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Inert gas and suicide bag, quick and painless, or not?

To underline the point of the speed and painlessness of the effect of the suicide bag technique, which has been contested by some editors and some researchers, I accessed some of Ogden's work via the library. Here is an interesting quote that may be suitable for inclusion or part inclusion:

PMID 20216304 Speed of unconsciousness with inert gas inhalation
The Internet, however, provides independent verification of the speed by which helium can induce unconsciousness without warning. A search of YouTube, the popular video sharing website, reveals several clips of people breathing helium with the purpose of altering the timbre of their voices for amusement, but with the unexpected side effect of sudden unconsciousness. The Internet links in the reference section of this paper show “Helium girl” losing consciousness after breathing helium from a balloon for 15 seconds and “Gabby” falls unconscious after 18 seconds. In “Passout” a young female inhales helium and begins to sing a song, but after 5 seconds of singing she spontaneously stops and falls unconscious to the floor. These YouTube cases involve breathing helium from a balloon, whereas the decedents breathed helium inside a prefilled environment sealed from outside air. Consequently, loss of consciousness was faster and with no chance of recovery. The individuals in the YouTube videos quickly recovered because they were in a normal air environment

Also from that paper are two eyewitness accounts of inert gas and suicide bag asphyxiations, which I have never seen described before:

Eyewitness description of inert gas and bag death
Case 1:After reciting her prayer, the decedent placed the hood on top of her head in line with her forehead and neckline. She opened the valves to both helium tanks and inflated the hood [suicide bag]. After the hood was inflated the decedent spent a moment to say good-bye. Next, in accordance with the instructions in Final Exit, she exhaled to remove residual oxygen and carbon dioxide from her lungs and then pulled the hood down to her neck. The pulse oximeter on her left index finger shifted during this process and therefore no pulse and oxygen measures could be recorded. Once the prefilled hood was over the decedent’s head she spoke something indiscernible that sounded like “good-bye.” Considering the time of the first breath inside the helium environment as 0 seconds, the following was observed: loss of consciousness at about 12 seconds followed by accelerated respiration continuing to about 55 seconds; at around 40 seconds there were reflexes in the right arm and in both legs. The reflex in the right arm was a single, slow contraction at the elbow. The extension reflex in the legs lasted approximately 15 to 20 seconds. At 1:44 there was a loud gurgling expiratory breath, possibly due to carbon dioxide escaping (from the 2 glasses of sparkling wine consumed earlier). At this time muscle tone relaxed and the head fell slightly to the right into a final resting position (Fig. 6). Very faint gasps occurred at 3:32, 4:26, and 4:55; the tongue distended at 4:55; further faint gasps occurred at 5:15, 5:47, 6:11, 6:36, and 6:46; barely perceptible muscular twitching of the right cheek took place from about 6:50 to 7:05; at 7:25 a hardly audible snort of the sinus replaced the faint oral gasping; further faint sinus snorts occurred at 7:46, 8:29, 8:51, 9:46, and 11:11, after which all visible respiratory movement stopped. Case2: Considering the time of the first breath inside the helium environment as 0 seconds, the observations are as follows: loss of consciousness at 10 seconds (about 3 breaths); breathing then accelerated for about 40 seconds. At 1:00 the heart rate had accelerated to 114 and saturation percentage of oxygen (SPO2) dropped to 39%. At about 2:00 breathing had stopped, the oximeter could not fix on a heart rate and SPO2 was 37%. At 3:00 the oximeter was still not measuring any heart rate and SPO2 was 34%, which is the minimum range for the device. At 3:45 the jaw fell slack and the tongue extended. Although breathing had ceased after 2 minutes there were 4 terminal gasps at 4:00, 4:45, 6:40, and 8:36. At no point in the dying process was there any extension or contraction reflex of the arms or legs.

I await comments from other editors as to how much of this material we can use. Ratel (talk) 03:55, 15 May 2016 (UTC)

WP:UNDUE, the article already dedicates a lot of space to Ogden's primary findings. The article already says that right-to-die groups advocate this method as "certain, fast, and painless." There's no reason (other than POV pushing) to reiterate that by quoting more Ogden. —PermStrump(talk) 21:16, 15 May 2016 (UTC)
  • Other opinions welcome. I found the data compelling and very apt for the article. There's nothing POV about it actually; Ogden is not commenting on it, merely reporting exactly what he saw. For legal reasons, his research is unique (how many other researchers have sat in on voluntary euthanasias? None afaik), so there are no secondary sources to draw upon (yet). If material can be supported by either primary or secondary sources – the secondary sources should be used, when available. MEDRS says that if conclusions (observations) are worth mentioning, they should be "described appropriately as from a single study". MEDRS states that "a reason to avoid primary sources in the biomedical field – especially papers reporting results of in vitro experiments – is that they are often not replicable", but I'd argue that this is not relevant to an observational study such as this, one that is not claiming any novel result or breakthrough, so it seems there is no prohibition on using it. As to UNDUE, it is not as if by quoting it we are piling more and more of Ogden's opinions into the article, merely his objective observations, same as you or I would have made in the circumstances. Ratel (talk) 22:53, 15 May 2016 (UTC)
I don't see a problem with using Ogden as a source if you think the information quoted above is important and relevant enough to include. What would the purpose be of adding the quoted information? How would it improve the article for the reader? • • • Peter (Southwood) (talk): 12:35, 16 May 2016 (UTC)
Well I found the second quote an eye-opener. I found it very interesting, and I guess other oldies like me, who want to have some control of the end of their lives, or at least the knowledge that could be used in the event of a serious illness, would also find it reassuring. Ratel (talk) 12:51, 16 May 2016 (UTC)
I too found it interesting. Also informative. Informative can be considered encyclopaedic, but not in every case. It must also be on topic and within scope. Whether others would find it reassuring is another question, and whether it is the purpose of an encyclopedia to provide reassurance is another one altogether. The relevant question here I think, is whether the information it provides is appropriate to the subject of the article. I think it could be argued that it is uneccessarily detailed considering the overall length and scope of the article, but as there is no reliable source available to say the same thing more succinctly, there also seems to be a reasonable case for inclusion. Ie. if it is inadmissible to state that it is a quick, painless and certain method of dying, because there are no reliable sources to cite, then the best option is to provide reliable reports on what actually appeared to happen and leave it to the reader to draw their own conclusions.
Quick is a subjective judgement. These quotes give a realistic idea of the actual time scale.
Certain is dependent on the situation. If interrupted in time, or if carried out incompetently, it is not certain, but if carried out competently and completely I doubt that anyone with a reasonable understanding of the physiological processes would claim that it would not be completely lethal.
Painless is more difficult to prove or disprove perhaps, and may well depend on one's definition of pain. I am insufficiently expert to argue this point. Lacking obvious signs of distress is about as far as I would consider the evidence supports. • • • Peter (Southwood) (talk): 13:18, 16 May 2016 (UTC)
The generally accepted (medical) definition of pain requires consciousness. That puts some firm limits on the risk of pain.
I like the idea of quantifying "quick", mostly because I think it could serve as a "don't try this at home" kind of warning. However, I'm dubious about using YouTube videos as the original source of these numbers. Someone might have fainted after just a few seconds on video, but we don't really know how many times she had done that before the camera was turned on. I think we'd do better to cite the numbers from Dignitas-supervised suicides. WhatamIdoing (talk) 15:28, 16 May 2016 (UTC)
  • WhatamIdoing could you provide a reference for the generally accepted medical definition of pain above, as it does not appear to be mentioned in the Wikipedia article Pain except where claims are made for absence of pain in organisms where consciousness is claimed to not exist, making it unclear as to whether the definition is relevant to humans where consciousness is generally accepted to exist.
  • There may be data on time to unconsciousness from industrial accident reports and the like. • • • Peter (Southwood) (talk):
    • User:Anthonyhcole knows far more about this subject than I, but the information is hiding in plain view in the lead of Pain: Pain is a subjective, emotional experience. When you are unconscious, you do not have any subjective, emotional experiences. They use a different word, nociception, to describe the non-subjective, non-emotional unpleasant thing that you would be noticing and reacting to, if the same thing happened while you were conscious. Or, more simply, pain is why they knock people out for major surgery; nociception is why they also give those unconscious people analgesics in addition to the anesthetics and/or amnestics. WhatamIdoing (talk) 15:51, 19 May 2016 (UTC)

I've included the quote because:

  1. It suggests that the procedure is quick and painless, as claimed by right to die groups
  2. It is informative and interesting and makes a suicide bag's function clear
  3. It underlines that the bag is really meant for old, sick people. Young people reading this may feel uncomfortable when it is clear this is not for their generation.
  4. It allows readers to make their own judgments as to "hurried, impersonal and undignified". Ratel (talk) 23:54, 16 May 2016 (UTC)
The material was removed as "too much" by whatamIdoing. Why is it too much? Ratel (talk) 01:14, 17 May 2016 (UTC)
Those quotations go into far too much detail for an encyclopedia article. If you've got a stable, free external link to that, then we could list it under ==External links== under the WP:ELYES #3 provision, but it doesn't belong in the article. It might be useful to read an honest-to-gosh encyclopedia article at this point, to get a feel for the general editorial goal; I recommend s:1911 Encyclopædia Britannica/Suicide as a relevant example. Detailed descriptions of individual human's personal experiences really aren't what we're aiming for. We're aiming for a concise summary of the main points.
Also, this comment about it being "really meant for old, sick people" is strange. Most of the people using it are middle-aged, mentally ill drug users. We can state that fact without passing judgment on them for being the "wrong" kind of person to use it. (Who gets to decide who the "right" kind of person is, anyway?) WhatamIdoing (talk) 01:22, 17 May 2016 (UTC)
The concern I've seen expressed about this page elsewhere in wp is that it might be read by the wrong kind of people eg. teenagers with psych problems. I should have said "old or sick" people. Ratel (talk) 02:27, 17 May 2016 (UTC)
I suspect that there are no suicide methods that anti-suicide advocates would agree are "right" for young people or people with psychiatric problems. But even if some advocates worry that "too many" younger people are using it, that doesn't mean that the method is "meant for" someone else. WhatamIdoing (talk) 01:51, 19 May 2016 (UTC)
Let me rephrase then: I thought that using the quotes of the actual use of the suicide bag would give the bags some context for readers, inasmuch as here we have two superannuated folk who are sick in body and needful of an exit. This is the page's target demographic, these are the majority of the article's readers, we hope. Why do we hope this? Because of the very same ethical concerns expressed in the article, namely that many people using this very quick and lethal method (this is no cry for help technique!) are fit in body, and young. So I was attempting to address the ethical concerns raised in the review paper by Howard et al (PMID 21394956). By placing the bag in the context of the sick and the old, the subliminal message to young, healthy readers is "this is not the kind of thing that you should be doing, it's for grandma". I hope that is clearer. Ratel (talk)
This is an encyclopedia. The page's target demographic must remain all people who wish to know more about the subject of the article. When you target a specific demographic it implies some form of bias. • • • Peter (Southwood) (talk): 06:27, 19 May 2016 (UTC)

My only bias is that I am attempting to avoid the ethical gotchas that plague this topic. But I accept that I am the only one here trying to do this, so I will not have my way. Ratel (talk) 07:31, 19 May 2016 (UTC)

I don't understand your expression ethical gotchas. • • • Peter (Southwood) (talk): 20:25, 19 May 2016 (UTC)
This topic is a gotcha topic because even by having an article, we run the risk of exposing people who are thinking about suicide, but who are merely depressed, to information that may hurt them, whereas if we do not have the article, i.e. we censor wikipedia, (a) that's unacceptable and (b) moreover robs truly suffering people, who are usually old (but not always), and people with terminal illnesses, of access to wikipedia-class reliable information on the topic. So how do we avoid being trapped by hurting, and not helping, while not censoring? I've explained what I would do above. Ratel (talk) 22:36, 19 May 2016 (UTC)
To underline the threat, this quote from a 2015 study : The increased use and high lethality of suffocation as a suicide method underscores the importance of early prevention strategies to reduce onset of suicidal thoughts in young persons and to help identify persons who are contemplating suicide or who are at greater risk for suicide (8). National data indicate that 17% of high school students reported seriously considering suicide and 8% reported making one or more suicide attempts in the preceding 12 months Ratel (talk) 22:47, 19 May 2016 (UTC)
Thanks for elucidating. I understand your position, but the world is full of inconvenient and potentially dangerous information, some of which has the potential for misuse. Ethics aside, it is impossible to hide all of it, or to protect everyone from the possible consequences. Wikipedia is intended to provide a neutral point of view. Where it fails, we should fix it. Unfortunately this is complicated by the advocates of non-neutral points of view who believe they are right. • • • Peter (Southwood) (talk): 07:13, 20 May 2016 (UTC)
Ratel, maybe we agree about more than I thought, but have different ideas of what neutral is. My concern is that many parts of this article glorify this method based on dubious sources, making it extra attractive for vulnerable people with mental illness and substance use disorders who might otherwise seek treatment. I also think the article over-cites books and other works by right-to-die advocates as a way to lead people to more information and not because those are the best sources to cover this topic. If right-to-die advocates want to idealize the method amongst themselves and the terminally ill, IDGAF, but I do care how it's presented to the public when it puts others at risk, which this specific article does according to PMID 26502782. Aversion to pain is one of the things that might keep someone from attempting suicide even at times when they can't find many other reasons for living,[1] so until we have multiple high quality sources attesting to it being pain free and as long as we're sourcing that statement to someone's primary research based on observing videos of 4 people dying, then I'm going to be here arguing that the statement needs to be removed or appropriately contextualized. —PermStrump(talk) 08:13, 20 May 2016 (UTC)
Permstrump I think that we can be pretty sure from multiple descriptions from multiple sources that an inert gas in an enclosed space (eg. a bag) will knock you out extremely quickly, and that once you are out you are insensate, just as when you are anesthetized, and that death will then follow within minutes. I don't think that's controversial at all. You, and indeed I, cannot find any source to contradict this, except Frost, who seems rather to have gotten himself a tad confused. You also have to think of the people who really need to access reliable information about this topic for good reason, not only the drugged or depressed young person. This is a grey area. You cannot suppress, or misrepresent as painful, based on concerns for one demographic. But I await your presentation of a source that disagrees with our other sources with interest. Ratel (talk) 10:03, 20 May 2016 (UTC)
"Reliable information"—We are not providing that. We're providing anecdotal reports written by a sociologist and a de-registered doctor who are too close to the topic to be unbiased. You discount Frost yet that's in the top five of the highest quality sources we have in this article according to WP:MEDASSESS. We also conveniently haven't mentioned the parts of Ogden's papers where he talks about feeling uncomfortable seeing people jerk and twitch or that one of the 4 people he observed took 40 minutes to die, which I haven't added because the 4 people were using masks, not suicide bags, so even mentioning it at all is a coat rack. I've read in a few places that right-to-die groups started recommending the suicide bag method because of logistics, access to lethal doses of other medications and cost, not because all things considered it's actually what they considered as the top choice. They seem to have gone all-in with promoting it though and aren't willing to acknowledge its deficits. Nitschke, who sells expensive nitrogen kits, says nitrogen is better than helium because nitrogen has less chance of adverse effects. Well, that implies that helium has adverse effects. Then a few paragraphs later we have Ogden essentially saying helium is fail-safe and pleasant. And you're telling me that they're so reliable we should ignore MEDRS. —PermStrump(talk) 16:06, 20 May 2016 (UTC)
From Ogden et al. 2011 (PMID 24501824): It was disturbing to witness preterminal gasping in both cases. In adults, gasping is witnessed in 30% to 40% of cardiac arrests. —PermStrump(talk) 19:25, 20 May 2016 (UTC)
And again you are waving with a nice policy to hide plain POV. The Banner talk 20:36, 20 May 2016 (UTC)
If there were actually independent reliable sources supporting the statements in this article that I dislike, my POV might very well be different. —PermStrump(talk) 21:21, 20 May 2016 (UTC)
I and others here contend that the sources are independent and reliable enough. Perm, if you stand back from the wikilawyering and just use common sense for a moment, you'll see that the article is on the right track. The bad outcomes we see from the Ogden study and the Dignitas videos all had to do with badly fitting MASKS. Now the Dignitas people were forbidden to help the decedents, so nothing could be done to hasten affairs, and likewise with Ogden. I think I'd be prepared to concede that painful, delayed deaths are possible with the suicide bag+inert gas if you can provide any proof at all (other than Frost, who from a very weak n=2 case study presented a case that had unusual features, and took emetic drugs beforehand — studies from centers that see such cases routinely, such as the review study by Ely and Hirsch, do not report such findings) that a properly used, properly constructed suicide bag with a properly attached tube and an adequate inert gas canister has led to a prolonged death or a severe injury that left the user alive and disabled. You have access to all the papers, care to try to find such? I am really interested to see if you can. Enough studies have been done into this topic for poor outcomes (i.e. a painful death or disablement) to have been well documented by now. Ratel (talk) 21:27, 20 May 2016 (UTC)
That is entirely beside the point as they do not abide by our sourcing guidelines. We do not interpret the strength of the evidence (such as n=) on Wikipedia, but the quality of the source. Please see WP:MEDRS — your argument is moot. Carl Fredik 💌 📧 09:49, 21 May 2016 (UTC) 

Pause. You people do realize that every time someone suggests IAR or accuses me of wikilawyering for bringing up RS guidelines, it makes it that much more obvious who here is actually doing the POV pushing, right? Unpause. —PermStrump(talk) 21:45, 20 May 2016 (UTC)

I agree entirely, and I can also say that I am favorably inclined to many of the pro-euthanasia arguments — but what I'm against is Wikipedia providing false information and how-to guides based on shoddy sources. Carl Fredik 💌 📧 09:49, 21 May 2016 (UTC)
Nice, but ineffective try to put the blame on somebody else. The Banner talk 18:54, 21 May 2016 (UTC)

Image

The image in this article constitutes a how-to diagram. Wikipedia is not a howto-guide, and for controversial statements WP:RS applies even to images - and always applies to information in their captions . Carl Fredik 💌 📧 11:51, 23 May 2016 (UTC)

And Wikipedia is supposed to be neutral and informative, not censored by a POV-pusher. The Banner talk 18:06, 23 May 2016 (UTC) reverted, as you can expect
Wikipedia is supposed to be neutral and informative. Agreed. This is why we require reliable sources and exclude how-to material since an encyclopedia is not a how-to manual. I agree with x-naying the photo. —PermStrump(talk) 18:18, 23 May 2016 (UTC)
It is creepy to see that you two mix up a clear description with a how-to. The Banner talk 18:29, 23 May 2016 (UTC)
Then I suggest you read up on WP:NOTHOWTO — a diagram with instructions on how to operate and use such a device is not encyclopaedic, an image of an actual device might be. Carl Fredik 💌 📧 20:58, 23 May 2016 (UTC)
What I want you to do is take a proper look a the image and read the texts. The Banner talk 21:22, 23 May 2016 (UTC)
  • Image is not a How-To. CFCF, first, up above, you demanded a source. When you got one, you went shopping for another policy, coming up with WP:NOTHOWTO. Unfortunately for you, that policy is pretty clear: Instruction manuals. While Wikipedia has descriptions of people, places and things, an article should not read like a "how-to" style owner's manual, cookbook, advice column (legal, medical or otherwise) or suggestion box. This includes tutorials, instruction manuals, game guides, and recipes. Describing to the reader how people or things use or do something is encyclopedic; instructing the reader in the imperative mood about how to use or do something is not.. Now a labelled diagram that contains no instructions is NOT a how-to, it is merely descriptive, so that readers know what the hell we are talking about. Ratel (talk) 19:27, 23 May 2016 (UTC)
I've asked for a source, but there is no source in the image-caption — and you wan't just use any source, you need a source that supports the content. I also strongly contest the above assertion — it is not encyclopaedic and NOTHOWTO applies. Carl Fredik 💌 📧 20:58, 23 May 2016 (UTC)
Could you please stop edit warring about this image? The Banner talk 21:33, 23 May 2016 (UTC)
By now you have removed the image at least six times (both 3RR-warnings were promptly removed). Please stop it. The Banner talk 21:57, 23 May 2016 (UTC)
Source: Dr Death 'DIY' kits for OAPs. But I guess you will reject this source as it does not fit your stance. The Banner talk 22:31, 23 May 2016 (UTC)


I've reverted to the last stable version and that one contained the image. Removing the image is disputed. Please observe WP:BRD and get consensus here for the image-removing edit first. Thanks. Anna Frodesiak (talk) 21:40, 23 May 2016 (UTC)

Chabot is a euthanasia expert

Chabot is a euthanasia expert, so do we need "self-published" tags around his quote? The tag is meant for "questionable sources", but when we are quoting an acknowledged expert, this is surely unnecessary. (WP:SELFPUBLISH : "Self-published expert sources may be considered reliable when produced by an established expert on the subject matter"). Chabot has also published studies on this topic eg. PMID 19375206 Ratel (talk) 04:17, 23 May 2016 (UTC)

"May be considered reliable"; for stronger claims, not so much. If what he says is "accepted knowledge" it should be possible to find a good source for it. Alexbrn (talk) 06:00, 23 May 2016 (UTC)
The lay press aren't an authority to call someone an expert. They have to be considered an expert by other experts in the field through direct statements or significant contributions to the field as evidenced by the volume of relevant publications in respected, independently published, peer-reviewed journals. WP:ACADEMIC. —PermStrump(talk) 06:09, 23 May 2016 (UTC)
He seems to have been published twice in peer reviewed journals, once in 1979 and once in 2009, neither of which have been cited that often. So clearly the newspaper was just sensationalizing. —PermStrump(talk) 06:18, 23 May 2016 (UTC)
"Others in this field" -- Chabot is knowledgeable in a very unusual field: euthanasia. he's written one of the very few books on the topic. There are very few people in the world who can claim this, or who have studied this topic. Permstrump has called all doctors and researchers in this field unreliable, which I find very POV. Alexbrn, Chabot is not making extraordinary claims. What he says is in line with all the other sources we line up in the article. Ratel (talk) 06:44, 23 May 2016 (UTC)
Then use the other sources. If it's not in them I suspect there's a weight issue here as well as a reliability one. Alexbrn (talk) 06:47, 23 May 2016 (UTC)
Chabot's opinions are included in academic works on the topic, for instance here at Cambridge Press publication Physician-Assisted Death in Perspective Assessing the Dutch Experience. His PhD also concerns the topic of suicide, as you can see here. To try to make out that he is unreliable and that quoting him presents a weight issue is absurd. Ratel (talk) 07:18, 23 May 2016 (UTC)
If it's in RS, then use it; if not we have problems. I see you've reverted this to the LEDE (which is meant to summarize the body, not have weakly-sourced novel content in it). Naughty. Alexbrn (talk) 08:04, 23 May 2016 (UTC)

Moved to history section, without the erroneous tag. Ratel (talk) 08:44, 23 May 2016 (UTC)

It needs to be removed if you can't produce good RS to establish weight & accuracy. Alexbrn (talk) 08:46, 23 May 2016 (UTC)
Chabot is RS according to WP:SELFPUBLISH. RfC this if you don't agree. You've already removed equivalent and equally accurate text: "Right-to-die groups recommend this form of suicide as certain, fast, and painless. PMID 18043029 " No matter where we get the text, it's not acceptable, even if true. This is just POV-pushing, nothing more. Ratel (talk) 08:58, 23 May 2016 (UTC)
Chabot is RS according to WP:SELFPUBLISH ← false. Alexbrn (talk) 09:03, 23 May 2016 (UTC)
Self-published expert sources may be considered reliable when produced by an established expert on the subject matter, whose work in the relevant field has previously been published by reliable third-party publications I've already proved that above. Plus he has a PhD is this field. Plus he's called an expert in the media. Plus he has [self]published books on this, several. Plus he was part of a ground-breaking lawsuit on the issue ... let's see, I think that makes him a bona fide expert. Ratel (talk) 09:11, 23 May 2016 (UTC)
"may be" ≠ "are". There is also the weight issue. Let's see what others say. Alexbrn (talk) 09:21, 23 May 2016 (UTC)
I agree with Alexbrn. Carl Fredik 💌 📧 11:49, 23 May 2016 (UTC)

As far as relevant, Chabot knows what he is doing and even was prepared to risk a jail term: The doctor who prescribed suicide. Swiping him aside is not in the best interest of this article. The Banner talk 09:45, 23 May 2016 (UTC)

I think it's a pretty weak argument against his credentials being sensationalist to link to an even more sensationalist article. Carl Fredik 💌 📧 11:48, 23 May 2016 (UTC)
It is your POV-opinion that it is a sensationalist article. To me the article is pretty neutral and even lets his opponents say their say. And for a Dutch case, it is rather interesting to see an article about the case in a British newspaper. The Banner talk 18:10, 23 May 2016 (UTC)
Including Chabot's source is undue and bookspam. —PermStrump(talk) 18:20, 23 May 2016 (UTC)
And again we see a lot waving with guidelines to hide a POV. The Banner talk 18:32, 23 May 2016 (UTC)

Side note: I deliberately added {{Self-published source}} (a template used inside the ref tags for tracking), rather than {{Self-published inline}} (a template used outside the ref tags for identifying problems), because I don't think that the use of this source for this purpose is necessarily problematic. WhatamIdoing (talk) 17:15, 26 May 2016 (UTC)

Another thought: If we're going to talk bout the speed of the method, then maybe we should differentiate between the parts that are "quick" (time after beginning to inhale the gas) and the parts that are not at all quick (buying and assembling all the pieces in the apparatus). Compared, to say, acetaminophen overdose, this method takes a lot of time to set up (days or weeks spent sourcing and acquiring the bag, tube, gas, etc. vs one quick trip to any American drug store) but much less time to die (minutes vs multiple days). WhatamIdoing (talk) 21:07, 26 May 2016 (UTC)

Some gaps in the information.

The article does not appear to cover the full range of information which may be considered encyclopaedic.

  1. General short term physiological effects of the gases which have been used (in non asphyxiant circumstances) (started)
  2. Risk to third parties associated with the different gases used (started)
  3. Demographics compared to the general demographics of suicide, not just the specific demographics of this method, which may introduce systematic bias.
  4. Consequences of incompetent application (interruption is partly covered already)
  5. Other?

Cheers,• • • Peter (Southwood) (talk): 07:14, 21 May 2016 (UTC)

For point 2 — [3] mentions fire risks for dispatchers with butane and propane. Should be more sources out there.Carl Fredik 💌 📧 21:18, 23 May 2016 (UTC)
There should be good sources for most of these points. Since no-one has suggested that they are not appropriate, and it doesnt look like anyone else will do it, I may add some information as and when the sources are found.
I will probably start with physiological effects on the user and third party risks of the commonly used gases, If anyone wishes to add something on physiological mechanism, go ahead. It is basically cerebral hypoxia, which is fairly well documented, but some numbers may be difficult to find. A summary section with links should be adequate. Consequences and prognosis of interruption at various stages should be mentioned. There may be good detail articles that can be summarised. · · · Peter (Southwood) (talk): 13:19, 3 March 2018 (UTC)

Helium and oxygen

(copied fron a user talk page discussion)

The helium balloon gas is supplied as 80 helium, and up to 15% air. [4] Although this can kill you, the small amount of air will cause the hypercapnic response, which is why Humphry says it won't work. Ratel (talk) 12:39, 2 March 2018 (UTC)

Ratel, 15% air in helium will give 3% oxygen. At normal atmospheric pressure this should not support consciousness long enough to notice hypercapnia. Once unconscious, hypercapnia is a moot point, as it is no longer possible to do anything about it. It may allow spontaneous recovery if the next breath is fresh air, but not if it is a 3% mix, regardless of carbon dioxide levels. This is an issue well known in rebreather diving. Is Humphry's claim supported by any experimental evidence? ·
The Worthington safety data sheet has some dubious information. It does not claim that the air is included for safety reasons, it is quite likely just to make balloon gas cheaper to produce. A 0 to 15% air content cannot be claimed to provide any reliable safety margin, as it may be 0%, and from a health and safety perspective must be considered anoxic. · · Peter (Southwood) (talk): 14:49, 2 March 2018 (UTC)
Moot point, because remember we are only reporting Humphry's opinions in that article, not scientific fact. As a peaceful death advocate, any chance of hypercapnia is anathema to him. Ratel (talk) 22:48, 2 March 2018 (UTC)
Ratel. Yes, but Humphry's opinions are not balanced by any indication that they may not be based on reality. They may be misleading to the reader. When there is reliable evidence available that an opinion reported in Wikipedia may be misleading and counterfactual, we should indicate this to be the case. The article about Humphry is an appropriate place to report his unsupported opinions, the article on suicide bags should be based on facts about suicide bags, not opinions of advocates and opponents, which should take a secondary place. However Humphry's opinion on this matter is of little importance in the article as the mention is in a history section and clearly stated as an opinion.
The real issue is Nitsche's suggestion that there are adverse physiological reactions to breathing helium at atmospheric pressure which is completely unsupported by any reliable source that I have been able to find, and flatly contradicted by both review sources and primary and secondary sources. · · · Peter (Southwood) (talk): 07:03, 3 March 2018 (UTC)
Not wishing to speak for Nitschke, but apart from the helium tremors (which you can dismiss as only occurring under pressure), there is PMID 19500647 that shows helium "had a detrimental effect on the cells". Ratel (talk) 22:53, 3 March 2018 (UTC)
Ratel,If you are referring to "Neuroprotection (and lack of neuroprotection) afforded by a series of noble gases in an in vitro model of neuronal injury". Neurosci Lett. 460 (3): 232–6. 4 September 2009. {{cite journal}}: Unknown parameter |authors= ignored (help), there is nothing in the abstract that suggests it is relevant in this case. As I do not have access to the article (It is paywalled) I must ask if you have read the relevant content and can say with any confidence that it is relevant. If you could send me a copy of the page/s where this can be shown, I will be happy to advise, or if it remains unclear, get an expert opinion. Knowledge of exactly what the article claims would allow confirmation or effective rebuttal. I also point out that this appears to be a primary source, referring to in vitro modelling (speculative) and may not pass WP:MEDRS. Cheers, · · · Peter (Southwood) (talk): 13:12, 5 March 2018 (UTC)
Getting back to your original statement that the air in balloon gas will cause a hypercapnic response and that this is anathema to Humphry:
He does not directly claim it. He implies it, saying the mixture of gases is no good for purpose. If you can find a source that says otherwise, I'd happily see it included. I suspect you'll struggle. Ratel (talk) 08:19, 3 March 2018 (UTC)
That is exactly my point. He does not state it. You interpret what he says as implying it, so it is for you to show that that is what he meant. I read what he says and as my experience suggests that similar mixtures of gases have killed several divers and nearly killed several others, who reported no hypercapnic distress, I give him the benefit of the doubt and assume that he may not be making claims that are not supported by any literature or experimental work that I am aware of, and this is a field I try to follow quite closely. Of course it is possible that you are right and he does not know what he is talking about, but I don't think you can prove that any more than I can't prove it. I did not add the statement claiming hypercapnic response, so have no need to try to disprove it. We can objectively claim that balloon gas may be diluted with air, that the resulting mixture as specified, will not support life, and that Humphry, for reasons he has not made clear, considers the gas not suitable for the purpose of suicide by inert gas asphyxiation. Cheers, · · · Peter (Southwood) (talk): 13:39, 3 March 2018 (UTC)
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