Based on my understanding of how medicine actually works in the world, I find it highly implausible that such a pair of drugs with truly identical long-term medical outcomes could exist.
If there is truly no difference at all between clinical outcomes, how did they gather the data about one drug inhibiting memory formation via the mechanism of unconsciousness and the other inhibiting memory formation via a presumably different mechanism? If we know that drug A causes anesthesia awareness and drug B does not, how do we know that? There has to have been some observable difference in the drugs’ effects. If there was no observable difference in their effects, the whole thought experiment would not make sense.
Maybe drug A paralyzes everything but the pupils. Maybe drug A lets the patient continue breathing on their own instead of requiring the services of a vent tech. If that’s how we can tell that it’s causing anesthesia awareness, those features of it are likely to be medically relevant in some cases.
Maybe we know patients are conscious under drug A due to a spike in stress hormones measured in the blood or something. If so, that’s likely to impact patient outcomes—we know that stress and immune response and healing all interconnect in complicated ways.
In short, if someone claims to me that two drugs are perfectly identical except one causes anesthesia awareness, I will distrust the whole experiment, because only erroneous or incomplete data would lead to the mutually exclusive claims of “there are important differences between the drugs” and “there are no important differences between the drugs”.
Based on my understanding of how medicine actually works in the world, I find it highly implausible that such a pair of drugs with truly identical long-term medical outcomes could exist.
If there is truly no difference at all between clinical outcomes, how did they gather the data about one drug inhibiting memory formation via the mechanism of unconsciousness and the other inhibiting memory formation via a presumably different mechanism? If we know that drug A causes anesthesia awareness and drug B does not, how do we know that? There has to have been some observable difference in the drugs’ effects. If there was no observable difference in their effects, the whole thought experiment would not make sense.
Maybe drug A paralyzes everything but the pupils. Maybe drug A lets the patient continue breathing on their own instead of requiring the services of a vent tech. If that’s how we can tell that it’s causing anesthesia awareness, those features of it are likely to be medically relevant in some cases.
Maybe we know patients are conscious under drug A due to a spike in stress hormones measured in the blood or something. If so, that’s likely to impact patient outcomes—we know that stress and immune response and healing all interconnect in complicated ways.
In short, if someone claims to me that two drugs are perfectly identical except one causes anesthesia awareness, I will distrust the whole experiment, because only erroneous or incomplete data would lead to the mutually exclusive claims of “there are important differences between the drugs” and “there are no important differences between the drugs”.