Freethought & Rationalism Archive

crocodile deathroll · 07-12-2002, 11:32 PM

You have to undergo a major life saving operation, which involves the drilling and cutting into bones and muscles, but you are warned by your physician that an anesthetic would be bit risky and possibly may even kill you. Would you consent to a go ahead without the anesthetic on the basis that when it is all over, the pain of it would only be a memory? Or would you risk the anesthetic?
However, there happens to be a drug <a href="http://www.infomed.org/100drugs/midatoc.html" target="_blank"> midazolam</a> which erases your short term memory with no side effects. So if a patient had woken up during an operation experiencing excruciating pain, he/she would be just given this drug and the short term memory will be totally erased and when the patient wakes up again after the surgery then he will be totally oblivious any memories of that excruciatingly painful experience.
So the physician offers you this risk free alterative to the anesthetic, and he just keeps drip feeding you that drug at ten minute intervals, the theory goes that when you wake up, because none of those painful short term memories were processed into long term memories you will be blissfully unaware that those painful experiences had ever happened. Would you consent to the use of midazolam rather than risk the anesthetic?

seebs · 07-12-2002, 11:52 PM

I have no idea. I would be concerned about the risk to me of shock from the pain, of course.

Apart from that... I'm not even sure I'm comfortable with the loss of memory, because I value the coherence of my mind. I'm also not real fond of pain.

How about I punt and say I hope I never have to make this decision?

excreationist · 07-12-2002, 11:57 PM

...However, there happens to be a drug <a href="http://www.infomed.org/100drugs/midatoc.html" target="_blank">midazolam</a> which erases your short term memory with no side effects. So if a patient had woken up during an operation experiencing excruciating pain, he/she would be just given this drug and the short term memory will be totally erased and when the patient wakes up again after the surgery then he will be totally oblivious any memories of that excruciatingly painful experience.
I think it makes you unable to form new long-term memories while you have that "anterograde amnesia". That drug might come in handy if you were a con artist, etc.

So the physician offers you this risk free alterative to the anesthetic, and he just keeps drip feeding you that drug at ten minute intervals, the theory goes that when you wake up, because none of those painful short term memories were processed into long term memories you will be blissfully unaware that those painful experiences had ever happened. Would you consent to the use of midazolam rather than risk the anesthetic?
Well I guess it is more important to guarantee that I survive the operation. I would have to be tied down and gagged though to stop me from trying to escape the operation. Then later I would be oblivious to what happened. On the other hand I'm not that worried about dying and I'd want to make all of my life as peaceful as I can.

Laurentius · 07-13-2002, 11:54 AM

AVE

Would you consent to the use of midazolam rather than risk the anesthetic?

This is the type of question you can only give the answer that defines you when you have to face the real situation. Hypothetical questions sin in that they make people use too much of their reason on the one hand and social ego on the other.

AVE

crocodile deathroll · 07-13-2002, 05:11 PM

This also reminds me of the argument of circumcising babies without an anesthetic. If the baby is not going to remember it when they grow up later in life then it could be argued that the procedure may as well of never happened. Medical ethics committees around the world had banned the practice in many parts of the world.

Midazolam may well work in theory but I think there would be an uphill battle trying to persuade medical ethics committees to agree for it to be use as a substitute to a general anesthetic.

If I had the choice however I would personally risk midazolam, as I would want to be sure I will wake up after the operation, but if I was given the choice of an anesthetic or nothing, then I would balk and opt for the anesthetic, because I feel enduing excruciating pain far beyond my tolerance threshold is not what life is all about as far as I am concerned.

tronvillain · 07-13-2002, 05:41 PM

One problem is that infants circumsized without anaesthetic remain sensitized to pain for quite a long time after the procedure. Anyway, it would all depend on the specific risks of the anaesthetic, the risks and effects of experiencing intense pain, and the effects of remembering intense pain.

Anyway, I would probably opt to forgoe both anaesthetic and midizolam. Of course, that assumes that the anaesthetic is more likely to kill or damage me than the pain. As for the midizolam - either way, I will have to experience the pain, so I might as well have the memory since I don't think the effects of remembering intense pain are necessarily all that bad.

Oh, and excreationist? You wouldn't be tied down and gagged, you'd just be paralyzed. As far as I know, a paralytic agent is normally used along with a more conventional anaesthetic.

punta · 07-13-2002, 05:44 PM

Extreme physical pain is something that can't be re-experienced by memory; at least not to the same degree. No one has ever died from shock at remembering pain.

I would take the anesthetic if possible. If there was no anesthetic I would forego the amnesia inducing drugs. It's good to look back at pain and appreciate that you got through that. Helps you appreciate the state you're in.

interesting question.

braces_for_impact · 07-13-2002, 05:47 PM

I'm having a bit of a problem understanding the question myself. I don't see any reason to forget the pain once the procedure is over. It's done, you've made it through and bore the excrutiating pain. What's the point of erasing memories at this time? I would opt for no aenesthetic and no drug. I was in oral surgery once, the medication wore off halfway through the procedure, and applying more didn't help. Now granted, this wasn't drilling into bone here, but it did involve cutting open my gums, removing the connective tissue between teeth and gum by scraping it out (except the root of course) and stitching them back up. As the medication wore off, it took everything I had to stay in the chair and try to hold still. I remember ripping the armrests of the chair open with my hands and stuffing from the chair all over the floor. If someone would have offered me a drug to forget the pain at that point, I still wouldn't have seen the purpose. I also see a way to abuse such a drug, to cover up medical malpractice, etc. But I am just so pessimistic.

punta · 07-13-2002, 05:49 PM

...and the effects of remembering intense pain.
what are the supposed effects of remembering intense pain?

crocodile deathroll · 07-14-2002, 03:15 PM

Quote:

Originally posted by punta:
<strong>Extreme physical pain is something that can't be re-experienced by memory; at least not to the same degree. No one has ever died from shock at remembering pain.

I would take the anesthetic if possible. If there was no anesthetic I would forego the amnesia inducing drugs. It's good to look back at pain and appreciate that you got through that. Helps you appreciate the state you're in.

interesting question.</strong>

Then again there is also the problem with flash backs and Post Traumanic Stress Disorder after the horrific experience

07-12-2002, 11:32 PM	#1
crocodile deathroll Veteran Member Join Date: Dec 2001 Location: Darwin Posts: 1,466	Fear of Death and Pain You have to undergo a major life saving operation, which involves the drilling and cutting into bones and muscles, but you are warned by your physician that an anesthetic would be bit risky and possibly may even kill you. Would you consent to a go ahead without the anesthetic on the basis that when it is all over, the pain of it would only be a memory? Or would you risk the anesthetic? However, there happens to be a drug <a href="http://www.infomed.org/100drugs/midatoc.html" target="_blank"> midazolam</a> which erases your short term memory with no side effects. So if a patient had woken up during an operation experiencing excruciating pain, he/she would be just given this drug and the short term memory will be totally erased and when the patient wakes up again after the surgery then he will be totally oblivious any memories of that excruciatingly painful experience. So the physician offers you this risk free alterative to the anesthetic, and he just keeps drip feeding you that drug at ten minute intervals, the theory goes that when you wake up, because none of those painful short term memories were processed into long term memories you will be blissfully unaware that those painful experiences had ever happened. Would you consent to the use of midazolam rather than risk the anesthetic?

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07-12-2002, 11:52 PM	#2
seebs Contributor Join Date: May 2002 Location: Saint Paul, MN Posts: 24,524	I have no idea. I would be concerned about the risk to me of shock from the pain, of course. Apart from that... I'm not even sure I'm comfortable with the loss of memory, because I value the coherence of my mind. I'm also not real fond of pain. How about I punt and say I hope I never have to make this decision?

07-12-2002, 11:57 PM	#3
excreationist Veteran Member Join Date: Aug 2000 Location: Australia Posts: 4,886	...However, there happens to be a drug <a href="http://www.infomed.org/100drugs/midatoc.html" target="_blank">midazolam</a> which erases your short term memory with no side effects. So if a patient had woken up during an operation experiencing excruciating pain, he/she would be just given this drug and the short term memory will be totally erased and when the patient wakes up again after the surgery then he will be totally oblivious any memories of that excruciatingly painful experience. I think it makes you unable to form new long-term memories while you have that "anterograde amnesia". That drug might come in handy if you were a con artist, etc. So the physician offers you this risk free alterative to the anesthetic, and he just keeps drip feeding you that drug at ten minute intervals, the theory goes that when you wake up, because none of those painful short term memories were processed into long term memories you will be blissfully unaware that those painful experiences had ever happened. Would you consent to the use of midazolam rather than risk the anesthetic? Well I guess it is more important to guarantee that I survive the operation. I would have to be tied down and gagged though to stop me from trying to escape the operation. Then later I would be oblivious to what happened. On the other hand I'm not that worried about dying and I'd want to make all of my life as peaceful as I can.

07-13-2002, 11:54 AM	#4
Laurentius Veteran Member Join Date: Dec 2001 Location: Lucky Bucky, Oz Posts: 5,645	AVE Would you consent to the use of midazolam rather than risk the anesthetic? This is the type of question you can only give the answer that defines you when you have to face the real situation. Hypothetical questions sin in that they make people use too much of their reason on the one hand and social ego on the other. AVE

07-13-2002, 05:11 PM	#5
crocodile deathroll Veteran Member Join Date: Dec 2001 Location: Darwin Posts: 1,466	This also reminds me of the argument of circumcising babies without an anesthetic. If the baby is not going to remember it when they grow up later in life then it could be argued that the procedure may as well of never happened. Medical ethics committees around the world had banned the practice in many parts of the world. Midazolam may well work in theory but I think there would be an uphill battle trying to persuade medical ethics committees to agree for it to be use as a substitute to a general anesthetic. If I had the choice however I would personally risk midazolam, as I would want to be sure I will wake up after the operation, but if I was given the choice of an anesthetic or nothing, then I would balk and opt for the anesthetic, because I feel enduing excruciating pain far beyond my tolerance threshold is not what life is all about as far as I am concerned.

07-13-2002, 05:41 PM	#6
tronvillain Veteran Member Join Date: Oct 2000 Location: Alberta, Canada Posts: 5,658	One problem is that infants circumsized without anaesthetic remain sensitized to pain for quite a long time after the procedure. Anyway, it would all depend on the specific risks of the anaesthetic, the risks and effects of experiencing intense pain, and the effects of remembering intense pain. Anyway, I would probably opt to forgoe both anaesthetic and midizolam. Of course, that assumes that the anaesthetic is more likely to kill or damage me than the pain. As for the midizolam - either way, I will have to experience the pain, so I might as well have the memory since I don't think the effects of remembering intense pain are necessarily all that bad. Oh, and excreationist? You wouldn't be tied down and gagged, you'd just be paralyzed. As far as I know, a paralytic agent is normally used along with a more conventional anaesthetic.

07-13-2002, 05:44 PM	#7
punta Regular Member Join Date: Mar 2002 Location: Can-a-duh! Posts: 148	Extreme physical pain is something that can't be re-experienced by memory; at least not to the same degree. No one has ever died from shock at remembering pain. I would take the anesthetic if possible. If there was no anesthetic I would forego the amnesia inducing drugs. It's good to look back at pain and appreciate that you got through that. Helps you appreciate the state you're in. interesting question.

07-13-2002, 05:47 PM	#8
braces_for_impact Veteran Member Join Date: Apr 2002 Location: In a nondescript, black helicopter. Posts: 6,637	I'm having a bit of a problem understanding the question myself. I don't see any reason to forget the pain once the procedure is over. It's done, you've made it through and bore the excrutiating pain. What's the point of erasing memories at this time? I would opt for no aenesthetic and no drug. I was in oral surgery once, the medication wore off halfway through the procedure, and applying more didn't help. Now granted, this wasn't drilling into bone here, but it did involve cutting open my gums, removing the connective tissue between teeth and gum by scraping it out (except the root of course) and stitching them back up. As the medication wore off, it took everything I had to stay in the chair and try to hold still. I remember ripping the armrests of the chair open with my hands and stuffing from the chair all over the floor. If someone would have offered me a drug to forget the pain at that point, I still wouldn't have seen the purpose. I also see a way to abuse such a drug, to cover up medical malpractice, etc. But I am just so pessimistic.

07-13-2002, 05:49 PM	#9
punta Regular Member Join Date: Mar 2002 Location: Can-a-duh! Posts: 148	...and the effects of remembering intense pain. what are the supposed effects of remembering intense pain?

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