT FABLE
Once there was a young man who said to himself, "This story about everybody having to die, that's not for me. I'm going to find a place where nobody ever dies." And so he said goodbye to his parents and his family, and he set off on a journey.
And after several months, he meets an old man, with a beard down to his chest, trundling rocks off a mountainside in a wheelbarrow. He says to the old man, "Do you know that place where nobody ever dies?"
The old man says, "Stay with me, and you won't die until I have carted all this mountain away in my wheelbarrow."
"How long will that take?"
"Oh, at least a hundred years."
"No," says the young man, "I'm going to find that place where nobody ever dies.
He travels on, and he meets a second old man, with a beard down to his waist. This old man is on the edge of a forest which seems to go on for ever and ever. And he's cutting branches off a tree.
The young man says, "I'm looking for that place where nobody ever dies."
"Stay with me," says the old man, "and you won't die until I've cut off the branches of every tree in this forest."
"How long will that take?"
"At least two hundred years."
"No. I'm going to find that place where nobody ever dies."
He travels on again. He meets a third old man, with a beard down to his knees, and this old man is watching a duck drinking sea water from an ocean.
"Do you know that place where nobody ever dies?"
And the old man answers, "Stay with me and you won't die until this duck has drunk the whole ocean."
"How long will that take?"
"Oh, at least three hundred years, and who wants to live longer than that?"
"No," says the young man, "I'm going to find that place where nobody ever dies."
The young man goes on. And he comes to a castle. The door opens and there is an old man, with a beard reaching down to his toes.
"I'm looking for that place where nobody ever dies."
"You've found it," replies the old man.
"Can I come in?"
"Yes, I would be glad, very glad, of company..."
Time passes. And one day the young man says, "You know, I'd like to go back--just for a moment. I won't stay long but I just want to go back to say hello to my parents and to see where I was born."
The old man says, "Centuries have gone by, they're all dead."
"I'd still like to go back if only--if only to see the street where I was born."
So the old man says, "All right, follow my instructions carefully. Go to the stables, take my white horse, a horse who is as fast as the wind, and never get off him. If you get off that horse, you'll die."
The young man mounts the horse and rides away. After a while he comes to the beach where the duck was drinking the sea. The sea-bed is now as dry as a prairie. The horse stops at a little heap of white bones--all that is left of the old man with the beard down to his knees.
"How right I was not to stop here," says the young man to himself. And he goes on, and he comes to where he saw the forest. The forest is now pasture-land--not a single tree is left.
"How right I was not to stop here," says the young man to himself. The young man goes on and comes to where the mountain had been, but it is now as flat as a plain. For the third time he says to himself: "How right I was not to stop here!"
Finally he arrives at the town where he was born. He recognizes--nothing. Everything has changed. He feels so lost that he decides to go back to the castle. One day on his return journey, towards nightfall, he sees a cart drawn by an ox. The cart is piled high with old, worn-out boots and shoes. As he passes, the carter cries out, "Stop, stop! Please get down. Look, a wheel of my cart is stuck in the mud. I'm alone. Please help me."
The young man answers back, "I'm in a hurry, I won't stop and I can't get off my horse."
The carter pleaded, "It will be dark in a moment, it'll freeze tonight, I'm old and you're young, please help me."
So, out of pity, the young man got off his horse. Before his second foot was out of the stirrup, the carter grasped him by the arm and said, "Do you know who I am? I am Death. Look in the cart at all those boots and shoes I have worn out chasing you! Now I have found you. Nobody ever escapes me..."

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