Lethal Injection – Not Fit for Dogs
By Jonathan Sheldon
This is adapted from a longer article. Please contact the author at attyjon@comcast.net
if you would like the supporting material for any of the assertions in this article.
Although lethal injection was supposedly a switch to an easier and more humane method of execution the reality is that this method of execution as implemented today is inhumane. The complication rate is in a range hundreds, if not thousands, of times higher than that of medical procedures involving anesthesia. It accounts for a greater average time in the death chamber than did electrocution, hanging, shooting or gas. The cause for these difficulties is mainly that the Department of Corrections (“DOC”) uses drugs inappropriate for lethal injection, they use insufficiently trained executioners and the practice is enveloped in a shroud of secrecy.
The Drugs: Lethal injection is accomplished by the intravenous injection of three drugs. The first, sodium thiopental, is intended to induce anesthesia. The second, pancuronium bromide, paralyzes skeletal muscles and thus will stop breathing. The third, potassium chloride, will cause cardiac arrest and near immediate death.
If performed properly, lethal injection should induce unconsciousness within thirty seconds of the administration of the sodium thiopental and cessation of cardiac function and death is likely in less than one minute following the potassium injection. If performed improperly, however, death will result with awareness of both painful suffocation from the pancuronium and extremely painful burning from the potassium.
Anesthesia awareness is well documented. It results from the lack of efficacy of the anesthesia in combination with the efficacy of the neuromuscular blocking agent: the mind wakes up, but the body is paralyzed. While the patient’s sensory perceptions are intact, the patient is unable to communicate. This occurrence is rare in anesthetic procedures because the patient undergoes monitoring by an expert anesthesiologist with the help of blood pressure and heart rate information (and often a BIS monitor).
The combination of drugs used by DOC in lethal injection is never chosen by doctors in other parts of the world where euthanasia is an accepted practice. For example, the Netherlands averages approximately 2000 cases of euthanasia per year, but no doctor ever has chosen that combination of drugs. Even animals are not subjected to this problematic combination of drugs. In fact, an expert panel of veterinarians has prohibited the use of the lethal injection drugs on animals, and at least 10 states have gone a step further and criminalized its use on animals. Drugs used for euthanasia of animals have been approved by the Food and Drug Administration. Irrationally, however, the drugs used for lethal injection have never been approved for executions and the FDA refuses to address lethal injection. In addition, Abbot Laboratory, the manufacturer of sodium thiopental, has stated that the drug is not approved for lethal injection and that they have “communicated with departments of corrections . . . to request that [it] not be used in capital punishment procedures.”
The Executioners: The standard of care for out-of-hospital anesthesia practice requires that an experienced anesthesiologist monitor the patient with heart rate and blood pressure monitors to determine the induction of anesthesia. In addition, where a “cut-down” procedure is necessary to find a vein suitable for intravenous fluids, the anesthesiologist or a surgeon is required to perform this function – no hospital would ever allow a doctor to delegate this duty to a non-physician. Both of these functions are performed in lethal injection by emergency medical technicians. Whatever training they have in anesthesia is useless, in any event, because once intravenous access has been established the executioner goes behind a curtain and does not monitor the inmate in any way.
The Shroud of Secrecy: During the initial phases of the execution and during complications, DOC hides the procedure and the condemned behind a veil. DOC then uses the chemical veil of a neuromuscular relaxant on the inmate to hide any outward signs he may show that would indicate pain or awareness. DOC also fails to collect any medical data on each lethal injection. Not only is peer review unheard of, but DOC goes to great lengths to ensure that others are unable to critique the protocol. In a recent response to a FOIA request, DOC refused to divulge the medical training of those performing executions, the procedures used in the event that venous access could not be established, and whether a doctor was ever consulted in the creation of its protocol. Amazingly, DOC claims that the answers to these questions would compromise security. It seems clear that DOC’s intent is not to protect the security of executions, but to avoid public accountability as it carries them out.