death penalty news April 14, 2005
USA: Execution by injection far from painless Execution by lethal injection may not be the painless procedure most Americans assume, say researchers from Florida and Virginia. They examined post-mortem blood levels of anaesthetic and believe that prisoners may have been capable of feeling pain in almost 90% of cases and may have actually been conscious when they were put to death in over 40% of cases. Since 1976, when the death penalty was reinstated in the US, 788 people have been killed by lethal injection. The procedure typically involves the injection of three substances: first, sodium thiopental to induce anaesthesia, followed by pancuronium bromide to relax muscles, and finally potassium chloride to stop the heart. But doctors and nurses are prohibited by healthcare professionals' ethical guidelines from participating in or assisting with executions, and the technicians involved have no specific training in administering anaesthetics. "My impression is that lethal injection as practiced in the US now is no more humane than the gas chamber or electrocution, which have both been deemed inhumane," says Leonidas Koniaris, a surgeon in Miami and one of the authors on the paper. He is not, he told New Scientist, against the death penalty per se. But Kyle Janek, a Texas senator and anaesthesiologist, and a vocal advocate of the death penalty, insists that levels of anaesthetic are more than adequate. He says that an inmate will typically receive up to 3 grams - about 10 times the amount given before surgery. "I can attest with all medical certainty that anyone receiving that massive dose will be under anaesthesia," he said in a recent editorial. Extremely anxious The authors of the new study argue that it is simplistic to assume that 2 to 3 grams of sodium thiopental will assure loss of sensation, especially when the people administering it are unskilled and the execution could last up to 10 minutes. They also point out that people on death row are extremely anxious and their bodies are flooded with adrenaline - so would be expected to need more of the drug to render them unconscious. Without adequate anaesthesia, the authors say, the person being executed would experience asphyxiation, a severe burning sensation, massive muscle cramping and cardiac arrest - which would constitute the "cruel and unusual" punishment expressly forbidden by the US constitution's Eighth Amendment. Koniaris's team collected post-mortem data on blood levels of sodium thiopental in 49 executed inmates. They found that levels varied dramatically - from mere trace amounts to 370 milligrams per litre - despite using the same execution protocol and the same blood sampling procedure. "Perverted medical practice" If these post-mortem concentrations reflect levels during execution, the authors say, 43 of the 49 inmates studied were probably sentient, and 21 may have been "fully aware". Because a muscle relaxant was used to paralyse them, however, inmates would have been unable to indicate any pain. Ironically, US veterinarians are advised not to use neuromuscular blocking agents while euthanising animals precisely so they can recognise when the anaesthesia is not working. People in the US assume that lethal injection is highly medicalised, and therefore humane, says Koniaris. "But when you look at it critically, it's anything but medical," he says. "It's a perverted medical practice." He says the people carrying it out are unskilled, the procedure is not monitored - the executioners step behind a curtain when delivering the lethal drugs - and there is no follow-up to ensure that everything worked as intended. Journal reference: The Lancet (vol 365, p 1412) (source: New Scientist)
