Method Proposing a new, easily-accessible method - Propofol (A Theoretical Method of Dying - The Two Drug Combination - Emulating BC's MAiD Protocol)

[Dying science gal]

I propose a new method based off BC's MAiD process:

Accessible Version
Full details below~

What you need:
1000mg of propofol - You can get this from Russian clearnet pharmacies. It is marketed for the euthanasia for animals. Propofol is generally not a controlled substance, and is widely used for the induction of anesthesia.
10ml of saline for injection - You can get this from your local pharmacy. Just ask.
0.5mg per kg Lidocaine 1% - You can also get this from your local pharmacy. Again, just ask.
IV Catheter (20G) - You can buy this from medical suppliers online.
IV tubing - You can buy this from any medical supply store... Again...
Tegaderm dressing for the IV - Again, purchasable from the pharmacy. Just ask.

Procedure:
Push 10ml of saline to ensure patency of IV catheter
Push lidocaine 0.5mg/kg of 1% preparation to numb the veins as sometimes propofol hurts on injection.
Wait for five minutes.
Administer propofol 1000mg via an IV syringe pump or drip (just stick the end of the iv tubing into the bottle) over 30 seconds — This induces anaesthesia and death. The IV syringe pump or drip is chosen as it will continue the infusion postmortem to ensure sufficient serum concentration.


Full Article
I came by a document titled "Medical Assistance in Dying (MAID) Protocols and Procedures Handbook of the Comox Valley, BC" (Reggler & Daws, 2021) and found interest in this document. It outlines the following protocol for medically assisted suicide by the intravenous route:

1. Saline 10 ml (upon insertion of new cannula or to ensure patency of existing)
2. Midazolam 10-20mg 2-4ml of 5mg/ml preparation
3. Saline 10ml (may be omitted)
4. Lidocaine 40mg 4ml of 1% preparation; pause to allow effect
5. Saline 10ml (may be omitted)
6. Propofol 1000mg 100ml of 10mg/ml preparation; give slowly especially if veins small or patient)
7. Saline 10ml (mandatory; prevents crystallization or Propofol with Rocuronium)
8. Rocuronium 200mg 20ml of 10mg/ml preparation
9. Saline 10ml (mandatory; ensures full dose delivered centrally)

I have decided to investigate the intravenous route as the oral route is extremely uncomfortable and can take up to twelve hours for an individual to die from such ingestion, and a complication rate of up to 14.8%. (pp. 18-19, Worthington, Finlay & Regnard, 2022)
Based on this guideline, I propose the following:

1. Saline 10ml (To ensure patency of IV catheter)
2. The midazolam is excluded as it's primary purpose is to reduce awareness of mild burning sensation, which the lidocaine should be effective at preventing. Ten to seventy percent of patients experience this in the absence of pretreatment. (p. 8, Reggler & Daws, 2021). However, pretreatment with lidocaine at 0.5mg/kg should be sufficient. (Kang et al, 2010)
3. Lidocaine 0.5mg/kg of 1% preparation; (The lidocaine is set to 0.5mg/kg as per Kang et al., 2010)
4. Propofol 1000mg via an IV syringe pump over 30 seconds - This induces anesthesia and death. The IV syringe pump is chosen as it will continue the infusion postmortem to ensure sufficient serum concentration.

Existing case studies suggests the possible use of propofol as a monotherapy in the use of medically asssisted dying, as it's use in physician suicides (primarily anesthesiologists) is widespread. In fact, induction agents are the leading drugs used for suicides among anesthesiologists. (Yentis, Shinde, Plunkett & Mortimore, 2019)

Bibliography:

1. Anna Pia Colucci, Gagliano‐Candela R, Aventaggiato L, et al. Suicide by Self‐Administration of a Drug Mixture (Propofol, Midazolam, and Zolpidem) in an Anesthesiologist: The First Case Report in Italy. Journal of Forensic Sciences. 2013;58(3):837-841. doi:https://doi.org/10.1111/1556-4029.12053

2. Silviya Stoykova, Kiryakova T, Nikolov D, Nedzhib A, Ivayla Pantcheva, Vasil Atanasov. Self-administrated propofol – a case report of a physician suicide. Annales de Toxicologie Analytique. 2018;30(2):142-148. doi:https://doi.org/10.1016/j.toxac.2018.03.002

3. Kirby RR, Colaw JM, Douglas MM. Death from Propofol: Accident, Suicide, or Murder? Anesthesia & Analgesia. 2009;108(4):1182-1184. doi:https://doi.org/10.1213/ane.0b013e318198d45e

4. Reggler J, Daws T. Medical Assistance in Dying (MAID) Protocols and Procedures Handbook Comox Valley, BC 2017.; 2017. https://divisionsbc.ca/sites/default/files/51936/Medical Assistance in Dying (MAID) Protocols and Procedures Handbook Comox Valley 2017 - 2nd edition_0.pdf

5. Yentis, S.M., Shinde, S., Plunkett, E. and Mortimore, A. (2019), Suicide amongst anaesthetists – an Association of Anaesthetists survey. Anaesthesia, 74: 1365-1373. https://doi.org/10.1111/anae.14727

 

[DeadManLiving]

Thx for the information. I've tried large saline concentrations orally in solution at high to induce dehydration but after the second day still alive sucking on an ice cube didn't want to risk permanent renal injury without a more lethal adjuvant. What about saline intramuscular? Full IV line bit tricky although in combination with profonol & then potassium would definitely do the job, but setting up a robust IV line is a bitch, especially keeping it in place. One way could be to get some low grade infection and a PICC line (for bolus continous delivery of antibiotics/ amoxicillin), or finding a physician that'll set you up with a PICC line would do the job, but you need a medically necessary reason. But I remember doing saline flushes with PICC lines and they were breeze as far as direct IV goes.

 

[Dying science gal]

Thx for the information. I've tried large saline concentrations orally in solution at high to induce dehydration but after the second day still alive sucking on an ice cube didn't want to risk permanent renal injury without a more lethal adjuvant. What about saline intramuscular? Full IV line bit tricky although in combination with profonol & then potassium would definitely do the job, but setting up a robust IV line is a bitch, especially keeping it in place. One way could be to get some low grade infection and a PICC line (for bolus continous delivery of antibiotics/ amoxicillin), or finding a physician that'll set you up with a PICC line would do the job, but you need a medically necessary reason. But I remember doing saline flushes with PICC lines and they were breeze as far as direct IV goes.

Saline IM will likely get you hypernatremia, so I guess someone could possibly die from it. You can use an IV catheter, and to keep it in place, use a tegaderm on top. And usually they wouldn't put a PICC line for an infection unless if you need an IV in for more than 96 hours~

 

[eden101]

bump

 

[Lady Laudanum]

How are you going to get yourself propofol though, assuming that you don't have a healthcare job that makes it possible to steal it from the facility you work in?

 

[Dying science gal]

How are you going to get yourself propofol though, assuming that you don't have a healthcare job that makes it possible to steal it from the facility you work in?

You can buy it otc - Shipped from Russia.