Lethal Injection Can Be a Slow, Painful Death

[Each Hit]

here's a real shocker: the dosage matters when you're giving lethal injections

http://www.cnn.com/2007/HEALTH/04/23....ap/index.html

Executed in U.S. may be awake as they suffocate
POSTED: 9:33 p.m. EDT, April 23, 2007

(AP) -- The drugs used to execute prisoners in the United States sometimes fail to work as planned, causing slow and painful deaths that probably violate constitutional bans on cruel and unusual punishment, a new medical review of dozens of executions concludes.

Even when administered properly, the three-drug lethal injection method appears to have caused some inmates to suffocate while they were conscious and unable to move, instead of having their hearts stopped while they were sedated, scientists said in a report published Monday by the online journal PLoS Medicine.

No scientific groups have ever validated that lethal injection is humane, the authors write. Medical ethics bar doctors and other health professionals from taking part in executions.

The study concluded that the typical "one-size-fits-all" doses of anesthetic do not take into account an inmate's weight and other key factors. Some inmates got too little, and in some cases, the anesthetic wore off before the execution was complete, the authors found.

"You wouldn't be able to use this protocol to kill a pig at the University of Miami" without more proof that it worked as intended, said Teresa Zimmers, a biologist there who led the study.

The journal's editors call for abolishing the death penalty, writing: "There is no humane way of forcibly killing someone."

Lethal injection has been adopted by 37 states as a cheaper and more humane alternative to electrocution, gas chambers and other execution methods.

But 11 states have suspended its use after opponents alleged it is ineffective and cruel. The issue came to a head last year in California, when a federal judge ordered that doctors assist in killing Michael Morales, convicted of raping and murdering a teenage girl. Doctors refused, and legal arguments continue in the case.
More than 2,000 executions

In 2005 alone, at least 2,148 people have been killed by lethal injection in 22 countries, especially China, where fleets of mobile execution vans are used, the editors write, citing Amnesty International figures. Of the 53 executions in the United States in 2006, all but one were by lethal injection.

The new review was written by many of the same authors who touched off controversy when they published a 2005 report suggesting that many inmates were conscious and possibly suffering when the last of the drugs was given.

That report was criticized for its methodology, which relied on blood samples taken from prisoners hours after executions.

The new paper looked at the executions of 40 prisoners in North Carolina since 1984 and about a dozen in California, plus incomplete information from Florida and Virginia. The authors analyzed details such as the dose the inmates received, their weight and the time they needed to die.

Most states use three drugs -- thiopental, an anesthetic; pancuronium bromide, a nerve blocker and muscle paralyzer; and potassium chloride, a drug to stop the heart. Each is supposed to be capable of killing all by itself, but if not, the anesthetic is supposed to render the inmate unconscious while the other drugs do the job.

In 33 North Carolina executions, the average death time was 10 to 14 minutes, depending on the combination of drugs used, the authors report. Calculating each inmate's actual dose, based on his or her weight, they concluded that some did not receive enough.

"The person would feel either asphyxiation or the burning sensation associated with the potassium," said Dr. Leonidas Koniaris, a surgeon and co-author at the University of Miami. "The potassium would cause extreme discomfort, something like being put on fire."

Even the final drug did not always prove fatal as intended. At least one California inmate required a second dose, and the California warden has said additional doses were used in two other executions, the study reports.

Death penalty proponents complained the report's conclusions were based on scant scientific evidence.

"It's more like political science than medical science," said Mike Rushford, president of Criminal Justice Legal Foundation in Sacramento.

Steve Stewart, prosecuting attorney in Clark County, Indiana, where an execution is scheduled for May 4, said the simple solution seemed to be to give a higher dose of the anesthetic, which probably would not satisfy opponents who see all methods as barbaric.

"It doesn't matter a whole lot to me that someone may have felt some pain before they were administered poison as a method of execution," he said.

Dr. Mark Heath, an anesthesiologist at Columbia University Medical Center who has studied lethal injection cases, took issue with some of the paper's conclusions, but said it generally showed that concerns about lethal injection in its current form "are well-justified."

Editors said they sent the manuscript to three independent medical experts for review -- an anesthesiologist, a forensic pathologist and someone in charge of a critical care unit, plus a lawyer.

"We were satisfied" with the science, said Dr. Virginia Barbour, a British physician who is managing editor of the journal, published by the nonprofit group Public Library of Science. "The difficulty of a paper like this is that there is very poor evidence for all the kinds of protocols used" in lethal injections, but the authors did a good job analyzing what there is, she said.

Reputation Comments on this post:

Very good article.

[Nagognog2]

We (ACLU) have known this for some time. Like since they began using this method. The prison authorities claim it's a "botched" job because they can't get a doctor to do it. You know - under the Hippocratic Oath every physician must take to be licensed, they swear to "do no harm." So that exonerates a doctor, and the prison staff if they happen to enjoy watching the black man in Texas freak-out as he dies with his eyes open. Who was the governor of that state before he moved on....?

There is plenty of info available if you'd like to try to stop this madness:

http://www.aclu.org/capital/index.html

You want a sick laugh? They always use an alcohol-swab on the arm of the victim - to prevent infection - before inserting the needle. Gotta look "Professional!"

[Nature Boy]

I saw an interesting documentary about this a few days ago. A botched lethal injection is a truly horrific and inhumane way of ending one's life (all capital punishment is I guess, but I won't get into it). It's shocking to see this going on today as if it's all fine and dandy. I'll bet there are plenty of people out there who smile when they think of mass murderers getting their comeuppance with a slow, painful death but it sends a shiver down my spine to think that any government, especially one that considers itself to be the world's role model, practices this in the 21st century. It truly is a cowardly act. I'm not in favour of the death penalty, but if you're going to do something, do it right. The goal is to systematically end a life as quickly and efficiently as possible, not torture someone before doing so.

[Each Hit]

here's another, perhaps better, article. i always wondered how they could deem a method of capital punishment painless, since there's no way to really ask the victim...

http://sciam.com/article.cfm?chanID=...mber=1&catID=1

Bad Drugs: Lethal Injection Does Not Work as Designed
A new study shows that failure to inject proper dosages potentially leads to slow, painful deaths from chemical asphyxiation
By David Biello


Lethal injection was invented in 1977 by Oklahoma state medical examiner Jay Chapman, who, based on his own experiences under anesthesia, concocted the drug cocktail from an ultrashort-acting barbiturate and a chemical paralytic. He added a heart-stopping drug to the mix to provide a painless, quick death with built-in redundancy. If one drug didn't kill the death row inmate, one of the other two would. But dosage is critical to the efficacy of lethal injection according to a new study, which found that if any of the doses are off the recipient not only feels pain, but he or she also must suffer a slow death by the asphyxiation following total paralysis.

Molecular biologist Teresa Zimmers of the University of Miami Miller School of Medicine and colleagues, including a surgeon, an anesthesiologist and a lawyer, analyzed the sparse public records of executions. Only two states provide such records: North Carolina and California, the latter of which was forced to do so by court order. In each of these states, varying dosages of sodium thiopental (a barbiturate to induce anesthesia), pancuronium bromide (a muscle relaxant that paralyzes all the muscles of the body) and potassium chloride (a salt that speeds the heart until it stops) are injected in doses designed to kill condemned inmates. Though the dosages vary by state, they do not vary by inmate—each is given the same amount of the drug whether short or tall, fat or thin.

As a result, death by lethal injection is not necessarily quick or painless, according to the study published in PLoS Medicine. In North Carolina inmates took an average of nine minutes to die (and much longer before flawed drug protocols were changed), and in California cessation of the heartbeat took from two to eight minutes after the last injection of the heart-stopping potassium chloride. "When potassium chloride was added, it didn't seem to change the time of death," Zimmers notes. "This suggests that potassium chloride may not be the agent of death."

In addition, researchers found that the amounts of thiopental used may not be sufficient to render the procedure painless, based on comparisons with veterinary data. In the veterinary realm, government and professional oversight has led to the development of strict dosage guidelines for the appropriate painless killing of animals. The dosages used in human executions are, in some cases, lower by body weight than the dosages that would kill only 50 percent of mice and from which monkeys have been able to successfully recover. "The way that thiopental is administered, it would be an unacceptably low dose if the inmate was a pig scheduled for euthanasia," Zimmers says.

And, although the dosages of potassium chloride would be considered adequate to kill animals, they do not appear to have the intended effect in humans, failing to hasten the time of death. "We are doing it successfully in animals and we're doing it successfully because they've taken a hard look at it," notes Jon Sheldon, a study co-author and criminal defense attorney in Virginia. "When you do it with animals, there is no pain. It's likely there is with people."

That pain takes the form of slow asphyxiation due to an inability to use the diaphragm muscle to breathe as a result of the pancuronium bromide. "In such case death by suffocation would occur in a paralyzed inmate fully aware of the progressive suffocation and potassium-induced sensation of burning," the researchers write.

The scientists analyzed only 41 of the 891 lethal injections that have taken place in the U.S. to date (and considerably more worldwide). But many of the remaining states' drug protocols and details of their executions remain secret. Nevertheless, researchers say the small sample indicates that the cocktail is not working as intended. "This idea that this is a painless procedure is completely wrong," Zimmers says. "It's just invisible because the person is paralyzed."

"The legal standard is you can't have unnecessary or gratuitous pain," under the Eighth Amendment of the U.S. Constitution, Sheldon adds. "It seems quite likely that a number of people are suffering pain. If a change to the protocol would be fairly simple to do, then the pain you are inflicting is clearly unnecessary."

[snapper]

It's not like a massive overdose of thiopental wouldn't do it fine with no consciousness. Why they would even care about regulating the dose of the anesthetic is beyond SWIM's comprehension. Thiopental is CHEAP with a DEA license - there is no reason to be stingy. SWIM is also opposed to the death penalty. The government should never be entrusted with the authority to end someone's life. It's harder on these criminals to live in a death row atmosphere anyways, which is a form of torture in itself. SWIM does not get why it is so hard for the executioners to effectively kill someone. Seems like it is done on purpose...

[UberDouche]

Any change in state will involve some level of stress. Distress or eustress. Stress nevertheless. Good or bad, it is taxing on the organism undergoing such stress. It is SWIM's position that death is the most dynamic change an organism can undergo, ergo the most stressful. SWIM posits that as such, the change from living to not living will necessarily involve a level of distress that SWIM would refer to as pain.
SWIM understands that some methods of execution will be more painful than others. SWIM believes that all methods of execution are painful in at least the academic sense of distress. Thus, SWIM believes the arguments over a particular method of execution being preferable over another are not particularly productive. These arguments avoid the core issue of whether or not a society supports the forced taking of another's life.
SWIM resides in the only state in the USA to still use electrocution as the sole method of execution available to the condemned. This has caused much debate over the last 5 years or so amongst this state's elected representatives, as well as among the voting constituency regarding this very issue.
In a few days Cary Dean Moore is scheduled to be electrocuted for the crime of premeditated murder. Mr. Moore and his younger brother robbed two taxi cab drivers in August 1979. Cary Dean Moore was 21 years of age at the time of the slayings.
Cary Dean Moore has told his attorney he no longer wishes to pursue any appeals on his conviction (legal appeals for capital crimes in the USA can be quite lengthy and in fact are required to a certain point regardless of what the defendant wishes). So, in SWIM’s state the argument put before the unicameral (the last one-house state legislature left in the USA) is whether or not to pass a bill into law that would allow lethal injection as an alternative to electrocution for the condemned.
The argument against this bill is whether it would constitute ‘cruel and unusual punishment’ (US Constitution, 8th amendment: Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.) to prevent those previously sentenced to die in the electric chair, but who have not yet been executed, from having the lethal injection option available to him or her. The State is worried this will provide additional 8th amendment appeals for those already sentenced under the current law. To rectify this non-sequitur would require a journey down the slippery slope, described above, of whether the intentional taking of a human life by the state can be reasonably considered to be without malice or cruelty. How do we, as a society want to define that?
The state SWIM resides in presently would really rather not have that discussion.