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Ah, but I disagree! The "gruesome" part is what changes it; it's an important detail in Pascal's Wager. If it were a sudden, painless death? I'd absolutely press it. If it meant death by being buried alive in a coffin? I wouldn't press it if the odds were 1,000:1, or 10,000:1. The "badness" vs "goodness" factor of each certainly factors into the decision process. The benefit would have to be enormous to outweigh the consequence of a long, terrifying, and/or painful death. Far more than money, for me.
But it if were even 50:1 odds, and the penalty is a sudden and painless death, vs the world being contacted and accepted into Iain Bank's The Culture? Heck yeah, gimme the button. I might take even worse odds.
And yet, I'm human, and humans are terrible at making decisions based on statistical odds; I'm maybe a little better than average for an American, but only because I have a formal process for making decisions like this. But I don't apply it intuitively to every risk, so I'm as bad as anyone else, in general.
Imagine that (hypothetical scenario) MDMA heals 70% of people, doesn't do anything for 10% of people, but throws 20% of people into mental disturbances.
Would you take it?
I don't have any mental illnesses of which I'm aware, but it depends on how bad the illness was if I did. Is it debilitating? Am I regularly having suicide ideation? Am I miserable all the time because of my depression? Is it running my marriage, my friendships? Yeah, I'd take it. 20% is pretty high odds, but if I'm so I'll I'm considering suicide already, 70% of being cured sounds good. Wouldn't you?
Is my illness such that I have sad days a couple of times a month? But 20% chance of getting a permanent psychosis? Probably not worth the risk.
If the perceived goodness value * % chance good outcome is greater than the perceived badness value * % chance of a bad outcome, then "Yes." That's the basis of Pascal's Wager, and it's a good a decision process as any I know.
Oh, heck... if I'm honest, I'd probably take MDMA recreationally at least once just to see what it's like, if it were legal and available.