[Discussion] Timed-IV Euthanasia Micro Device

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Quarky00

Quarky00

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Dec 17, 2019
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I view ctb as euthanasia rather than suicide. I feel that not only the discomfort should be minimized, but it should also be pleasant. People in pain, not just 'terminally ill', should leave with a smile.

I'd love to have a small device with IV that can administer, automatically, the right amounts at the right time. I think it's best with morphine , first allowing 1 hour of mild euphoria, then introducing sleep that would feel very natural (loss of consciousness), and then death (CNS/respiratory arrest). That way a patient can go to their favourite location, which can really be anywhere, and end their life with a smile, with a friend/family or alone, without much hassle or medical staff. One can even have an emotional support companion/pet. Device can signal medical staff when patient dies, to collect body.

Other "recipes" could include ketamine-benzo-barb, to induce mild euphoria and tranquility, gradual sleepiness, and death, accordingly. Everything needs to be tested and adjusted per patient beforehand, but that should be a short procedure. The device can be very tiny and inserted by a nurse prior to the process, operated with a press of a button. (careful not to accidentally press it)

When self administered medical assisted dying would be expanded , that would be better than Seconal/Numbutal (5 minutes and bye)
 
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Busdriver

Busdriver

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Feb 11, 2020
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I would love this. Hopefully a megathread can be opened about this method soon.

It seems easier than to create and produce a big SARCO device.

I like how the SN expert talks about Nembutal/Seconal:smiling:
 
A

Aap

Wise
Apr 26, 2020
216
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There is a picture of such a device (Small, spring loaded) in the newest PPH handbook. I don’t recall the name, but it was pictured with the discussion of thiopental (thiopentone as it is called in the book - towards the end in the big barbiturate chapter). Your post starts as personal and ends as general; apologies if I am misinterpreting a generic wish for a personal goal.

An autoinjector is pretty easy to design, especially if you use gravity and a bag of saline as the propulsive force.
 
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meerpasta

Member
Jan 29, 2020
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Great idea, this could be feasible as a DIY solution perhaps? One fear of mine with overdosing on opiates is not getting enough into the system and waking up with brain damage instead, a device that constantly injects more should prevent that. if this could be assembled from easily purchased or homemade parts then opiates could be ordered from the darknet and that'd be it.
 
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Quarky00

Quarky00

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Dec 17, 2019
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1. Opioids
One fear of mine with overdosing on opiates is not getting enough into the system and waking up with brain damage instead, a device that constantly injects more should prevent that.
That is true. I did not think of that, though I knew, and this also solve many opioid-ctb problems like vomiting or plugging. See SC instead IV in parts (3) & (4) :) Just to recap, from PPH:
The biggest problem associated with taking opioids is predicting the effects of particular dose. There is a remarkable individual variability in sensitivity to these drugs within the normal population. People who are similar physically (same height, weight, sex, etc) can have a vastly different response to the administration of the same dose of a drug.
A small opioid dose may have almost no effect on one person, while the same dose could kill another person.
Prediction the effect of the drug on an individual is difficult. When these drugs are used cilinically, where accidental death would be disastrous, the rule of thumb has been to 'start low and go slow' untill the individual's sensitivity to the drug is established .


2. PPH Device
There is a picture of such a device (Small, spring loaded) in the newest PPH handbook. I don’t recall the name, but it was pictured with the discussion of thiopental
Nice one, thanks. PPH says:
An Exit contributor's personal solution:
A spring powered assembly inspired by the original Deliverance machine.
An IV catheter needs to be correctly placed. Opening the line tap, bottom left, allows for the self administration of a lethal dose of thiopental.
The Deliverance Machine was a laptop computer and program that gave these individuals the ultimate control over their deaths . . .
After pressing the button for a third time , The Machine would deliver a lethal dose of the barbiturate, Nembutal.

Your post starts as personal and ends as general; apologies if I am misinterpreting a generic wish for a personal goal.
An autoinjector is pretty easy to design, especially if you use gravity and a bag of saline as the propulsive force.
It is indeed personal and general. I was thinking of the ideal ctb, and it was mostly brainstorming and fantasizing. A saline bag is good solution but I would like to keep it minimal in size and setup.

The 'solution' in PPH is "Springfusor". It's a low cost, non-sterile, reusable pump that requires no programming or external power source. People can Google it and here's a video of it. There are two problems: it's not readily available to purchase (say in big sites) and one needs to buy different tubes (CFT) for different flow. It is pretty cool though. If it is intended to use with barbiturate it needs to by IV, so person need to practice on insert it into the vain, which may be painful and distressing.

I wasn't thinking of this solution in practical terms, but ....



3. Ideal Solution


Like an Insulin Pumps. So neat.
pump_mg_0.jpg






So this is also an easy SC solution (no need for IV):
Morphine is typically given by intramuscular or intravenous injection but there are theoretical advantages for the subcutaneous route of administration. Fifty-nine patients entered a prospective randomized double-blind cross-over study comparing intermittent intramuscular and subcutaneous morphine boluses. Patients received 0.15 mg/kg of morphine by subcutaneous or intramuscular injection. They were reviewed at the time of injection, after 15 minutes and each hour for four hours. The majority of patients indicated a strong preference for the subcutaneous route. There were no significant differences in pain scores, respiratory rate, arterial oxygen saturation, heart rate, mean arterial pressure, sedation or nausea scores between intramuscular and subcutaneous administration of morphine. Postoperative analgesia by subcutaneous morphine bolus injection is as effective as intramuscular injection with a similar side-effect profile but with greater patient acceptance and less risk.
Those cost around $3000 :) It's a great future solution -- or real option now if you have money. This needs to be tested and researched further but an insulin pump should be readily available , and from that point it's buying morphine (not easy but possible) . Easier, nicer and cheaper than Dignitas .

(Opioid patches deliver over time (24h) and one need to stick themselves all over with these patches)



4. Practical Solution?


There are really good simple auto-injectors , especially for a single predetermined dosage of a medication, pretty common with Insulin or Epinephrine. That can be useful but tricky with morphine -- due to dosage variability. The good ones are also costly. EpiPen costs $300 to $630. But that is Epinephrine . An Insulin pen from china can cost 15$ or 30$. The needle is pretty tiny and it is not like IV. Still requires some handling or practice -- inserting at an angle to a fatty tissue etc. Insulin pens have dosage selection.



If the flow rate is flexible and controlled, patients could basically "start low and go slow" (as medical practice) and when they feel "they've had
enough" -- then "pump up the volume" .. and "go to sleep".

I would like to have a real auto injector that is cheap and available . That you don't have to mess around with inserting it or anything . This is used by army -- atropine. I don't think they sell atropine out there on the market ;) This is really really hassle free .



As for the "needle issues" , one can buy lidocaine cream (OTC). But it's really a tiny needle and less than 2 seconds.

The big problem here is morphine . Some think opioids are basically available (street, darknet) but it's not that easy for members, compared to ordering from big sites -- or even TCAs OD from online pharmacies (ami)


I'm not suggesting to buy needles or inject anything !
 
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Aap

Wise
Apr 26, 2020
216
202
The epipen is nothing more than a syringe, and insulin injectors are nothing more than a syringe with a dial a yield. The sq pump could work with certain compounds, namely high potency opioids such as hydromorphone or better. The biggest issue one would have is volume of fluid needed and med selection. For example, barbiturates are quite cytotoxic given the concentration required and can’t lend themselves to sq or im.

Given how slowly items work when given sq or im, I can’t imagine a situation where you couldn’t just self administer whatever dosage you wanted. Said another way, if you wanted to use 70mg of dilaudid IM or SQ, it wouldn’t make sense to not administer it all at once. (Incidentally, Oklahoma has or had method on the books for using IM hydromorphone as a single injection for execution if a suitable line can’t be placed iv. )

The only need for a controlled infusion is IV, and methods as simple as an IV bag or spring/gravity/piston loaded mechanisms already exist.
 
Quarky00

Quarky00

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Dec 17, 2019
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The epipen is nothing more than a syringe, and insulin injectors are nothing more than a syringe with a dial a yield. The sq pump could work with certain compounds, namely high potency opioids such as hydromorphone or better. The biggest issue one would have is volume of fluid needed and med selection. For example, barbiturates are quite cytotoxic given the concentration required and can’t lend themselves to sq or im.
The entire point of my original post was a simple device with no hassle. You don't inject -- you click a button. There is not reason to build auto-injector if it's cheap. Barbs are IV only. SC for morphine, benzo, and ketamine.

I don't understand the rest.. Really thinking about small device (nice 1h then sleep) not a setup .. Seriously it's in the title :wink:
 
A

Aap

Wise
Apr 26, 2020
216
202
Apologies, I guess I’m not following. The items you show under 4. Practical solutions are IM or SQ syringes that are spring loaded where a button is pressed (in other words a very short plunger) rather than pressing a traditional plunger, Nothing more.There isn’t a scenario where you wouldn’t have ample time to self administer a fatal dose this way using a traditional syringe, not to mention they can only be used when solidly held.

If you want to have fun with opiates, especially for opiate naive, using prior to an extremely stressful event isn’t the way. Premedication prior to surgery is an example. Most people do not find it anything remotely close to the best time of their lives. The same would happen with a very slow sq or Im injection of a fatal dose vs a fast one. You’d spend the first 20 minutes wondering why it isn’t working and panicking Vs simply going to sleep in 5-10m.
 
Quarky00

Quarky00

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Dec 17, 2019
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@Aap , the entire point of this thread is not "quick" ctb but a different orderly euthanasia .

You seem to insist about a medical setting or a traditional injecting . The entire point is against that . People don't like hospitals/syringes . People don't want to die in a strange place . People want to die with a smile . This is a preplanned Dignitas-like flexible procedure :)

The title is "timed device" so why panic? Title says "micro" so why IV bags? You write everything against subject lol... If you don't follow then move on :heart: I have explained
 
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Aap

Wise
Apr 26, 2020
216
202
Ok will do. My posts have nothing to do with hospitals. Rather that extreme anxiety in opiate naive individuals, as well as the fact that an accommodating dose seems to be needed in some opiate naive individuals, can be be the primary emotion felt upon first administration, not euphoria.
 
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meerpasta

Member
Jan 29, 2020
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34
$3000 is pretty expensive, I was hoping for some easier and cheaper home made solution like having a liquid container slowly empty into your system until depleted without advanced electronics. Piercing myself with a needle is no problem I've had self administered injections before.
 
Quarky00

Quarky00

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Dec 17, 2019
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Ok will do. My posts have nothing to do with hospitals. Rather that extreme anxiety in opiate naive individuals, as well as the fact that an accommodating dose seems to be needed in some opiate naive individuals, can be be the primary emotion felt upon first administration, not euphoria.
STOP IT.

Morphine does not cause "severe anxiety" . You're polluting thread . Pre surgery wtf . I specifically said I'm reflecting against "5 minutes" yet you insist . FFS , annoying to have a nice thread about theoretical ctb ruined by useless back and forth with wrong information .

People go to Dignitas and they die peacefully -- not anxious . So ctb does not have to include severe anxiety . That's what I'm talking about . Euthanasia . I am reflecting against 'quick is peaceful' , and I think some people in the Dignitas-like path are not into wham-bam-bye . I dislike pre conceived notions about what ctb should be ... I want my last hour to be nice -- not fasting or preparing chemicals. I am thinking about something different.

I'm talking about relaxed-setting , pre-planned , gradual process of euthanasia ("Dignitas-at-home") with a small automated hassle free device .
 
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original80

New Member
May 23, 2020
2
1
I think OP suggestion is indeed a very good one. Morphine does not cause anxiety, sometimes nausea and definitely itching. So usually given with small dose of antihistamine for those who itch.
Morphine - Morphea - the goddess of dreams.
I have never disliked a pre-med proir to an operation. Midozolam usually. Thus, one could fill the autoinjector with whatever one wanted. Slowly a mix of morphine, promethazine, diazepam, lorazepam sounds ideal - maybe some fentanyl to get things perfect. They would all have to be in IV preparation, and they are indeed have an IV prep as luck so has it. Great idea!
 
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Quarky00

Quarky00

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Dec 17, 2019
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Thus, one could fill the autoinjector with whatever one wanted. Slowly a mix of morphine, promethazine, diazepam, lorazepam sounds ideal - maybe some fentanyl to get things perfect. They would all have to be in IV preparation, and they are indeed have an IV prep as luck so has it.
The problem with opioids is the effective dosage is unkown.. So if it's legal euthanasia a ctber would have to adjust first dose with a nurse prior to ctb to determine their 'basic level' of mild sedation (not sedated) . If it's by themselves that could be a problem (e.g. testing morphine dosages at home) .

But if there was such a mix/solution in a device that a ctber could easily adjust & time -- that would be great . One would not need to worry about first dose and effectiveness . With IV it's pretty instant and then just up the dosage slowly until you feel relaxed . When level reached set timer to 1 hour , and device will then deliver bigger final dose . That's what I was wishing for .

Another big problem is inserting the needle . Need a nurse for that . If it's not legal process one would have to practice at home which is inconvenience and deterring . Many opioids users (and others) dismiss that but I'm sorry it's not that easy . Paramedics take time to learn and even phlebotomists miss sometimes . Subcutaneous could replace that , it's also a smaller needle , more convenient , hurts less . But onset and peak time are longer -- 20 minutes and 60 minutes .

So problems are (1) Primary dose , (2) Administration (vein? SC?) .



$3000 is pretty expensive, I was hoping for some easier and cheaper home made solution like having a liquid container slowly empty into your system until depleted without advanced electronics. Piercing myself with a needle is no problem I've had self administered injections before.
$3000 cheaper compared to Dignitas . $15 also mentioned . Pump just idea prototype . So be mindful of context ;) Yeah it's expensive .

Something simple without electronics was mentioned -- "Springfusor" (pros and cons detailed). (1) Is such product available in 'big sites' ? (2) Can one find vein and insert ? (3) How to adjust rate (which FCT) ?



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I did not think this is realistic, honestly was just fantasy . If a 1 hour delay is not desired but one wishes 'instant death' then a different ctb method would be better , or set the device timer to 0 seconds (and it would be instant) . But the main idea is to drift away very slowly . Like CO -- only better .
 
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