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In my world, a doctor needs a reliable way to kill a human quickly and painlessly. The original concept on how to do this involved the use a long spike extending into each side of the head and piercing through the brain stem, ensuring clinical death. The problem here is that the process used must ensure the patient either ceases all functions immediately, ensuring no pain, or gets put into a state in which they will not feel anything. One issue with this method is whether it'd be truly effective in such a short time span, as there are enough cases of brain damage in which the patient was able to survive and even live a normal life after incredible damages caused to their brains (even if the brain stem is recognized as incredibly important for survival).

Given this, is the use of spikes through the brain stem (or an alternative that involves severing its connection from the spine) a "reliable" enough option to ensure a relatively quick and painless way to go? Is there a better way to ensure a peaceful departure? I'd rather limit the use of chemicals to cause the departure as much as possible, since, as it's been discovered not too long ago through research made on the chemicals used in executions in the US, chemicals can potentially fail and result in something that only looks like a peaceful end. The spikes have more than enough capacity to penetrate the skull and have the diameter of an average pencil at the widest side. They also have pinpoint accuracy, as the doctor himself is a machine.

Note: the reason for this execution and its nature as quick and painless is due to the organic body also being seen as a patient by the doctor, meaning he desires to end their existence in a way that's quick to perform and (preferably) gives little to no time for the patient to perceive or rationalize their incoming end.

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    $\begingroup$ Doctor Joseph-Ignace Guillotin says that severing the connection of the brain with the spine is most definitely an absolutely certain and quick way to end a person's existence in this valley of sorrows. $\endgroup$
    – AlexP
    Dec 22 '20 at 17:23
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    $\begingroup$ I edited your question a lot. You can restore if you wish, but your backstory was obscuring the question. My experience with WB is that a horter questions focused on your problem get better answers. My goal is to get you the most people reading and answering your question so you get good results. $\endgroup$
    – SRM
    Dec 23 '20 at 2:54
  • $\begingroup$ Piercing the brainstem is a tricky job! It is relatively well armored and hidden away. Traditionally we just sever the spinal cord that leads from it, either by handing or guillotine. Much easier to mass-produce! $\endgroup$
    – PcMan
    Dec 23 '20 at 6:19
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    $\begingroup$ @john Firing squad is not 100% effective, at least that is what Wenseslao Moguel says. ripleys.com/weird-news/survived-execution $\endgroup$
    – PcMan
    Jan 22 at 10:17
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    $\begingroup$ Decapitation is not an instant death by any means, and many guillotine victims took upwards of 30 seconds to lose consciousness. If you want to end consciousness immediately, you need to rapidly and quickly destroy the thalamus. Simply cutting the brainstem isn't going to do it. $\endgroup$
    – stix
    Apr 16 at 18:03
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There's a historical device that was frequently used to bring about a patient's end of life by disconnecting the brainstem from the rest of the spinal column, it was called a guillotine.

While not a perfect 1 to 1, you should begin to see some of the similarities between your execution machine and Terror of the French Revolution.

Even if your metal spike is more concealed than a massive hanging blade, surely being strapped into the contraption that is used to end people's life will come with some... minor stresses.

Might I suggest a much more reasonable, humane, and cleaner approach?

Nitrogen asphyxiation.

Nitrogen suffocation is peaceful and painless. The patients are not aware that they are suffocating thanks to a quirk of our biology that we can't detect a lack of oxygen in our blood, only a build up of CO2.

A patient could be administered a face mask delivering Nitrogen gas, and would slip into a euphoria before falling asleep and never waking up again.

Then if you need to make sure they don't wake back up, go ahead and destroy the brainstem or do what ever other procedure you need to carry out.

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    $\begingroup$ Downvote because helium is much funnier, and this grim business of killing needs some leavening with levity. $\endgroup$
    – Willk
    Apr 17 at 19:23
  • $\begingroup$ @Willk Nah Nitrogen is freely available in the atmosphere and Helium is a limited resource. The induced euphoria should still yield some humorous quips as they slip away though. $\endgroup$
    – abestrange
    Apr 19 at 17:01
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Use a Killing Rod

While piercing the brain stem alone may prevent signals from getting between the brain and body, the rest of the victim's brain will still function for several seconds, if not minutes, able to experience the pain and fear of death, just without being able to let anyone around know it.

That said, the livestock industry has already figured out a better solution. Instead of a sharp spike, they use a very blunt rod accelerated with great force. The reason this is more humane than a spike is that is sends a shockwave through the whole brain, not just the targeted area. This shockwave immediately renders the whole brain unconscientious while simultaneously delivering enough localized trauma to result in a rapid death.

The only solutions that would be more full proof would involve annihilating the head through crushing or blowing it up as other answers have suggested, but there are other humanitarian reasons not to choose these form of execution. If your executioner is empathetic enough to care about if his victim will suffer, then watching his victim's head explode will be particularly traumatizing, as will the clean up there after. Then there is also the psychological trauma you inflict on the kin and loved ones of the victim. By completely destroying the head, then you eliminate the option for open casket funeral rites and you traumatise any other witnesses to the execution too; so, destroying the head may save the victim a little bit of physical pain, but causes a lot of extra emotional pain for many other innocent people which could stick with them for a lifetime.

enter image description here

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Might I suggest crushing?

Whatever method that destroys the brain quicker than it can react is, per definition, painless. This is also way cheaper than the explosives suggested by @JacksonDunn .

A cubic meter of solid metal should weigh enough; just drop it from enough height that the time it takes to traverse the skull is small. You need well under a meter of fall to take destruction time below 0.01 seconds.

How much to crush is a matter of taste. Putting the whole body under the sledge might, perhaps paradoxically, be less gruesome than just crushing the head.

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Piercing the brain stem as a painless way to go, a reliable method?

No it isn't. Not with spikes. There will be some pain and it isn't guaranteed to be fatal.

  1. Putting a spike through someone's flesh before it hits the brainstem will cause moments of pain.

  2. The brainstem is not a single point. It is quite large. Where exactly are you going to strike?

  3. Quote

Massive brainstem injuries, such as extensive infarctions or barbiturate overdoses, cause coma, but otherwise brainstem injuries do not impair cognition https://www.tbi.org/seizures/what-is-brain-stem-injury.html

In other words, there is a good chance you will leave them still alive and able to understand their predicament. This will cause mental and physical pain.


The brainstem is quite large - see red portion of diagram enter image description here


There are other better ways

  1. Carbon monoxide poisoning.
  2. Overdose of opiates.
  3. For a quick flash of pain with certain death - the guillotine
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  • $\begingroup$ The "red diagram" of your picture includes the thalamus, which is not generally considered a part of the brainstem. $\endgroup$
    – stix
    Apr 16 at 18:04
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It ends with a bang

In line with your time period, there was both incredible finesse at the time (in art and literature) coupled with incredible brutality in war, with the guns and gunpowder becoming commonplace, but ineffective and dangerous, and medical science being still quite archaic. With this in mind, there is no reason to have an "elegant" solution; if the person now has been completely transferred to the machine, the body can be disposed of much like any garbage of the day, in a crude but effective manner. An implanted (or a room filled with) explosive will be more effective and just as instantaneous as any spike. While a spike might well work (and usually such severing would be fatal), not all humans have identical placement- think of doctors missing veins in today's world -so without pinpoint vision coupled with the doctor's pinpoint accuracy, instant death could not be assured. If the doctor needs the patient to positively have no pain, have the doctor prepare a tincture of poppies rich in opium, or purified opium if it fits your story, to sedate the patient before the explosion.

Edited to add: If opium exists in your timeline, can an overdose or a continuous IV be used?

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  • $\begingroup$ I'll echo this. The only truly painless way to kill is to destroy the brain faster than the pain sensation will reach it. Shockwave from an explosive device placed at your temple ensures that and leaves no room for accidentally remaining alive. $\endgroup$ Apr 16 at 18:31
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Oddly enough, you probably want to look into how we slaughter animals. After all, a mammal is a mammal; if it works on cows or pigs, it will probably work (perhaps with minor adaptations for anatomy) on humans.

Several options are available:

CO₂ (or other gasses)

The basic idea is to subject the victim to enough of something unbreathable so that they pass out. If you can get them into a sealed room without tipping your hat, you're good to go.

Other gasses you might use are carbon monoxide, nitrogen, or nitrous oxide.

Exsanguination

Removing your victim's blood is considered acceptable for animal slaughter and is thought to be painless. Very slow unless you can tap a major vessel, and not exactly subtle, although if you can get the victim to relax first, may be feasible. Try offering them a massage (face down) and ensuring that their eyes are closed. In theory, if you slit their neck with a sufficiently sharp blade, they won't even notice the cut. (If you've ever cut yourself shaving and not noticed right away, you'll know this is less implausible than it sounds.) Alternatively, maybe you can find some excuse to use a topical analgesic.

Captive bolt pistol

This device basically causes an instant concussion resulting in unconsciousness. Once the victim is unconscious, you can use your choice of methods to finish the job, or you can use one of the versions that does both. (Note that this is the same device as in Nosajimiki's answer, which goes into more detail.)

Electrical

There are also ways to stun using electricity, but I'm less sure they're painless, and this seems more awkward than the alternatives.

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    $\begingroup$ If you have ever been out of air, for instance been held under water, you know that it's an extremely distressing experience. Look up some footage of pigs being asphyxiated with CO2, they spend their last half minute or so screaming and climbing over each other, desperately trying to get away. Over all, the way animals are treated is not good inspiration for humane ways to treat humans. $\endgroup$
    – EdvinW
    Apr 16 at 20:03
  • $\begingroup$ @EdvinW, yeah, I wondered about CO₂. The problem is that you know when you have too much CO₂. As I understand it, you don't know when you don't have enough O₂, so I'd expect carbon monoxide or nitrogen would work better. I have doubts about electrical stunning for the same reason, but exsanguination is based on religious slaughter practices that do actually care about the animal's welfare. $\endgroup$
    – Matthew
    Apr 17 at 12:29
  • $\begingroup$ @Matthew My understanding is that CO at high levels isn't too nice a way to go. $\endgroup$ Apr 18 at 3:39
  • $\begingroup$ @Matthew There are some very unpleasant videos online of exsanguination used for slaughter that I highly recommend you don't look up. It is probably the least humane slaughter practice used today. The ancient Hebrews did not exsanguinate out of compassion, they did it because blood was considered "unclean". AKA: to avoid blood borne illnesses. Also, asphyxiating gases cause death because lack of O₂ creates CO₂ build-up in your system; so, they all have the same symptoms as CO₂ toxicity, because that is how asphyxiation kills. Some gases just also have narcotic effects to ease the suffering. $\endgroup$
    – Nosajimiki
    Apr 18 at 4:44
  • $\begingroup$ @Nosajimiki, I'd be surprised if there aren't many, many places using blades that are not sharp enough. Or doing it just plan wrong. From this article: "shechita is performed correctly when a shochet severs the animal’s carotid arteries with a knife that is surgically sharp and without imperfection, causing the animal to lose consciousness instantly" (emphasis added). (con't...) $\endgroup$
    – Matthew
    Apr 18 at 13:04
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Rapidly Destroy the Thalamus

Simply destroying the brainstem is not enough. Experiments during the Reign of Terror with guillotine victims shows that a decapitated person can remain conscious for up to 30 seconds, even capable of responding to their name being called out.

You need a way to effectively end consciousness as rapidly and immediately as possible. Enter the thalamus.

The thalamus has often been referred to as the "hub" or "switchboard" of the brain. All of your senses save smell must pass through the thalamus before being interpreted by the higher cortex. The thalamus is also associated with regulating wakefulness and consciousness.

But neurologists have a suspicion that the thalamus is much more than a simple hub. It is very likely that the thalamus is, itself, the part of the brain that is "conscious" in the sense that it is the part of the brain that experiences qualia.

EEGs have shown that when the thalamus is inactive, the cerebral cortex enters a "standby" state, waiting for input from the thalamus. This is seen in experiments that selectively shut down the thalamus and in comatose stroke victims whose cortex is intact, but whose thalamus is not.

In addition, the experience of users of the drug ketamine lends credence to the "thalamus is the part of the brain that is conscious" view, specifically the experience of a "k-hole," in which users describe the bizarre and paradoxical sensation of being conscious of "nothing."

In it, they can hear nothing, see nothing, feel nothing, remember nothing, think nothing, but yet are somehow still aware they exist.

EEGs from experiments in sheep have shown that the k-hole state is one in which the cortex is shut down, but the thalamus is quite active.

Similarly, there is the fact that even brain damage which destroys large portions of the cortex does not result in coma, but a relatively small amount of damage to the thalamus does.

This leads to the very intriguing idea that the cortex, despite being the newest and most advanced part of the mammalian brain, is not itself "conscious," and instead merely processes information for the thalamus, which is the part of the brain that actually "experiences" the sensations. In this theory, the thalamus receives input from the senses, sends it to the cortex, which then interprets the data and sends it back to the thalamus as sensations. It is these "thalamo-cortical loops" that are the basis of the human mind.

So long story short, if you want to rapidly end consciousness, the best way to do that is to rapidly end the part of the brain experiencing the consciousness.

Unfortunately, that is easier said than done. The thalamus is at the direct center of the brain, about as deep into the skull as you can get.

There are a number of ways you could do it. The most obvious is the rapid pneumatic rod that others have mentioned. You just have to ensure that it hits directly into the thalamus.

Another, shall we say "less invasive," method would be to use microwaves, or perhaps even high energy gamma rays, to destroy the tissue in the thalamus.

There is a procedure for non-invasive operation on brain tumors called the Gamma knife. In it, multiple very narrow gamma ray beams are made to intersect on a specific point inside the brain (presumably the tumor). Any single gamma ray itself does not carry enough energy to harm the tissue, but the point where the beams overlap experiences a tremendous amount of ionizing radiation.

In theory, you could do the same thing with RF or microwaves, but given gamma rays have much more energy and a much shorter wavelength, they can be formed into a much smaller knife, allowing for fine, delicate ablation to very small areas, which will spare surrounding healthy tissue.

However, in your case, that doesn't matter, since the point of the exercise is to end the patient, so you could build a device much cheaper and simpler using RF and/or microwaves.

The overlapping microwaves could be triangulated on the thalamus, and as they heat it up, the cells would rapidly die, leading to loss of consciousness.

Rather disturbingly, it appears this technology already exists in our world and has been used against humans. A few years ago, after the US reopened relations with Cuba, many US diplomats were suddenly stricken with traumatic brain injury after being exposed to some kind of device in their rooms.

An investigation showed that they were most likely the victims of some kind of attack with a device that exposed them to high energy microwaves. The microwaves caused heating of their brains, which in turn lead to the damage.

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Simple answer is no; however the doctor could use a captive bolt to drive a rod through the temple while aiming towards the bottom of the opposite ear and that should do the job. If you really want to make sure that euthanasia was successful, you could have the doctor shove a wire through the recently made hole to mash up the midbrain. This is what happens in the real world when you captive bolt pigs that you aren't exsanguinating so it should be a suitable strategy for the double tap. A bit messy though.....

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