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Induction Eligibility and Contraindication Screen

Eligibility review — instantiates Reopened Malleability Window

Decides whether it is justified to reopen this particular system at all — checking mechanism fit, interacting risks, authorization, and consent before any trigger is applied.

Certifying that a window is closed says only that reopening is possible — not that it is warranted for this specific case. Induction Eligibility and Contraindication Screen is the go/no-go gate that decides whether this system or participant should be reopened at all: it confirms that the proposed trigger's mechanism actually fits the case, screens for interacting conditions that would make destabilization dangerous, and secures informed authorization for a deliberately hazardous intermediate state. Its distinguishing move is that it can return not eligible on grounds that have nothing to do with whether the reopening would technically work — a contraindication or a failure of genuine consent halts the protocol even for an ideal candidate.

Example

A clinic is evaluating a patient for a reconsolidation-based treatment intended to loosen and rewrite a stabilized traumatic memory. Before any session is scheduled, the screen runs. It checks mechanism fit — is this a consolidated, reactivatable memory of the kind the trigger is modeled to destabilize, or a chronic mood condition the mechanism was never meant to touch? It checks contraindications — active psychosis, certain medications, a dissociative pattern that makes a labile, suggestible state unsafe. It checks authorization and consent — does the patient understand that the procedure deliberately renders a settled memory temporarily editable, with real risk of distortion or worsening, and are they choosing it freely rather than under pressure? A single hard contraindication returns not eligible regardless of how promising the case looks, and the patient is routed to an ordinary-care path instead of an induced-lability one.

How it works

The screen is a conjunctive gate — every arm must pass, and any one can veto:

  • Mechanism-fit check — confirm the case is the kind the trigger's model applies to, not a superficially similar condition the induction would not actually reach.
  • Contraindication screen — enumerate interacting states, exposures, and comorbidities that turn a bounded labile interval into a broad hazard, and treat any hard hit as disqualifying.
  • Consent and authorization — establish that the responsible party genuinely understands the hazardous-intermediate framing and is authorizing it freely, and that rescue and stop provisions are in place before eligibility is granted.

Tuning parameters

  • Contraindication strictness — how disqualifying a borderline risk is. Stricter protects the marginal participant but excludes people who might have benefited.
  • Consent depth — how much of the hazard is disclosed and tested for comprehension. Deeper consent is more honest but can deter, and over-disclosure can itself distress.
  • Eligibility breadth — how tightly "the kind of case this fits" is drawn. A wide gate admits more candidates and more off-mechanism failures; a narrow one is safer but slower to accrue.
  • Re-screen cadence — whether eligibility is a one-time clearance or re-checked as the case evolves between screening and induction.

When it helps, and when it misleads

Its strength is that it puts a human-judgment veto upstream of a physically hazardous act, catching the cases where reopening is feasible but wrong — the wrong mechanism, a dangerous interaction, a consent that isn't real. It keeps the pattern from treating "the trigger would work" as sufficient license.

Its failure modes are the quiet ones. An over-broad gate lets off-mechanism cases through, so the induction destabilizes something the trigger was never modeled to reach. Consent can be nominal rather than real — a therapeutic misconception in which the participant hears a hazardous experiment as ordinary care.[1] And the gate is easily run backwards, relaxed case-by-case to admit a candidate the operator already wants to treat. The discipline is to fix the criteria before the candidate is in front of you, and to keep the stop-and-consent authority independent of whoever is eager to perform the induction.

How it implements the components

The screen realizes the archetype's authorization gate — the one component that governs whether induction may begin:

  • eligibility_contraindication_and_consent_gate — its entire function: the conjunctive check of mechanism fit, contraindications, and free informed authorization that must clear before any trigger is applied.

It does NOT certify that the system is closed (Closed-State Capacity Challenge Panel), model or dose the trigger (Trigger-Specificity and Dose-Escalation Trial), or hold the in-session stop authority (Adaptive Stop, Reclosure, and Rescue Protocol) — it only decides whether this case may enter the protocol at all.

References

[1] The therapeutic misconception — a participant's tendency to believe a risky, investigational procedure is individualized treatment chosen for their benefit. Naming and testing for it is the standard corrective in consent for experimental interventions, which is why the consent arm tests comprehension rather than assuming it. ↩