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Petechiae

At what stage of hypoxia do petechiae develop? Would this be before or after loss of consciousness? Would the victim notice? What is the mechanism of damage? • • • Peter (Southwood) (talk): 16:43, 14 May 2016 (UTC)

I found a useful looking reference, probably MEDRS - Ely, Susan F.; Charles S. Hirsch (2000). "Asphyxial deaths and petechiae: a review" (PDF). Journal of Forensic Science. 45 (6): 1274–1277.• • • Peter (Southwood) (talk): 16:53, 14 May 2016 (UTC)
Informative and relevant. It answered my questions. I recommend it as relevant and probably useful for this article. • • • Peter (Southwood) (talk): 18:09, 14 May 2016 (UTC)
Peter (Southwood), based on the title alone, I thought for sure this was going to devolve into another debate about SYNTH and IAR. But it appears to be an independent, reliable source and a review article written by an expert in the field of forensics and published in a peer-reviewed journal (aka WP:MEDRS) that directly addresses postmortem findings in deaths involving, among other things, suicide bags. WTG! :-P We just have to be careful not to draw conclusions the author isn't making. Most of the references to plastic bags are combining all cases where the majority of deaths involving plastic bags are considered accidental and some are homicide, and some a suicide. This is the only part where she talks specifically about suicide:
Extended content

Moreover, hundreds, if not thousands, of persons who have accomplished suicide by placing a plastic bag over their heads, without a concomitant drug overdose, have performed “human experiments” by inducing pure hypoxial deaths. Unless the bag is fastened around the neck by a ligature with sufficient tension to obstruct venous return from the face, in our experience, such persons never have facial or conjunctival petechiae. Persons with tight fastenings around the neck are recognizable instantly by their facial plethora and numerous petechiae. We are aware that some observers may have seen an occasional petechia in rare instances of plastic bag suicide (22). However, we have not seen detailed descriptions of such observations that permit another person to evaluate the variables that might have produced an isolated petechia in a rare victim. Conversely, in New York City, an average of approximately 15 persons per year accomplish suicide by plastic bag, and we never have observed petechiae in a person who did not tightly fasten the bag around his/her neck (19).

Basically, the major conclusion of the whole paper is that petechiae occur in hypoxial deaths when there's something around the neck restricting circulation. In suicide cases involving plastic bags, in the her own experience of ~15 cases/year (out of how many years, I don't know), petechiae always coincided with ligature marks from the tightly fastening the bag around the neck. Some other researchers reported petechiae related to suicides with plastic bags, but didn't provide enough information to evaluate other possible variables, so it's a bit anticlimactic, but one of few decent sources. What are you suggesting we add? PermStrump(talk) 19:03, 14 May 2016 (UTC)
More or less what you say. I agree that the extract above is the most relevant material. • • • Peter (Southwood) (talk): 19:31, 14 May 2016 (UTC)
Nice catch, Peter. That material will go in. It rather undermines Frost's assertion that petechiae (inter alia) "challenge the assumption" that this form of death is painless. He's really out of his depth on this topic, despite having classed his little low-powered study (n=2) as a "review". Ratel (talk) 22:34, 14 May 2016 (UTC)
Ratel I guess you overlooked the part where I said, "Most of the references to plastic bags are combining all cases where the majority of deaths involving plastic bags are considered accidental and some are homicide, and some a suicide." The thing about 3% was referring to all case, not exclusively suicide bags. If someone is murdering you with a plastic bag, they're not going to need to tie it around your neck because they can just hold it over your face. Likewise in cases involving accidental deaths (I assume usually infants and children), aren't going to need to tie something around their neck to keep the gas in, so petechiae are going to be more likely in cases of suicide, which we can't say in the article because the source doesn't say it, but it's why we also can't use the 3% figure as if we can accurately extrapolate that to deaths with suicide bags. PermStrump(talk) 21:26, 15 May 2016 (UTC)
In addition, it's ridiculous to say Ely's study was disagreeing with Frost when it was written 13 years earlier AND didn't say it was disagreeing with Frost. In the case of Frost and Kleespies, they explicitly said they were refuting specific claims by specific people. PermStrump(talk) 21:32, 15 May 2016 (UTC)
I would agree that Ely's study does not disagree with Frost on the grounds that it was previous to Frost and could not reasonably have predicted Frost, but also I don't find that Ratel has claimed that it disagrees with Frost. It does come to a rather different conclusion, and that, I think, speaks quite adequately for itself. Whether undermines is a good way of putting it is also debatable, but clearly the conclusions are not entirely compatible, and on the face of it, Ely has done a more rigorous review. • • • Peter (Southwood) (talk): 12:56, 16 May 2016 (UTC)

Yes, but we as editors can point out that the studies disagree without being OR or SYN. Ratel (talk) 21:51, 15 May 2016 (UTC)

Do we need to? it is fairly obvious. • • • Peter (Southwood) (talk): 12:44, 16 May 2016 (UTC)
I agree it's obvious, so that's why I've just left it as is. Ratel (talk) 12:48, 16 May 2016 (UTC)
we as editors can point out that the studies disagree without being OR or SYN No, that's the exact definition of OR/SYNTH. It's also not true in this case since the author didn't talk about pain and it preceded the other study by 13 years. PermStrump(talk) 15:09, 16 May 2016 (UTC)
No, it isn't. "Alice said X, and Bob said not-X" does not violate any policy (assuming both of those sources verifiably said those things).
Ratel, a "case study plus review" is not an unusual form of source for rare medical issues. It's important to separate the (primary) case study parts such as Frost's statments about the two cases from the (secondary) review parts such as Frost's discussion of Ogden's work, and to handle that primary content appropriately, but the existence of the primary-source material does not invalidate the whole thing. WhatamIdoing (talk) 15:21, 16 May 2016 (UTC)

Natural gas

Pipeline quality natural gas is 95-98 percent methane [1]. Ratel (talk) 03:28, 16 May 2016 (UTC)

Introducing this into the article amounts to WP:Original research as synthesis of two unrelated subjects. Carl Fredik 💌 📧 07:20, 16 May 2016 (UTC)
How so? Perhaps there is a natural gas that ISN'T methane! Tell me about it. Ratel (talk) 07:47, 16 May 2016 (UTC)
Well, ethane. Carl Fredik 💌 📧 08:01, 16 May 2016 (UTC)
After methane, ethane is the second-largest component of natural gas. Natural gas from different gas fields varies in ethane content from less than 1%-6%, so as I said above natgas is methane 95-98%. For all intents and purposes, it is methane. Ratel (talk) 12:00, 16 May 2016 (UTC)
And since it makes no effective difference whether it was methane, ethane, or a mixture of the two called natural gas, why argue about it? It is marginally more correct to link to natural gas, where the readers can find out for themselves that it is methane with a bit of ethane and other impurities. Breathing ethane would have almost identical effects as it is also tasteless, odourless, an asphyxiant and highly inflammable. • • • Peter (Southwood) (talk): 12:25, 16 May 2016 (UTC)
For whatever reason, the authors decided to refer to it as natural gas throughout the paper and specifically said they didn't know exactly what the person had inhaled. I think it's better to link to natural gas and let the reader decide to learn more about it on their own. They wrote, "Natural gas is a high methane (an inert gas)-content mixture (GazMetro, 2007)... all of these cases were relevant to inhalation of natural gas and its components... The source of methanol in these samples is not clear... Under certain combinations of high pressure and relatively low temperature, many components of natural gas (methane, ethane, propane, isobutene, carbon dioxide and hydrogen sulfide) interact with water and form hydrates that can plug the side of wells and pipelines. Pumping different inhibitors (methanol) are used to overcome hydrate formation (Stanislav, 2008)." One of the points of the paper is to figure out a way to tell exactly what they inhaled, which the authors concluded the current investigative techniques weren't able to do, so we shouldn't imply that it did. PermStrump(talk) 12:56, 16 May 2016 (UTC)
Agreed. • • • Peter (Southwood) (talk): 06:41, 19 May 2016 (UTC)

POV

To my opinion this is plain POV: [2]. Unfortunately User:CFCF immediately started slapping nonsense warning on my talk page and it looks like he is searching for an edit war. The Banner talk 21:02, 17 May 2016 (UTC)

as "certain," "fast," and "painless." That takes care of the issue (IMO) 7&6=thirteen () 21:07, 17 May 2016 (UTC)
The source is paywalled. Does anyone have access that can quote the relevant paragraph? Adding the bit about belief looks like editorializing. • • • Peter (Southwood) (talk): 06:37, 19 May 2016 (UTC)
Adding the bit about belief is adhering to science and our sourcing policies. These are beliefs that have not been proven — from primary sources. Carl Fredik 💌 📧 06:40, 19 May 2016 (UTC)
(ec) The statement Right-to-die groups recommend this form of suicide as "certain," "fast," and "painless." already provides the information that it is a recommendation from those groups and by implication, that Wikipedia and the authors of the article do not claim it to be fact. That is already sufficient to be within our sourcing policies providing that it is accurate. Checking whether that is a true reflection of the source is NPOV, and what I am trying to do here by asking for a quote to check against. Adding the bit about belief is not science, it is opinion, unless that information is also included in the source. • • • Peter (Southwood) (talk): 07:37, 19 May 2016 (UTC)
It's about speaking in Wikipedia's WP:VOICE — and any statement that is held only by a minority group should not be claimed as fact. The reason I chose "believe" rather than for example "hold that" is because it is unfounded and based on unscientific notions. Carl Fredik 💌 📧 08:20, 19 May 2016 (UTC)
Wikipedia's "voice" was saying that it was reported, not claiming it as fact, and (see below) this may not even be an accurate representation of the source, making it a moot point. • • • Peter (Southwood) (talk): 20:48, 19 May 2016 (UTC)

The abstract states it plainly, as a recommendation of the named groups. Since when has it become policy to ignore abstract text and insist on data being embedded inside studies? Just curious .... Ratel (talk) 07:45, 19 May 2016 (UTC)

This is not an unusual kind of dispute. Editors frequently want some WP:WEASEL words added to facts that they disagree with. It is not unreasonable of them to assume that some readers will interpret "Alice says X is good" as meaning "the Wikipedia editors agree with Alice that X is good". WhatamIdoing (talk) 15:36, 19 May 2016 (UTC)
Abstracts are not reliable sources. They are mainly promotional material and have been known to conflict with the text, report overly positive results, and often fail to provide needed context. Here's a link to a study about it. This should be common knowledge though, at least among wikipedia editors. It's one of the main reasons why journalists are always so wrong when they try to talk about research. Unless you've read the full text and know the statements are supported in the body, people shouldn't be citing an article based on the abstract (see archived RSN discussion about it). In this case, the only reference to right-to-die groups in the full text is:

Compared with other suicide methods, suicides by placing a plastic bag over the head are said to be uncommon, whereas in New York, the number of these suicides rose clearly after the publication of the book “Final Exit—The Practicalities of Self-Deliverance and Assisted Suicide for the Dying” written by D. Humphry.

It doesn't say anything even remotely similar to "certain, fast and painless" in the text. PermStrump(talk) 16:50, 19 May 2016 (UTC)
Thanks. Does it say anything that we can use? 7&6=thirteen () 17:22, 19 May 2016 (UTC)
We've already cited it 3 times, so other than that? I'll look at it again when I have more time a little later and see, but it's pretty short and I think most of it is already covered by plenty of other sources. It mainly says the same thing as a lot of the case reports, which is basically that this method is becoming more common, it can be difficult to detect with routine postmortem analysis, then it offers some advice to forensic pathologists about signs that should alert suspicion of this COD and extra things to look/test for when this COD is suspected. PermStrump(talk) 17:48, 19 May 2016 (UTC)

I tagged some undesirable sources as "self-published" in lieu of removing the inappropriate references and their content completely, but the templates were removed by Ratel with this edit and an edit summary that says, "no need for continual "Self-published" tags if you make it clear who is saying what." This is not my understanding of the policy on reliable sources, specifically WP:SELFPUB. FYI I posted a question about it on the Reliable sources/Noticeboard for outside input. PermStrump(talk) 07:47, 11 May 2016 (UTC)

Note that blogs of experts in their fields are considered RS when I last looked, which was several years ago (may have changed). In any event, when you make it clear who the source of the claim/statement is, what does it matter if for instance Humphry is reported as saying something in a newspaper or saying it on his own website? Ratel (talk) 07:54, 11 May 2016 (UTC)
You say that it's the references themselves and their content that you don't like, however, it all looks fine to me. Not that I'd object if the entire article itself was censored, but WP generally doesn't work like that. Bromley86 (talk) 08:12, 11 May 2016 (UTC)
It depends on what the content is, as far as quoting expert blogs (also Nitschke's newsletter is not a blog and Nitschke is not an expert since his medical license was revoked). His newsletter contains advertisements for the sale of nitrogen tanks, suicide bags, other related products. This statement is the one I find most problematic: Nitschke has stated that nitrogen has a lower risk of an adverse reaction by the body than helium. It makes a little more sense to quote him and cite his website in the next sentence, Nitrogen has been advocated as a replacement for helium not because of reactions to helium, but due to a "temporary restriction on the availability of disposable helium in Australia (and New Zealand), helium has been difficult to procure." though it still feels like linkspam. I feel strongly that it's irresponsible to use his self-published work to support a statement about adverse reactions related to nitrogen. PermStrump(talk) 15:38, 11 May 2016 (UTC)
Does anyone have a link to that claim about adverse reaction to helium? I have not heard of one that would be relevant in the time scale involved. • • • Peter (Southwood) (talk): 20:05, 12 May 2016 (UTC)
PermStrump you should recuse yourself from editing this article and related subjects. You obviously have a bias against the subject and you refuse to address any of the points that I bring up about this directly. You're only making this worse for yourself. --Lo te xendo (talk) 16:23, 11 May 2016 (UTC)
My bias is for using reliable sources and giving due weight to viewpoints based on their prominence in the mainstream, majority opinion. I'm also guilty of bias towards making it a priority to scrutinize the quality of sources supporting information related to health topics, especially where life and death and the potential for legal issues are concerned. I'm pretty sure those aren't reasons to recuse oneself from editing an article. I've directly addressed your concerns that were related to the content of this article (here, for example) despite the fact that you've replied to most of my concerns with non sequitors and made false accusations against me (this thread is a perfect example). Here you accused me of "engaging in wikilawyering slight of hand" and "acting as the sole arbitrator" because I bought my issues with the article to the talkpage and cited the relevant guidelines and policies. Here, as opposed to responding to the issue I had raised (which were in direct response to something you had said), you accused me of giving a false pretense of having a neutral point of view on this topic because I previously consulted with Wikiproject Medicine about this article and the legality of posting directions for suicide and other content that could potentially be interpreted by a court as encouraging suicide by promoting fringe views with a deceiving tone that seems WP:NPOV at first glance.
TLDR: It’s absurd to say I should recuse myself or drop the “pretense” of having a neutral point of view when I’ve been discussing issues on the talkpage and I've supported all of the issues I’ve raised about the content in this article with directly relevant policies and guidelines. I offered to initiate an RFC and the only response to that was from an editor who said that that would be equivalent to an "enemy takeover" to "legalize" my agenda. PermStrump(talk) 18:16, 11 May 2016 (UTC)
"Nitschke's newsletter is not a blog and Nitschke is not an expert since his medical license was revoked" I'm sorry, but this line of argument is not to your credit, as it makes it look like you're desperately scrambling for some sort of policy to use to censor. It matters not whether its a newsletter or a blog (did you just suggest that it somehow does!) and the fact that he's been effectively struck off because he would not conform to the current Australian medical norm re. suicide does not invalidate his medical qualification; if anything, it's more likely to establish that he's an expert in the field of assisted suicide advocacy. Bromley86 (talk) 21:27, 11 May 2016 (UTC)
  • Perm, the argument that Nitschke (PN) is not an expert will not fly, and citing the fact that he burned his MD license in disgust does not add weight to your argument. Today I'd say it's fairly easy to prove that PN is probably the foremost expert on "rational suicide" and voluntary euthanasia in the world. If you read his book (I have), you'd have to agree. He's been called a "euthanasia expert" by numerous sources, for instance The Guardian [3]
Look, I understand your crusade to expunge details from the article, and your concerns. I share some of them. But I'm afraid it cannot be censored. The only way this information could become less important is if governments legislate for assisted dying for those who require it, as some are now doing, and others considering doing. That will take the heat out of this issue and perhaps then governments can simultaneously legislate to remove all inert gases from OTC sale. Ratel (talk) 22:15, 11 May 2016 (UTC)
Permstrump has been trying to help the encyclopedia by editing according to the mainstream view. Read WP:UNDUE. ThePlatypusofDoom (Talk) 20:35, 11 May 2016 (UTC)
These sources are reliable and citable for the reasons Ratel and Bromley86 have stated. 7&6=thirteen () 00:44, 12 May 2016 (UTC)
Ratel: Accolades from journalists do not qualify someone as an expert. According to WP:Selfpub, we should only make an exception for him if he’s an “established expert on the subject matter, whose work in the relevant field has previously been published by reliable third-party publications.” Virtually none of that applies to Nitschke. As a former psychiatrist with only one peer-reviewed publication that was on assessing depression in chronically ill patients, he has not had work in a field relevant to assessing the adverse effects of nitrogen inhalation published by reliable third-party publication. More importantly, he is not considered an expert by other experts in the field (his views aren’t even widely accepted within right-to-die groups) and a major authority in the field—the Medical Board of Australia—does not consider him fit to be a medical doctor at this time. Identifying reliable source#Medical claims says, "It is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge." It's clearly not in the spirit of wikipedia's policies and guidelines to make an exception for supporting biomedical information with this particular self-published source. PermStrump(talk) 01:10, 12 May 2016 (UTC)
We will have to agree to disagree. Without being disagreeable. Cheers. 7&6=thirteen () 01:14, 12 May 2016 (UTC)

FYI I redirected the conversation from the Reliable source noticeboard here, so there won’t be two parallel conversations. This comment is in response to @Bromley86 and SJK: who referenced the line in WP:SELFPUB that would allow making an exception for citing Nitschke’s self-published work on the grounds that he’s an "established expert on the subject matter, whose work in the relevant field has previously been published by reliable third-party publications." First, see above for my explanation as to why he's not an established expert. And second, the next line of the same policy states, "Exercise caution when using such sources: if the information in question is really worth reporting, someone else will probably have done so." Identifying reliable sources#Exceptions is more explicit in stating “Avoid using [self-published material] to source extraordinary claims,” where extraordinary claims are defined as “challenged claims that are supported purely by primary or self-published sources or those with an apparent conflict of interest.” Here we have a claim that’s both: it’s being disputed and it's sourced to the self-published work of someone with a conflict of interest based on the fact that Nitschke promotes and sells nitrogen as part of suicide kits (at $690 per kit).

There are no reliable, independent, third-party sources that support Nitschke's claim that using nitrogen with a suicide bag has no adverse effects. Therefore citing a statement only found in questionable sources give undue weight to an idea that "departs significantly from the prevailing views or mainstream views in its particular field." See also WP:FRINGELEVEL which says, "Fringe theories may be excluded from articles about scientific topics when the scientific community has ignored the ideas." Finally, WP:ONUS says, “The onus to achieve consensus for inclusion is on those seeking to include disputed content.” So 7&6=thirteen, we can certainly agree to disagree, but the policies state that the disputed biomedical content comes down until there multiple high-quality sources can be found.

TLDR: Self-published and primary sources cannot be used as the only source for extraordinary claims. Nitschke’s claim that using nitrogen with a suicide bag has no adverse effects is an extraordinary claim, meaning it requires multiple high-quality sources. The onus to provide multiple high-quality sources is on the editors who wish to include disputed content. PermStrump(talk) 01:22, 12 May 2016 (UTC)

Have at it. Put it on the notice boards you like. The more the merrier. 7&6=thirteen () 01:25, 12 May 2016 (UTC)
  • Consensus at the RS noticeboard, so far, seems to be against Permstrump. Also, Perm, please note that Nitschke was never a psychiatrist (please check your facts). And it's fair to say that his Peaceful Pill Handbook, which is much better than Final Exit, is the most comprehensive book on this topic available, making him an expert in this field. As such, his opinion about nitrogen is notable. Ratel (talk) 02:32, 12 May 2016 (UTC)
I don't see consensus on the noticeboard. Alexbrn said, "A self-published newsletter should generally not be used, and especially not to convey scientific/medical information as in the above example (this is more an NPOV/weight issue rather than one of reliability since strictly the source is reliable for what "Nitschke has stated ...") and SJK said, "assuming his opinion is being cited in a due proportion, I don't think it matters whether it comes from a self-published source or not. His opinion is certainly not being cited in due proportion to mainstream medical views (see my comment above). All of the editors who disagreed with me did so based on arguments that are unsupported by WP's policy's and guidelines, such as, Ratel's argument above, "Nitschke is an expert because he wrote the most comprehensive book on this topic available" (no source), after I'd already pinged Ratel in my comment above where I pasted wikipedia's policy on defining an "established expert" when considering if it's ok to include self-published material. PermStrump(talk) 03:05, 12 May 2016 (UTC)
Alexbrn is an involved editor. The uninvolved editors at the noticeboard do not agree with your contentions about the experts Nitschke and Humphry that we use in this article. I will source the statement to Nitschke's book, if you like, because it's there too. And I' about to check your re-instatement of the claim that PN sells bags, because I have not seen it said anywhere else. Ratel (talk) 04:29, 12 May 2016 (UTC)
So, the contention of Nitschke which is controversial here is that there is a lower risk of adverse reaction with suicide by nitrogen asphyxiation than suicide by helium asphyxiation. Thinking about it, I think Nitschke could well be right, since inhalation of helium has a greater risk of gas embolism, which could lead to unpleasant experiences (distinct from those of inert gas asphyxiation). (Apart from the question of side effects, nitrogen is cheaper than helium, and can be easier to acquire.) But, even if Nitschke is wrong here, I don't see what harm is caused by citing the opinion of Nitschke on this issue, so long as it is clearly qualified as his opinion. What harm does it actually do? (I also don't see the relevance of the currency of his medical registration, since the reasons for his problems there are ethical concerns which have nothing to do with his comptence on factual questions like this.) SJK (talk) 08:11, 12 May 2016 (UTC)
SJK, it's difficult to discuss the guidelines governing the content of the article when you keep giving your personal opinion. As wikipedia editors, it doesn't matter when we think. We need to follow the spirit of the policies and guidelines, which specifically say that it doesn't matter what's right or true if it's not stated in reliable sources. The question here isn't what's right or true, the question is, regardless of what's right or true, does including biomedical information from Nitschke qualify for the exception for self-published content per WP:RS#Exceptions and WP:RS/MC (see also WP:SELFPUB and WP:RS#Exceptions. I haven't heard a cogent argument from anyone as to how this statement qualifies as an exception. PermStrump(talk) 16:49, 12 May 2016 (UTC)
I think you are focusing too much on the letter of policies rather than the purpose they are suppose to serve. WP:IAR. The most important question is, does it make the article better or worse to include some point. Policies are just guidelines, not laws, or else WP:IAR wouldn't be a policy. Rather than focusing on the fine print of policies, focus on the quality of the article. SJK (talk) 20:41, 12 May 2016 (UTC)

My comment at wikiproject medicine [4] may help here ... sorry for not presenting this before (getting old, brainfart), could have prevented some of the wikidrama. Ratel (talk) 22:45, 12 May 2016 (UTC)

@Permstrump:, I think you are mistaken in this claim. Firstly, there is a very large body of research into the effects of breathing nitrogen at higher partial pressures, and at the concentrations involved here there are no measurable adverse effects due to the nitrogen, and secondly, this is well known and entirely uncontroversial to both medical and laypersons involved in underwater diving and diving and hyperbaric medicine. Much the same goes for the physiological effects of breathing gases containing helium, but these are somewhat less known to the average diver. • • • Peter (Southwood) (talk): 06:40, 13 May 2016 (UTC)
Pbsouthwood I'm not mistaken in anything, because I haven't made any personal claims. I've quoted sources that I provided citations for though. You'd need to provide sources that disagree with my sources if you want to have a real debate about what content belongs in this article. Wikipedia is not a discussion forum and I honestly don't care about scuba divers. I only brought them up at all to show why another editor's comments about nitrogen in a context unrelated to suicide bags was irrelevant. I'm interested in hearing about independent, reliable sources in peer-reviewed academic literature that talk about potential reactions (or lack their of) to nitrogen asphyxiation with a suicide bag. PermStrump(talk) 08:59, 13 May 2016 (UTC)
Nitschke’s claim that using nitrogen with a suicide bag has no adverse effects is an extraordinary claim (my italics) is what I was referring to. A meta-claim perhaps,but to my mind, still a claim, and one which for which I would like to see your sources, since the evidence I am familiar with suggests otherwise. • • • Peter (Southwood) (talk): 16:37, 13 May 2016 (UTC)
I don't think it's an "extraordinary claim". If he claimed that nitrogen cured cancer, that'd be an extraordinary claim. If the claim is that death by nitrogen asphyxiation is likely quick and painless (to the extent that we can be sure that any particular means of death is quick and painless), that's not extraordinary at all, but generally accepted as true. See Inert gas asphyxiation. SJK (talk) 22:30, 13 May 2016 (UTC)
Peter (Southwood): Extraordinary claims require "multiple high quality sources" (WP's italics) and meta claims are definitively not high quality sources in support of the statement being widely accepted. A meta claim is only more evidence that Ogden/Nitschke made that statement. There's no issue there; we all believe they said it. SJK: Please don't waste our time bringing up sources that aren't explicitly talking about asphyxiation with suicide bags. Read SYNTH if you don't understand why. PermStrump(talk) 04:08, 14 May 2016 (UTC)
@Permstrump: WP:SYNTH isn't an absolute rule – no rule is – see WP:IAR. I don't think it was ever meant to prohibit the kind of obvious inferences involved in "Suicide by nitrogen gas asphyxiation is a form of nitrogen gas asphyxiation; source X says Y about nitrogen gas asphyxiation; therefore, Y applies to suicide by nitrogen gas asphyxiation too". See WP:UIAR which says Both those who wish to enforce a rule and those who wish to break it should explain why they feel doing so is the best course of action. I think WP:SYNTH should be interpreted in a moderate way, in which simple obvious interpretations are allowed; an overly stringent reading of policies like WP:SYNTH (and WP:SELFPUB and others) makes the encyclopaedia worse, especially on topics where the available sourcing isn't as thick as one might like. Per the quoted part of WP:UIAR, you should explain why you think WP:IAR should not be applied to override these rules (or should I say your personal interpretations of them.) SJK (talk) 04:25, 14 May 2016 (UTC)
I have SYNTH articles that disagree with your SYNTH article (see WT:MED#Suicide bags result in quick and painless death — MEDRS or not?). But WP:SYNTH is part of No original research, which is almost as absolute as you can get. You're not going to win this argument, so let's use our time more wisely. PermStrump(talk) 04:56, 14 May 2016 (UTC)
You keep on ignoring WP:IAR. It is just as a valid a Wikipedia policy as any other, and can't be ignored. SJK (talk) 05:03, 14 May 2016 (UTC)
Permstrump, Perhaps I did not make myself clear. I was quoting you. It was you who claimed that Nitschke's claim (that using nitrogen in a suicide bag has no adverse effects) is an extraordinary claim. I, and apparently several others here do not consider it an extraordinary claim as we are all breathing nitrogen at a very similar partial pressure every day as there isn't really any reasonable option. It is about 78% of Air. I assumed you are aware of this. Hundreds of people breathe nitrogen at considerably higher partial pressure every day while diving or working in pressurised environments, even in deep mines. This partial pressure is insufficient to cause discernible nitrogen narcosis, a well documented, painless, and usually mildly euphoric effect with no long term consequences unless you do something stupid while under the influence - the effect is much like nitrous oxide but a lot milder - and there is no problem with decompression sickness at 1 bar partial pressure even from saturation. There are no other physiological effects that I am aware of. If you know of any, I would be very interested to know of them. In my opinion, and probably that of many reputable researchers and practitioners in the field of hyperbaric medicine and physiology, 1 bar partial pressure of nitrogen over a period of less than an hour would have no deleterious effects, either in the short run or in the long run, and would for most people not even be noticeable, even over a longer period. The only adverse effect of breathing pure nitrogen at atmospheric pressure is that you end up dead from hypoxia, which is rather the point here. Cheers, • • • Peter (Southwood) (talk): 16:29, 14 May 2016 (UTC)

Pbsouthwood, you missed my point, which is that we're using low-quality sources to support claims that contradict each other yet people keep arguing that they're both reliable, so much so that we should ignore MEDRS and the rest of the rules all together. PermStrump(talk) 21:43, 20 May 2016 (UTC)

Perm, you did not gain much traction when you pushed this line at RSN, so perhaps time to drop it? Ratel (talk) 21:56, 20 May 2016 (UTC)
I did not miss your point about low quality sources, I was simply not discussing it. What I was discussing is that stating that breathing nitrogen has no adverse affects is not an extraordinary claim. I also mentioned that there is a large body of reputable research covering it if anyone needs to get reliable references. • • • Peter (Southwood) (talk): 05:47, 21 May 2016 (UTC)