Sunday 30 January 2011

A unique placebo trial which could only be done at Dignitas

There's a bit in the film Nikita (the original) where she's killed by
lethal injection. It's a fake injection and from that point she's
recruited into the secret military.

It makes me think of an experiment. It could either be something to
trial the nocebo effect, i.e. the negative placebo effect, so patients
would initially be given an anaesthetic which renders them unconscious
rather than kills them. The experiment would seek to find out how
powerful the nocebo effect was. It's not an unethical study except for
the problem of people walking up and feeling that they've been betrayed.
They'd gone through the process it takes to come to the decision to end
their life and had gone through the 'death' process only to find it
wasn't real (unless the nocebo effect kills them). A second, lethal
injection would be offered at this point.

In fact I wonder if that's what happens anyway. It gives a person that
last chance to change their mind but if they're set on it they can still
get the lethal injection. It's a betrayal of course and I suppose it's
not very good of me to think about this betrayal of trust at such an
important part in a person's life: their last contact with society.

I'd be fascinated to know if the nocebo effect is true. There's a single
case study often cited to show the nocebo effect. It broadly goes a
doctor diagnosed a patient with (stomach?) cancer and gave them 3 months
to live. In 3 months they died but when they autopsied the patient they
found no traces of cancer and were unable to determine cause of death.
It was assumed that this patient was killed by the nocebo effect. Like a
swallow in summer, a single case doesn't indicate fuck all but a
possibility.

The Dignitas clinic presents a unique opportunity. It presents the
opportunity to experiment on people who are just about to die. The
experiment is to see if the nocebo effect can really kill someone.
Honestly I doubt it can but if this became standard practice at Dignitas
(a single injection to knock the person unconscious which they're told
is a lethal injection then the second true lethal injection) it would be
an opportunity to prove me right or wrong. Their could be two groups: a
placebo and an active group. I'm just not sure what the point would be.
I'd expect placebo comparisons in any good experiment except one
investigating the nocebo effect in this way but I'm assuming that
everyone who gets helped to die at Dignitas is killed successfully first
time using the lethal injection.

The value of this experiment is higher than one might think. In the
hypothetical situation that people can die from the nocebo effect there
are signifcant things which doctors and other professionals need to
consider when interacting with patients/clients/etc. A misdiagnosis
could kill quicker than a germ.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"