Talk:Suicide bag/Archive 4

Prioritizing issues discussed for an RfC
I think it's pretty clear that it's unlikely the 4 of us will reach much consensus without more input, so I'm planning to make an RFC. Before I do that, I'm hoping we can at least come to some consensus about prioritizing one or two issues to tackle first before moving on to debating the next thing as opposed to having ~6 simultaneous conversations that never reach a conclusion. These are the policy issues that have led to disagreements over content recently:
 * Main image
 * Neutrality
 * MedRS
 * Primary sources
 * Case reports
 * Fringe
 * Spam

Am I leaving anything out? I don't know if it makes the most sense to pick 1-2 policies at a time and go through each place in the article where issues arise in regard to that policy or if it makes more sense to look at each disputed line/paragraph separately. My inclination would be to organize the discussion around the policy issues, but I'm genuinely asking for opinions, because I'm not sure if that's the best way to conceptualize it or if there's a better option that I didn't mention. Either way, my vote is for tabling discussion on the image until we get some of the other content issues out of the way since the image has previously been discussed in more depth than the other issues and also because I think that conversation could go on indefinitely without consensus and we'd never get to talk about the rest of the article. PermStrump (talk) 02:11, 10 May 2016 (UTC)


 * Careful here, this is bigger than those purely technical issues. You, CFCF and Ozzie10aaa are essentially trying to remove the bulk of an article that (a) has been here for several years and has been scrutinized by thousands of eyes, and (b) more importantly, intimately concerns end-of-life choices for all people. With an ageing global demographic, this topic (and its related articles) is becoming more and more important, and is finding more and more acceptance, as recent legislative changes around the world show.


 * As an aside, I wonder what motivates editors who want to slash and burn this and other similar articles, because it is rarely the desire to see a good encyclopedia. My experience with them is that they are motivated by a misplaced sense of outrage over the availability of information about a quick, easy, painless death on WP (despite the fact that the same information is all over the net and in several books), or that they are actually religiously motivated, or both. And there seems to be an unconscious bias among many in the medical fraternity that controlling access to a means of suicide is a self-evident good, as typified by this study. This attitude is, methinks, popping up here again as well.


 * In the end, this is an article about a bag, a plastic bag, an item of $0.05 worth, that can be used to end life very quickly and peacefully if combined with the right gas. We have many case histories testifying to that, although since case histories are not part of a secondary study, you wish to exclude them. So I think the problem here is not so much npov, fringe or spam, but MEDRS and exactly how far it extends into articles that are not really medical in nature, articles that are about empowerment, end of life choices, the history of such, and so on. I'd like to see that decided, above all else. Ratel (talk) 03:09, 10 May 2016 (UTC)
 * Conflicts between advice pages says:
 * It shouldn't be that hard to determine which one should suffice.--Lo te xendo (talk) 03:19, 10 May 2016 (UTC)
 * There are plenty of independent, peer-reviewed sources on this topic. We're no where near the point of scrapping MEDRS and going with whatever we've got now. Here the one I have on hand: It's both a review article and a few new case reports from the authors. Until we come to consensus about including case studies, the review part of the article is a strong source. I'm compiling a list of sources that I'll start a page for at Talk:Suicide bag/Source dump. The list will include the current sources and other peer-reviewed sources that aren't cited yet. IMHO we should avoid adding more non-peer-reviewed sources until we have a better sense of the full scope of the peer-reviewed articles available. Other people should feel free to add sources as they come across them. FYI I'll be basing "peer-reviewed" status off of Ulrich's Periodicals Directory because I have access to it through work and I don't know how else to reliably check if something is peer-reviewed in a way doesn't require a subscription. PermStrump (talk) 04:37, 10 May 2016 (UTC)
 * Not much to see yet, but FYI: Talk:Suicide bag/Source dump. PermStrump (talk) 05:52, 10 May 2016 (UTC)


 * So, you are of of arguments for this "enemy take over" and you are now planning to bring in the friends to legalize it by using an RFC? But in your long list of policies, you have missed an important one: Ownership of content as that is what you do. The Banner talk 08:29, 10 May 2016 (UTC)

It is significant the Medical Project rates the importance of this article as "low" (see above). That is inevitable, since the global medical industry with its huge multi-trillion dollar annual payoff to loyal adherents is predicated on its perceived attempts to "cheat death". But in parallel to this splendid endeavour are huge and separate ethical issues. These are to do with whether actual real people, in extreme and impossible positions at the end of their lives, have the right to control their termination with a measure of dignity and without unnecessary further distress. Yes, the issue is complicated by other considerations, particularly with younger people who may have other options. These things are not simple. It is also understandable that some young or religiously indoctrinated members of the medical fraternity should regard these matters as of small significance. Eventually the young ones will age themselves and may become a little more humble, while the religious ones will tumble unredeemed into the abyss. The medical fraternity should not be allowed to carelessly control issues to do with end of life in this manner on Wikipedia. --Epipelagic (talk) 10:22, 10 May 2016 (UTC)
 * There may be "huge issues" attached to the topic but from our perspective as humble editors of an encyclopedia the issues are rather more narrowly-defined. We need to construct an article in line with the WP:PAGs and that means that WP:Biomedical information needs to be sourced to WP:MEDRS and that the article as a whole needs to be reflect accepted knowledge as published in the best sources. So, not suicide advocacy sites and crappy self-published books. That this is a emotive topic does not means the rules go out the window. Talk of the "medical fraternity" and "loyal adherents" is not helpful here - this is not a forum for general discussion. Alexbrn (talk) 10:52, 10 May 2016 (UTC); amended 12:16, 10 May 2016 (UTC)


 * So are you saying ethical issues have no place on Wikipedia and sourcing to WP:MEDRS alone is acceptable to this article? --Epipelagic (talk) 11:06, 10 May 2016 (UTC)
 * No. Alexbrn (talk) 11:09, 10 May 2016 (UTC)
 * Then it would good if you can explain what you are saying. For obvious reasons, it is clearly of utmost importance that purely medical issues are sourced in the most rigorous manner possible, and I fully support WP:MEDRS in that context. However, I do not support aggressive and damaging attacks made using WP:MEDRS in areas outside the scope of purely human medical matters. --Epipelagic (talk) 11:24, 10 May 2016 (UTC)
 * I put WP:Biomedical information needs to be sourced to WP:MEDRS, not "WP:MEDRS alone is acceptable to this article?". It could hardly be clearer. Alexbrn (talk) 11:29, 10 May 2016 (UTC)
 * Okay, since you want to split hairs, where I said "purely human medical matters" substitute WP:Biomedical information. That doesn't change anything. Now can you explain what you mean? --Epipelagic (talk) 11:37, 10 May 2016 (UTC)
 * No better than I have done. I'm glad you agree that biomedical content needs WP:MEDRS-compliant sourcing. Alexbrn (talk) 11:43, 10 May 2016 (UTC)
 * Well of course I'm glad that you are glad, but you haven't explained your position with regard to the ethics at all. --Epipelagic (talk) 12:12, 10 May 2016 (UTC)
 * I put the article as a whole needs to reflect accepted knowledge as published in the best sources. That applies to ethical aspects. But I'm not saying anything novel; we should simply be adhering to the WP:PAGs. Alexbrn (talk) 12:14, 10 May 2016 (UTC)
 * Yes, let's adhere to WP:PAG. But you cannot apply the restrictive WP:MEDRS to the ethics of the right to control your own death with some dignity. It is not designed for that. That is not something that medical scientists can resolve in a laboratory. --Epipelagic (talk) 12:32, 10 May 2016 (UTC)
 * Good job I never said MEDRS applies to "the ethics of the right to control your own death" then. Alexbrn (talk) 12:41, 10 May 2016 (UTC)
 * Epipelagic, I think I can help you with Alex's earlier comment. He said that "WP:Biomedical information needs to be sourced to WP:MEDRS".  He also meant "non-Biomedical information does not need to be sourced to MEDRS".  You two might disagree over exactly where to draw the line between "biomedical" and "non-biomedical" information, but Alex does not have a history of saying that absolutely everything in the world is biomedical information.  WhatamIdoing (talk) 19:16, 10 May 2016 (UTC)

The issues span several different areas. These include e.g., legal, ethical, situational, religious, moral, historical, philosophical and medical. It is a question of finding WP:RS that are appropriate for individual assertions. Nonetheless, this should not be characterized s solely a medical issue. The article should be enlarged in its scope, not contracted. 7&amp;6=thirteen () 11:54, 10 May 2016 (UTC)
 * The topic area of suicide in general has a wide range of aspects, sure. But a "suicide bag" is a niche sub-topic. We shouldn't need to import the whole context of suicide here, but focus on the item itself (with sourcing specific to it). I'd expect that to give us quite a compact article. Alexbrn (talk) 11:59, 10 May 2016 (UTC)
 * Yes, there are other articles, and they should be mentioned and linked. However, wWe will have to agree to disagree.  Relevancy is far broader than you posit. Bowdlerized and expurgated articles without context are no service to the encyclopedia and our readers.  7&amp;6=thirteen (☎) 12:03, 10 May 2016 (UTC)
 * Sure, other articles may be mentioned/linked-to but it's simply wrong to say that a suicide bag has all these aspects you mention - e.g. "religious" ... unless there's some religious text that prohibits suicide except by bag that I'm unaware of! Alexbrn (talk) 12:07, 10 May 2016 (UTC)
 * It's use entails that stuff. Yes, we need sources.  This is a moot (hypothetical) argument until we put in text and references.  <b style="color:#060">7&amp;6=thirteen</b> (<b style="color:#000">☎</b>) 12:45, 10 May 2016 (UTC)
 * I have difficulty imagining any religious issue that is relevant to a suicide bag and not equally and identically relevant to suicide by most other methods. Ethical issues are different:  even if you believe that suicide is perfectly ethical, it is absolutely unethical to use a suicide method that puts others in danger (e.g., any method that involves Search and Rescue personnel).  WhatamIdoing (talk) 19:16, 10 May 2016 (UTC)


 * For me, the crux of the issue seems to be: to what extent is the content of this article WP:Biomedical information? That's apparently not easy to decide. A close reading of WP:Biomedical information would suggest to me that most of it is outside the ambit of MEDRS. That's my reading. Can we nail this down please? Ratel (talk) 12:49, 10 May 2016 (UTC)
 * That's only one issue. In general the article has a problem with poorly-sourced and undue content of all kinds, not just medical. Alexbrn (talk) 12:58, 10 May 2016 (UTC)
 * This is indeed the crux of the issue. Why is it that some MEDRS editors, such as yourself, come to articles containing material outside the scope of MEDRS, and then misplace their energy by becoming aggressive with, as you put it, "content of all kinds, not just medical"? This provocative behaviour has been upsetting editors who edit outside medical issues in other parts of Wikipedia, contributing for example to the recent retirement of a profligate writer of animal articles. This unpleasantness could be avoided if the application of WP:MEDRS was confined to where it belongs, which is WP:Biomedical information. --Epipelagic (talk) 19:53, 10 May 2016 (UTC)
 * Badly sourced non-biomedical information would still be badly sourced, even though it's badly sourced according to plain old "RS" rather than according to "MEDRS". WhatamIdoing (talk) 20:35, 10 May 2016 (UTC)
 * Exactly. It is not a WP:MEDRS issue. --Epipelagic (talk) 20:46, 10 May 2016 (UTC)
 * Alexbrn, I keep seeing people cite undue this and undue that. Excuse me for a second, but; WHAT IS THE MAINSTREAM MAJORITY OPINION. If the content is giving undue credence to a specific group you should be able to show this. I've yet to see anyone actually state this. --Lo te xendo (talk) 17:37, 10 May 2016 (UTC)
 * Simple fact is there is no mainstream opinion on this topic, so the constant use of "undue" is hand waving. Ratel (talk) 00:25, 11 May 2016 (UTC)


 * The title refers to a device. It should be in scope to address the nature of that device and issues around its usage, while avoiding a how-to or a POV on the issues.  Sources should, as normal, be the best quality secondary sources that can be identified. They do not need to be free of their own POV, but it should be identified and balanced by other equivalent-quality sources from other POVs in proportion to their prevalence in such high-quality literature. Can we all agree that policy calls for these things? LeadSongDog  come howl!  13:51, 10 May 2016 (UTC)
 * agree w/ LeadSongDog--Ozzie10aaaa (talk) 18:10, 10 May 2016 (UTC)
 * Yes, and the "issues around its usage" need to be specific to the device, not a rehashing of wider issues suitable for the (wider) suicide article. Alexbrn (talk) 13:54, 10 May 2016 (UTC)
 * Is that adequately described by wp:COATRACK? LeadSongDog come howl!  17:56, 10 May 2016 (UTC)
 * Disagree. The title may refer to the device but the device has been promulgated by the groups already mentioned. It is the same as trying to remove Thomas Edison in the Incandescent light bulb article. FYI, WP:COATRACK is an essay not a policy or guideline. Also, refer to my post above about the parachute...--Lo te xendo (talk) 19:04, 10 May 2016 (UTC)

Mainstream majority opinion/Due and undue weight
I'm starting a new section as the one above is getting long and has branched in a few directions, but I thought asked a good question that is worth focusing on: "I keep seeing people cite undue this and undue that. WHAT IS THE MAINSTREAM MAJORITY OPINION."

(1) For people who don't have access to some of the journals cited in the article or on Talk:Suicide bag/Source dump, if you tell me the author/title and something specific to look for, I'll do my best to paste some quotes on the source dump page. I probably won't have time until late tonight or tomorrow though and I'm pretty sure none of the books were available online through the library.

(2) When I've read more, I'll make an update if I think there's a summary for what the mainstream majority opinion is, but for now I can tell you what it isn't...


 * Ogden, a masters-level sociologist and right-die advocate, has written 4 articles on this topic (if we continue to include suicides using masks) that are currently cited in the article, all case reports, that were published in peer-reviewed journals (the peer-review status of 2 articles is somewhat questionable, which I can elaborate on another time, so we'll assume peer-reviewed for now). All of his publications are about his primary research. Out of all of the peer-reviewed literature (there's a good amount listed at Source dump now), he's the only one (that I've seen so far) who asserts that his research showed that the suicide bag method is quick and painless. He's also written about feeling uncomfortable while watching people twitch and contort. He's cited by far the most frequently and in many places without attribution, as if he speaks for the mainstream, majority opinion, which there's no evidence of. I consider the fact that he's not allowed to teach at his university anymore and there seems to be some kind of NDA, as strike against the likelihood that he's speaking on behalf of the mainstream majority opinion. I'm in a rush, so I can't give a source, but google "Russel Ogden canada suicide university" or something like that. It's not hard to find.

All of the other peer reviewed articles that mention it's painless are saying it in the context of summarizing the existing literature. Most haven't claimed it was true or wasn't true. There's at least one literature review that challenges that this method is painless (Frost 2013). Lit review isn't the gold standard, but it's higher on the list than case report. I'm pretty sure I read more articles that challenged it a few weeks ago, but I haven't had a chance to go back to them yet. Even if Frost were the only one (which I don't think it is), due weight would say we should give more attention to Frost et al and use careful wording to express Ogden's view as his own. I was planning to give more examples, but I'll have to come back to it later, because this is getting long. <b style="color:indigo;">PermStrump</b> (talk) 20:25, 10 May 2016 (UTC)


 * Let me check this: If a review article says that it's painless, and cites Ogden, then you reject that source, because you reject Ogden and the source accepted Ogden.  If any source says that it's painless, and cites nobody at all, then you reject that source, because you assume that they're relying upon Ogden without attribution.
 * So the only acceptable source is someone who is not Ogden or associated with him, and who cites someone other than Ogden, but who has done such a limited literature search that they don't find one of the foremost experts in the field and whom all the other sources cite. Right?
 * Oh, and no right-to-life advocate would ever include such a statement in any published source, even if s/he fully believed it (because it might be "promotional"), so that limits the field even further.
 * I think you've just asked for an impossibility. WhatamIdoing (talk) 20:47, 10 May 2016 (UTC)
 * 1. We have an idea of what you think the mainstream authority is on this matter. In [|WikiProject_Medicine#Suicide_bag] you all but called this article illegal. Do you think you can decouple your dislike of suicide from the issues that affect this article? I think it's okay to drop the pretense that you have a neutral point of view on this issue --Lo te xendo (talk) 21:20, 10 May 2016 (UTC)
 * 2. The main issue that the MedRS crew seems to misunderstand, possibly intentionally, is the difference between belief and medical fact. The promulgators of the suicide bag BELIEVE that it is quick and painless method of suicide. This belief is pretty damned important, otherwise this article probably wouldn't exist, and doesn't need to be substantiated by a second party restating. Your worrying about this article leading people to commit suicide shouldn't preclude this important bit of information. Remember Wikipedia isn't WP:CENSORED.--Lo te xendo (talk) 21:20, 10 May 2016 (UTC)
 * When you are only allowed to use MEDRS-sources for certain parts of the article, that is in fact already censorship. <span style="font-family:'Old English Text MT',serif;color:green">The Banner <i style="color:maroon">talk</i> 21:29, 10 May 2016 (UTC)
 * Not at all what I said. The only sources that mention the pain/time say it in the context of, "this type of suicide is becoming more common because it's promoted by advocates as being quick and painless." Most don't give an opinion if they agree or disagree. At least 1 that I can name off the top of my head explicitly disagreed. None expressed agreement. There are 2 articles on Source dump that have titles that say something about being commentary or response to Ogden. I read them a few weeks ago and forget what they say, but I remember them as both being critical of his arguments. I didn't mention them in my first comment because I don't remember the details and don't have time to read them right now, but you can look for them in the meantime if you want to know what other people have to say about the topic. Those are primary sources published in peer-reviewed journals and per WP:PARITY, we should use them if we're going to use Ogden's case reports. <b style="color:indigo;">PermStrump</b> (talk) 21:36, 10 May 2016 (UTC)
 * Which articles claim that it is not painless? There appears to be a reasonable amount of evidence on the time-span, and as there is no universal standard for "quick" there is no point in quibbling over whether or not it is quick, when actual times can be quoted. Painless is probably the more important and controversial claim, and less easily measured, so it would be interesting to read an opinion which claims it is not painless and gives some evidence to support that opinion. &bull; &bull; &bull; Peter (Southwood) (talk): 19:58, 12 May 2016 (UTC)

Ogden
Just regarding Ogden and Permstrump's statement "the fact that he's not allowed to teach at his university anymore and there seems to be some kind of NDA, as strike against the likelihood that he's speaking on behalf of the mainstream majority opinion", you can read about his circumstances here. He's doing very unusual and remarkable research. Ratel (talk) 21:31, 10 May 2016 (UTC)
 * I'm not making a judgment about what he did. Just that the response from the university is a reflection of other people's opinions on his views. <b style="color:indigo;">PermStrump</b> (talk) 21:36, 10 May 2016 (UTC)
 * No, it's not that, it's more to do with the legal implications of his research.
 * Here's an article about him in Scientific American. That's a good source for this article, BTW, for example:
 * Certainly worth reading, that article! Ratel (talk) 21:41, 10 May 2016 (UTC)
 * Ogden and his POV are already getting undue weight. Is it preferable to cite his views to a secondary source that hasn't been peer-reviewed or to his primary work that has been peer-reviewed? I don't know which is better, but there are plenty of sources NOT affiliated with Ogden that need way more attention in this article first. <b style="color:indigo;">PermStrump</b> (talk) 22:35, 10 May 2016 (UTC)
 * The legal implications of Ogden's research are also a reflection of the mainstream views on his work. That's part of the point I was trying to make. <b style="color:indigo;">PermStrump</b> (talk) 22:37, 10 May 2016 (UTC)
 * The sheer fact that you think about it as "Ogden and his POV" makes your motives also suspect. <span style="font-family:'Old English Text MT',serif;color:green">The Banner <i style="color:maroon">talk</i> 23:40, 10 May 2016 (UTC)
 * The legal implications where? Legal/illegal does not equal mainstream. I could step across a state border in America and something I do everyday could be illegal. You're gonna have to make a better case. --Lo te xendo (talk) 23:42, 10 May 2016 (UTC)
 * Permstrump, regarding your assertion that Ogden is getting undue weight in the article, I would counter that Ogden happens to be the world's pre-eminent expert on this very topic. The Vancouver Sun, a major Canadian newspaper, referred to him as "Internationally known assisted-suicide expert Russel Ogden" . I don't think anyone else has studied the issue as closely, or do you have another such expert? If not, I don't think using him as a major source is undue at all.
 * Permstrump, regarding your assertion that Ogden is getting undue weight in the article, I would counter that Ogden happens to be the world's pre-eminent expert on this very topic. The Vancouver Sun, a major Canadian newspaper, referred to him as "Internationally known assisted-suicide expert Russel Ogden" . I don't think anyone else has studied the issue as closely, or do you have another such expert? If not, I don't think using him as a major source is undue at all.


 * And you have yet to answer the question asked above by about why you said Ogden has a "vested interest" in the topic. How exactly is he gaining from this topic generally, or more specifically from exit bags? Thanks! Ratel (talk) 00:15, 11 May 2016 (UTC)

I spent a bit of time asking a famous web search engine about Ogden. Here's some descriptions:


 * "prominent assisted-suicide researcher" and "a researcher who's been called to every parliamentary committee in Canada talking about this issue"
 * "Internationally known assisted-suicide expert"
 * "a world-leading researcher"
 * "the first researcher in North America to have formally studied the practices of underground assisted suicide and euthanasia"; "in Ottawa, Senate committees in Parliament have repeatedly relied on his data for their reports and recommendations."
 * "Ogden's research has been cited over the years both by proponents and critics of assisted suicide"; "a respected social scientist doing research on illegal behavior"
 * "[His research, especially on the percentage of botched suicides] altered fundamentally the way the situation is looked at"
 * "one of the world’s foremost experts on assisted suicide"; "right-to-die activists have been frustrated he has not been a stronger advocate for their cause....The world should be aware of the underground world of assisted suicides, he said, and should not be relying on the questionable evidence provided by right-to-die advocates, who have normally been the only ones providing information about NuTech suicides."

That all adds up to "Ogden is the mainstream researcher" AFAICT. A guy who's off in the fringes does not get called "world-leading" or "foremost expert" by high-quality sources. A guy who's off in the fringes does not see his testimony to legislative bodies shaping the laws so consistently. It's very difficult to give too much attention to a mainstream expert. We can and should be paying a lot of attention to his sources.

I'm also dubious that he could be fairly described as a "right-to-die advocate". After reading through a stack of articles, it appears to me that he's pro-science. WhatamIdoing (talk) 18:13, 13 May 2016 (UTC)
 * I think that after many years of working in this field, Ogden did become an advocate of legal reform and called for the right to assisted suicide in terminal cases. Hardly a radical position, considering surveys show most people feel the same way. Ratel (talk) 21:17, 13 May 2016 (UTC)

What's the deal with Worthington Industries?
For readability, I had changed this sentence from:
 * In 2015 author and right-to-die advocate Derek Humphry reported that Worthington Industries, the world's largest manufacturer of disposable helium cylinders, had announced that their helium cylinders will guarantee only 80% helium, with up to 20% air, making them inappropriate for use with a suicide bag.

To:
 * "In 2015 author and right-to-die advocate Derek Humphry reported that the world's largest manufacturer of disposable helium cylinders had announced..."

Who cares what the name of the company is? It just an extraneous detail in an article that already qualifies a lot of names with a lot of different organizations. It's the second time someone re-inserted Worthington Industries after I tried to remove it. The first time I assumed it got added back in as part of an indiscriminate mass revert. This time I'm getting suspicious that it's spam. From my perspective, it's either extraneous or it's spam, and either way, it doesn't need to be there. What's the deal? <b style="color:indigo;">PermStrump</b> (talk) 05:23, 14 May 2016 (UTC)
 * Sigh. 2 reasons:
 * you're going to soon end up with "reported that the world's largest manufacturer of disposable helium cylinders had announced..."
 * if people in terminal illness read this page, they will want to know which manufacturer brand to avoid.
 * Isn't it obvious? Ratel (talk) 05:31, 14 May 2016 (UTC)
 * Oooh I was thinking I didn't get why you'd want to direct them there. I don't really care that much about the company's name being there or not. It just seemed weird that other people did. That makes sense. <b style="color:indigo;">PermStrump</b> (talk) 05:49, 14 May 2016 (UTC)

FEN and John Celmer
I'm not happy with the way the FEN is being represented on the page. John Celmer is portrayed as a cancer-free man with a hangup about his appearance and some arthritis pain that could be treated with drugs. The reality is very different. He was fresh out of cancer surgery, in a lot of pain, with disfigurement. You can read the full story in an article from the Atlanta (magazine) here:

It was oral cancer, on the floor of his mouth and under his tongue, likely caused by years of smoking. In September of 2006 John had his first surgery. They cut the skin along his throat from ear to ear and pulled his face up. They removed the spot from under his tongue and much of the floor of his mouth. Then he was released. For most of that fall, John underwent radiation treatment five days a week, which damaged his jawbone severely. By early 2007, a hole had appeared in his lower jaw, below his chin. He cut his mouth on exposed jawbone. He lost teeth. Traces of cancer remained .... everything he ate continued to fall through the hole in his jaw. ... Given John’s condition—he’d lost more than fifty pounds since the first operation—and the complexity of the procedure they had in mind, doctors said he had a roughly 30 percent chance of emerging cancer-free this time. Over the course of twelve hours on May 23, doctors removed his partly disintegrated jawbone and reconstructed it using bone and tissue from his leg and skin grafts from his thighs. In June he returned to have skin grafted from his chest over the hole in his jaw. The patches left by the harvested chest skin were, in turn, covered by thigh skin. A man only has so much skin, or patience, for cutting. But it was a success: John’s doctors declared him cancer-free. Still, he walked with a crutch. He couldn’t eat or speak normally. The pain was unrelenting.

Also an interesting account of his death: According to Goodwin, shortly after 11 the three of them went upstairs to John’s bedroom, where he lay on his bed and put his head in a plastic bag filled with helium. Goodwin says he and Blehr held John’s hands until they went limp. As he asphyxiated, there was no involuntary reflex of the hands or body, a phenomenon that occurred with maybe half of those Goodwin has watched die by helium inhalation. In other words, he did not struggle. “He just lay there and very peacefully, you know. . . he knew that we were there for him and he was happy. I could see his face through the bag, and I know that he was very content.... [Celmer] was unconscious within twenty seconds and dead in twelve minutes, according to the affidavit...

I don't think we are doing this topic any good service by seeking to portray people like FEN, Nitschke, Exit International, Derek Humphry or Russell Ogden as unethical, profiteering ghouls. That's really juvenile and horribly POV. Ratel (talk) 06:31, 14 May 2016 (UTC)
 * Do you know the date the article was in Atlanta? <b style="color:indigo;">PermStrump</b> (talk) 07:19, 14 May 2016 (UTC)
 * "Final Exit," Atlanta Magazine, March 2010 Ratel (talk) 07:42, 14 May 2016 (UTC)

Five Last Acts book
I see you removed the reference to ""Five Last Acts", so I checked on the book's content via Amazon. There is some very interesting material there that could go into the article, such as (page 112) Ratel (talk) 07:40, 14 May 2016 (UTC)
 * What are you suggesting to put in the article? <b style="color:indigo;">PermStrump</b> (talk) 07:43, 14 May 2016 (UTC)
 * Something about petechiae. He also states that about 3% of the cases of inert gas asphyxia (all gasses) in the med lit show petechiae, which is interesting (he gets this from ). I'll get to it, eventually. Ratel (talk) 08:19, 14 May 2016 (UTC)

Potential copyright violation
There's a sentence in the Bioethics section that essentially splices a couple of different lines from Ogden's paper. I think it's too close to the original source and should be paraphrased or directly quoted in the right way. The first half of the sentence is paraphrased enough. It's this second half that I'm talking about: "...an emerging counterculture of death providers, operating outside of the traditional medicolegal framework of health care, was placing assisted death outside the normative gaze of medicine." There are so many vague buzzwords that I think it would be more readable and meaningful to paraphrase as opposed to directly quoting the source. It sounds like a lot of fluff without a lot of meaning to me, so I don't have any suggestions. —PermStrump ( talk )  21:43, 15 May 2016 (UTC)
 * Fixed. Ratel (talk) 22:34, 15 May 2016 (UTC)

Kleespies paper
Your recent addition,, of the Kleespies opinion needs some clarification and amendment. I'm not sure it touches on ethics in any way...
 * 1) The sentence "He also stated that in contrast to descriptions by Ogden and other right-to-die proponents, it is an undignified and impersonal method of dying" is nothing but an emotional opinion, an aesthetic judgment, nothing to do with ethics. I'd also like to see the exact source text you derived that from. Whether or not having your head in a bag is undignified is purely a matter of taste. It's certainly more dignified than dying in agony, incontinent or utterly disabled, which is what the anti-euthanasia activists would prefer people do. And what's impersonal about it? Plenty of people who die like this have the covert assistance of loved ones or friends, who often remove the apparatus after death. Is it less impersonal to die in a hospital, surrounded by strangers? And how does this speculation and presumption from Kleespies add value to the article?
 * 2) The sentence "They appear to have been hurried exits in which the individuals were hooked to a death-delivering apparatus or were wearing a scuba mask or had their head in a plastic bag" seems worthless to me, just pure conjecture offering no value to the article. For a start, this sort of suicide is perhaps the least hurried of all, with much preparation and several purchases that need to be made. It's not like jumping off a building or hanging yourself with a cord. It's very deliberate and premeditated. So simple common sense dictates that Kleespies is indulging in rhetoric here, and is also plain wrong. I'd vote to remove this. Ratel (talk) 20:55, 13 May 2016 (UTC)


 * Of course, [the right-to-die movement] also arose in reaction to the remarkable advances in medical technology that enabled modern medicine to sustain life beyond the point where it might have meaning and purpose, and to change the major causes of death to illnesses that had prolonged and debilitating courses that can deprive the individual of autonomy and dignity.
 * As Battin (1994) has noted, however, autonomy in end-of-life choices should be respected provided the person is competent and doing so does not violate other moral obligations. With such provisos in mind, and at the risk of sounding like one of those "patronizing politicians, doctors, ethicists, and all other do-gooders or nay-sayers," (Ogden, 2010=this issue, p. 300, quoting Hofsess, 1998), I would like to give emphasis to the concerns that Ogden has mentioned about the NuTech practice of covert assisted suicide and=or euthanasia.
 * Although the ultimate aim of NuTech supporters, and others such as Dr. Kevorkian, may be legal reform that allows for the choice of an assisted death, their means seem to be reckless and dangerous. Such, however, are the very real risks of covert, unregulated, assisted death in which there are few, if any, safeguards for vulnerable people who may not have had the opportunity to fully discuss and consider the implications of their decision.
 * There is little in the Kevorkian deaths, or in the NuTech deaths as described by Ogden, that would suggest a dignified process. They appear to have been hurried exits in which the individuals were hooked to a death-delivering apparatus or were wearing a scuba mask or had their head in a plastic bag.
 * My hope, however, is that with improved and more person-oriented care during the living-dying phase of life, there will be less and less of a perceived need to turn to the impersonal and undignified NuTech methods of self-deliverance.


 * I don't see how the Scientific American reference is any more or less about ethics: Ogden views a bag and inert gas as "the quickest way to go; used properly, you're unconscious after the second breath and dead in about 10 minutes" than the Kleespies citation, "in contrast to descriptions by Ogden and other right-to-die proponents, it is an undignified and impersonal method of dying. According to Kleespies, "They appear to have been hurried exits in which the individuals were hooked to a death-delivering apparatus or were wearing a scuba mask or had their head in a plastic bag." <b style="color:indigo;">PermStrump</b> (talk) 01:10, 14 May 2016 (UTC)


 * The Ogden comment goes to ethics because it is about the objective patient experience, whereas the Kleespies comments are about the aesthetics of what it all looks like ("appeared") and contains his subjective interpretations (undignified, impersonal). No comparison. I think it should come out. It adds nothing but an opinion, and we all have opinions, so why do we need to hear what one psychiatrist thinks? Ratel (talk) 03:51, 14 May 2016 (UTC)
 * The bit that runs "Ogden's work calls attention to some of the risks associated with covert assisted suicide using unregulated methods" seems like a WP:COATRACK problem. Ogden's work called attention to covert assistance; those problems apply to all methods, not just this one.  It feels like we want to have this sentence somewhere in Wikipedia, and that Odgen's name formed a hook in the article, so we hung the material here.  It'd make far more sense to put that sentence in an article about assisted suicide.
 * Determining whether an action transgresses human dignity is a reasonable topic for ethics, as is the question of informed consent. But I'm not sure how this method is undignified (and, say, suicide by firearm, hanging, or poison isn't equally undignified).  It would be informative to know whether Kleespies has identified any methods that meet his standards for being "dignified".  WhatamIdoing (talk) 04:00, 14 May 2016 (UTC)
 * That's not what a coatrack means. It's also an essay, so what policy/guideline are you referring that you think this specific circumstance violates? Kleespies isn't implying that this method is more or less dignified than other methods. He's saying that advocates are recklessly and dangerously promoting it as an idealistically dignified method and that's not what he sees as the reality of the situation when it's most commonly used by vulnerable people with mental illness. "Covert" and "unregulated" might apply to other methods, but so does "certain, fast and painless." I'd be totally fine removing "covert" and "unregulated" if "certain, fast and painless" weren't there. As it is, it needs to be contextualized, including in the lead adjacent to "certain, fast and painless." <b style="color:indigo;">PermStrump</b> (talk)  04:27, 14 May 2016 (UTC)
 * I've helped write that essay, so I believe that I'm familiar with its meaning. We can very simply re-phrase the opening sentence to identify the relevance:  "A coatrack for an article on suicide bags is a one that ostensibly discusses suicide bags, but instead focuses on another subject entirely, i.e., the problems of covert assisted suicide."  In its taxonomy, this statement is "The Flea":  The article is ostensibly about suicide bags, but let me tell you about this guy's research into people covertly and illegally assisting suicide, mostly using unrelated suicide methods!
 * Also, see WP:PGE. The official written policy that discourages including tangents is at WP:DUE.
 * The way Kleespies's view is being presented suggests that Kleespies believes that it is less dignified and less personal than other methods. If that's not true, then we're misrepresenting the source and should omit it on those grounds.  If Kleespies instead believes that all methods of suicide are undignified (certainly a POV that exists, and I would expect at least the Roman Catholic Church to hold that view), then we should omit it here and add it to the general Suicide article instead.  And if there's something specific about this method, then we should include it with specifics, so that it seems less like some random guy's personal aesthetic opinion.  For example, from one of the quotations above, it appears that Kleespies might object to his (possibly erroneous?) idea that the suicides were "hurried" or that he has a personal distaste for having something on his face (perhaps he would believe that general anesthesia is also "undignified"?).  If we're going to include it, then I think that it needs more substance than "Kleespies said so".  WhatamIdoing (talk) 15:12, 16 May 2016 (UTC)