Contributed by Carla Sharetto| 14 April, 2005 23:48 GMT
The lethal injection method of capital punishment used in the US may cause unnecessarily suffering, in that prisoners may have received too little sedation to prevent awareness and pain during their executions, according to a research letter in this week's issue of
The Lancet.
The authors are calling for a cessation of lethal injection as a means of capital punishment, and they say a public review into anesthesia procedures during executions is necessary.
Suffocation and Excruciating Pain
No other method of execution is used as much as lethal injection in the US. The general perception is that it provides a humane way of carrying out the death penalty and does not violate the Eighth Amendment's stricture against cruel and unusual punishment.
Lethal injection generally consists of the following steps:
- The condemned prisoner is given sodium thiopental for anesthesia;
- Pancuronium bromide is administered to induce paralysis;
- A lethal dose of potassium chloride is given to stop the heart and cause death.
A person who received no or insufficient anesthesia would experience suffocation and excruciating pain while being unable to move. Anasthesia during lethal injection is essential, say the authors, to minimize suffering and preserve public opinion that lethal injection is a near-painless death.
Lack of Training, Record Keeping
Leonidas Koniaris of the University of Miami Miller School of
Medicine and colleagues analyzed information from Texas and Virginia, where approximately 45% of US executions are carried out.
Among their findings:
Executioners -- typically one to three emergency medical technicians or medical corpsmen -- often had no training in anesthesia;
Drugs were administered remotely with no monitoring of anesthesia;
No data collection, documentation or post-procedure peer review of of anesthesia procedures took place.
The researchers also noted that neither state had a record of the creation of its protocol. Data from autopsy toxicology reports from 49 executions in Arizona, Georgia, North Carolina and South Carolina also was reviewed.
The study team found that concentrations of thiopental in the blood were lower than that required for surgery in 43 of the 49 executions, and 21 inmates had concentrations consistent with awareness. The study suggests that the current practice of lethal injection for execution fails even to meet veterinary standards for putting down animals.
Public Review Is Warranted
"Our data suggest that anesthesia methods in lethal injection in the US are flawed," Dr. Koniaris states. "Failures in protocol design, implementation, monitoring and review might have led to unnecessary suffering of at least some of those executed.
"Because participation of doctors in protocol design or execution is ethically prohibited, adequate anesthesia cannot be certain. Therefore, to prevent unnecessary cruelty and suffering, cessation and public review of lethal injection is warranted," Dr. Koniaris concluded.
'Stain on Democracy'
"Whether you receive the death penalty depends not on what you have done, but where you committed your crime, what color your skin is, and how much money you have," says The Lancet in an accompanying editorial. "The use of the death penalty not only varies from state to state (12 US states have no death penalty) but from jurisdiction to jurisdiction within a state. Repeated studies have shown a pattern of racial discrimination in the administration of the death penalty.
"Capital punishment is not only an atrocity, but also a stain on the record of the world's most powerful democracy. Doctors should not be in the job of killing. Those who do participate in this barbaric act are shameful examples of how a profession has allowed its values to be corrupted by state violence," The Lancet concludes. |
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