INFORMED CONSENT IS A HUMAN RIGHT
BY GOLLY… I DID IT!
I did real, university-supervised psychological research!
I also got fucking statistically significant results!
Swish!!!
The whole dang year-long study came to be because doctors told my wife to take a daily Aspirin and neglected to mention the negative impacts.
During my wife’s pregnancy, she consistently showed high blood pressure. Therefore, the risk of preeclampsia was legit. Preeclampsia can freakin’ k-i-l-l. The prescription was straightforward: low-dose Aspirin every day. It works! Even by my layman's understanding: Aspirin dilates blood vessels, causing blood pressure to drop, and thus my precious-es would be safe.
A little cost/benefit analysis: Living family with ruined gut microbiome V.S. … “the alternative” = LE DUH!!!
I would encourage my wife to take that damn daily pill 172158343923 / 172158343923.
Buuuuuuut, there is nuance to be had.
I was in a psychology program at the time that this was going down. In class, we discussed how prolonged Aspirin use disrupts the protective chemistry of the gut microbiome. We talkin’ ulcers. Straight up stomach bleeding risk. And yo, gut health is downstream of almost everything wellness:
Homeostasis = Happy Gut.
Oh! Also, my wife’s microbiome was in the process of being passed down to my unborn child… meaning my little would be born behind a gut 8-ball.
So… like… why didn’t any doctors at our numerous appointments regarding preeclampsia mention this??? These medical professionals JUST gave the benefit of their plan and withheld the trade-off. Even more odd still, a simple offset in the form of probiotics exists…
These medical professionals failed to provide a precious teachable moment:
EVERYTHING HAS A TRADE-OFF
Listen to your elders!
A FAILURE OF INFORMED CONSENT
I ain’t yellin’ about the evidence… I’m yelling about my hemorrhoids.
Informed consent means YOU, the owner of the body that will be impacted, receive the entire relevant picture before YOU give the thumbs up. Call me crazy… me thinks this concept is extra important when YOU are being asked to ingest… or inject… something into YOUR body.
My wife was presented with a version of information distribution optimized for compliance.
That’s bullshit.
WE ALL deserve the whole story. In fact, I think it should be an established human right.
Therefore, this life experience lit a fire under my ass! I had experienced injustice, like so many others have previously and will going forward… so I was inspired to act and attempt to make a difference in this world! BUT, before doing my usual screaming into the internet void, I decided to explore. I chose to spend years procuring this thing called “evidence” (weird!) to actually prove whether people actually care about actual informed consent.
And NOW, I shall scream into the void (with evidence):
MY RESEARCH DESIGN (THE SCIENCEY PART)
I designed a between-subjects quasi-experiment in the form of a survey where participants were presented with a series of progressively invasive government-imposed health interventions.
The first three interventions are real in some jurisdictions (aka, where I live, Canada):
Vitamin D in milk
Iodine in salt
Fluoride in public water supplies
The last three interventions were COMPLETELY MADE UP! *FAKE*! Created to be deliberately extreme:
Nicotine in toothpaste*
Sunscreen in apples (by way of antioxidants)*
Microchips in vaccines*
Experiments, by design, require manipulation, so two versions of the survey were created:
VERSION A: Presented the public health interventions with POSITIVE FRAMING
Health benefits only
VERSION B: Presented the public health interventions with FULL DISCLOSURE FRAMING
Health benefits and downsides together
All introduced attributes of the interventions, both positive and negative, were backed by cited, peer-reviewed scientific papers.
Different kind of framing, Ron.
The variables were operationalized by focusing on the CONSENT THRESHOLD. This metric was established by giving participants the option to either state:
I CONSENT
I DO NOT CONSENT
to each of the government health interventions. The survey terminated the first time “I DO NOT CONSENT” was selected. Therefore, a participant could experience anywhere between 1 and 6 of the interventions, depending on their willingness to consent. The average percentage completed by participants across each version of the survey became the Consent Threshold.
MY RESEARCH RESULTS (THE STILL SCIENCEY PART)
The two surveys were distributed, with a total of 276 participants completing them (N = 276).
VERSION A (Positive Framing) = 31.7%
VERSION B (Full Disclosure) = 41.7%
* The chance that these results were gathered at random (false positive) = 0.2% (p = .002)
The results are in: I clearly don’t know where my watch is!
My study suggests that when the general population is presented with information that has a strictly positive skew, people are 10% more likely to consent to government-imposed health interventions.
That finding is not surprising. It is also not trivial…
The spooky part: institutions already know this! Doctors know it (they smart). Governments know it (they… kinda smart). Therefore, when the goal is maximum uptake at population scale, positive framing gives the powers that be a little “oomph” for compliance.
On the positive side for us, the plebs, this tactic reduces decision fatigue. AND in a genuine crisis, it can save lives in the short term.
We have to acknowledge the nuance on all sides.
But ya… we have a number: 10%
THE COMMERCIALS THAT MADE THE COVID-19 VACCINE A “HELL NO”
For copyright purposes: Spidey-cents.
My Spidey-senses were on high for our pre-eclampsia situation because years earlier, during the height of the COVID-19 vaccine rollout, a flashbulb life moment went down for me:
I was a good soldier when it came to COVID-19 protocols! I diligently social-distanced, I always wore a mask, I even quarantined for 8 weeks of my life. I was happy to play my part in saving my community! Then the vaccines rolled out… And (I’m shocked I can admit this now), I was on the fence! *GASP* I’m human; I was scared of the pathogen. I also wanted to help others! BUUUUUUT this stuff rolled out really quickly, and I was being asked to inject it into my body… multiple times!
Given our siloed media, I knew I had to do my own digging. I deep-dived: I read medical literature, I spoke to friends who were fans and friends who were skeptics, I listened to podcasts on both political sides. Plus, I was living in the vastness of rural Nova Scotia, so I had time to think.
I went DEEP, above my intelligence pay grade… That felt good in and of itself.
Then two commercials played back-to-back:
- FIRST: A classic pharmaceutical ad
You know those hilarious ones… Happy people in a field, playfully shoving each other as a random guitar appears for an “impromptu" singalong. Then, and you can set your watch to this, the rapid-fire list of side effects:
“May cause fatigue / leaky anus / DEATH!!!”
By the way, I looked into it… ONE. One reported death from the use of a pharmaceutical drug is enough to trigger disclosure under FDA rules.
I have always been grateful those warnings exist… I bet you are too.
- SECOND: The very next commercial was the Government of Canada
My people’s governing body spoke directly to us, asking for all to be a good Canadian and go get the COVID-19 vaccine. Which by the way, is fine! They, or whoever else buys airtime, are welcome to push any wares they’d like!
I approve!
Then the commercial just ended. Dead air. Where are the side effects?
I do NOT approve!
Government of Canada, your double standard made my VERY tough decision easy.
What must we take away from this?
- A private company is required, by law, to tell you that its product might kill you.
- The governing body that polices these private companies… they ain’t gotta tell you shit.
Fuck that.
REALITY FROM THE MOUTH OF THE MANIPULATOR
Right now, the Canadian government’s website lists over40,000 non-serious adverse events and over 10,000 serious adverse events to the COVID-19 vaccine. That same awesome government webpage also officially lists 24 possible side effects from the COVID-19 vaccine…
Yet, at the moment of my big decision, the public messaging contained exactly ZERO mention of any of this.
I am willing to grant the most charitable take on this: Probability. Public health officials believed the benefits dramatically outweighed the risks and that a higher uptake would save more lives overall. Therefore, they broke the very rules they enforce by solely presenting the positive outcomes of the COVID-19 vaccine.
REMEMBER: My data suggests that their use of positive framing moved the needle by 10%. Canada’s population is over 40 million… Good intentions or not, more than 3.5 million people were tricked into injecting themselves with something they wouldn’t have normally… but, broader strokes:
WE WERE ALL MANIPULATED!!!
THE MECHANIC AND THE MISSED OPPORTUNITY
I’m a middle-aged man, so I can confirm one of the truest clichés of life: We all search for a good mechanic.
Yeah… I want them to be able to fix my car, but honestly, that’s the expected bare minimum. What I really want is for them to be honest with me. I don’t understand the magic they are performing! I am vulnerable, so I want the trusted mechanic who uses honest full disclosure: They tell you what is ACTUALLY wrong, a fair price, and how much tread is realistically left on your jalopy.
An honest mechanic is as good as gold, and when you pass their contact on to a loved one… well, there’s no greater bonding experience.
Unfortunately, the antithesis also exists. The dishonest mechanic sells you the service that maximizes their invoice… Service your ride doesn’t need, insane markups, calling you back earlier than you need… after all, the average customer (me) is none-the-wiser.
Governments and medical systems that rely solely on positive information framing are choosing something analogous to the second model. Yes, they may win in the short term with their higher compliance (unfairly high invoices); HOWEVER, they erode communal trust to get it… which results in the people talking amongst themselves. The back-ass-wards part of this strategy: once that trust is gone, every future recommendation becomes harder.
“Ummmm… No, I will not replace my discombobulation level gauge accelerometer for the 6th consecutive visit to your garage!”
For trust, I go with left... for eating off the floor, I go with right.
Then there’s the people like me: previously a staunch government truster, who become permanently, foreverly skeptical.
Ya lost me, gov. That makes me sad. I liked what we had going.
Yes, I am but one; however, zoom out to the positive side of governmental use of full disclosure, and it is not a small side effect! A population that trusts its institutions is more prosperous, more cooperative, and more resilient. In contrast, a population that feels managed (or more accurately, infantilized) rather than informed (treated like adults) becomes harder to lead when the next real crisis arrives.
WHAT WE DESERVE
The alternative is not complicated:
- Here is what we know.
- Here is what we do not know.
- Here are the benefits.
- Here are the risks.
- Your body, your choice. We are here if you need us.
That there move… it treats adults like adults. Yeah, it is slower. YES, it produces lower short-term compliance…
BUT
It would also cast our government in a light similar to a mechanic we can trust… one to whom you could send your mom.
The highest honour.
TWIST AND SHOUT
How are we supposed to avoid smoking when it looks THAT cool‽
Eeeeeeeeee, what’s that‽ Oh geez… a complication that I HAVE to own.
Embarrassing.
The Canadian government not only requires cigarette manufacturers to disclose the negative outcomes of their product; they even demand that these companies paste extremely graphic images of disease on the packages.
Pure, hardcore NEGATIVE FRAMING.
BUUUUUUUUUUT(t). The biggest but(t). Yo mama’s but(t).
I’ve been talking a big game, being all absolutist when it comes to informed consent by way of full disclosure… sooooo then consistency would demand that those Canadian cigarette packages also mention that nicotine is a cognitive enhancer.
Hold up. I do NOT actually want that.
*GASP!*
The cost/benefit of smoking is so lopsided that I am comfortable with heavy negative framing for the good of my people. I still want the liberty of peeps being able to buy them… but I don’t think we should be giving these cancer sticks any props!
I think most would agree: Incentivizing cigarettes isn’t a good idea.
Well… well… well… pure principle runs into real-world nuance.
FRAMING. IS. A. TOOL!
And what uses tools?
HUMANS! It’s what separates us from the beasts!!
Therefore, we need to diligently examine how the humans involved in any issue use said tool. Furthermore, the ethical use of the framing tool is not identical across every domain. Don’t get it twisted: the existence of nuance does not erase my core claim, informed consent = preferred path… however, it does mean that we have to keep on thinking case by case, including considering the people (and incentives) attached to every side of every situation.
Ron found his voice!!!
THE TWIST’S TWIST
By admitting to the points above regarding being pro-negatively framing cigarettes, as well as situational nuance… I just kinda sorta ruined my entire research project.
I lost some of you… BUT you trust me a little more, don’t cha?
So, I’ll catch ya on the next one.
I’m okay with that.
WHAT’S IN YOUR POWER
Ask questions.
The next time a clinician or an official recommends an intervention, ask the obvious questions:
What are the benefits?
What are the risks?
What are the unknowns?
What are the downstream impacts?
Are there alternatives?
We ain’t talkin’ about becoming a dang conspiracy theorist!
You only have to refuse to be managed like a child, and instead, demand autonomy like an adult.
Good clinicians will respect your questions, and government folks will want to stoke personal liberty by hearing you out! Plus, it’s fun to be challenged at your job! The docs and officials who get their backs up at the idea of telling you something useful will say a lot about how they see your role in your decision… ABOUT YOUR FUCKING LIFE!
Informed consent is NOT a bureaucratic hoop.
It IS the minimum respect owed to a free person.
THE COOLEST PART. PERIOD.
I had major beef with a major crisis that occurred in this major world, but instead of jumping on my internet soapbox (which is so fun)… I put in the WORK. I was generative. I gathered evidence to support my claim.
Kaboom.
No, I don’t expect anyone to spend years researching and then write a supervised scientific paper about every single idea they have…
Luckily, the concept shrinks.
Fight for your right to make informed choices.
My next beef leading to a research study: I fucking hate hangnails!
Fin.