April 14 USA: Study: Inmates suffer during lethal injections----Inadequate anesthesia may cause 4 in 10 to stay conscious VIEWS OF PAIN Dr. Leonidas Koniaris, study's lead author: "We were asking: Is there a possibility of awareness during an execution? Is there a large degree of pain and suffering associated with it? And I think the answer we found is yes." Andy Kahan, crime victims ' advocate: "Whether or not it is painful, one thing is for sure, it is certainly less painful than the excruciating and horrific death that the victim suffered at the hand of the defendant." As many as four of every 10 prisoners put to death in the United States might receive inadequate anesthesia, causing them to remain conscious and experience blistering pain during a lethal injection. Researchers in Florida and Virginia drew this conclusion after reviewing levels of anesthetic in the blood of 49 inmates after they were executed. "I approached this as a physician," said the study's lead author, Dr. Leonidas Koniaris, chairman of surgical oncology at the University of Miami. "We were asking: Is there a possibility of awareness during an execution? Is there a large degree of pain and suffering associated with it? And I think the answer we found is yes." Of the inmates studied in a report published by the British journal The Lancet, 43 % had concentrations of anesthetic in their blood - as measured by medical examiners during autopsies - that would indicate consciousness rather than sedation during an execution. Koniaris, who says he does not oppose the death penalty, thinks the study warrants a moratorium on executions until a publicly appointed panel can review whether some inmates remain conscious during lethal injection. "If that's the case, as a society we need to step back and ask whether we want to torture these people or not," he said. Death penalty supporters dismissed the suggestion of a moratorium. "Lethal injection represents the most humane possible means of punishing a brutal, heinous murderer," said Andy Kahan, Mayor Bill White's advocate for crime victims "Whether or not it is painful, one thing is for sure, it is certainly less painful than the excruciating and horrific death that the victim suffered at the hand of the defendant." And Mike Viesca, a spokesman for the Texas Department of Criminal Justice, said his medical staff has assured him the combination of drugs used in a lethal injection renders a person incapable of feeling pain. The anesthetic, sodium thiopental, is the first of three drugs given in the execution protocol used by Texas and most other death penalty states. The amount typically administered through an IV, 2 to 3 grams, is far more than the amount used to sedate surgical patients and, doctors say, should prove fatal by itself. Yet, some death penalty critics say poorly trained executioners - most have no formal anesthesia training - could miss a vein or otherwise err in administering a dose. The anesthetic also could wear off during a prolonged execution, which typically last at least 8 minutes. If the anesthetic somehow fails and an inmate regains consciousness, the second step of a lethal injection, administration of a muscle relaxant, paralyzes the muscles and lungs. The third drug given is potassium chloride, a toxic agent that stops the heart. The implications of an ineffective anesthetic are, in the words of a Lancet editorial accompanying the article, troubling: "It would be a cruel way to die: awake, paralyzed, unable to move, to breathe, while potassium burned through your veins." Argument for a stay The potential inhumanity of lethal injection is sometimes raised by lawyers trying to win a last-minute reprieve for their death-row clients. In December 2003, Texas killer Kevin Lee Zimmerman had his execution stayed after his lawyers argued that the lethal-injection procedure masked severe pain and thus constituted cruel and unusual punishment. The U.S. Supreme Court soon lifted its stay, and Zimmerman was executed six weeks later. Still, death penalty lawyers say courts may reconsider the issue if more evidence, such as that in the new study, is presented to suggest that executions are extremely painful. The study reviews the blood records of inmates from Arizona, Georgia, North Carolina and South Carolina. Texas, the national leader in executions, refused to provide data for the study. A critical question, the study authors admit, is whether measurements of the levels of sodium thiopental in the blood minutes or hours after death correlate with levels in the blood at the time of execution. However, they note that sodium thiopental levels remain stable in stored human blood. A local anesthesiologist, Dr. Lydia Conlay, said the extrapolation of postmortem sodium thiopental levels in the blood to those at the time of execution is by no means a proven method. "It's an interesting and thought-provoking study," said Conlay who chairs the department of anesthesiology at Baylor College of Medicine. "I just don't think we can draw any conclusions from it, one way or the other. I just can't be sure what the numbers mean." Some opponents of the death penalty say the public accepts lethal injection as a painless medical procedure because, with the IVs, it appears to be one. "The bottom line is that the there's a real problem with the perception of how lethal injection goes down in the public, and what we believe really goes on," said Gary Clements, deputy director of the Capital Post-Conviction Project of Louisiana, a group that represents death row inmates. Lack of data and records The study's authors said this question of whether an inmate can feel pain ultimately can't be answered because of the unwillingness of states to maintain or share their execution data and records. In addition to asserting that the TDCJ had no autopsy or toxicology reports for inmates executed by lethal injection, Texas officials told the researchers it did not even have records of how it created the protocol it uses for injections. Another of the study's authors, University of Miami anesthesiologist Dr. David Lubarsky, said the research team would have greatly preferred to use blood data from inmates at the time of executions. But the data doesn't exist, or it wasn't provided, Lubarsky said. "What we do have is data to suggest the process might be critically flawed," Lubarsky said. "It's now up to the corrections systems to show that, at the time of death, inmates are asleep. We should accept no less when we're killing people." (source: Houston Chronicle) ********************** Lethal injection execution 'cruel' - U.S. researchers American researchers have called for an halt to lethal injection, the most common method of capital punishment in the United States, because it is not always a humane and painless way to die. Some executed prisoners may have suffered unnecessarily because they had not been sedated properly, they said. The current way inmates are given lethal injections does not even meet veterinary standards for putting down animals, they added. The research was carried out by Leonidas Koniaris of the University of Miami Miller School of Medicine, and colleagues. "Failures in protocol design, implementation, monitoring and review might have led to unnecessary suffering of at least some of those executed," Koniaris said in a study published in The Lancet medical journal. "Therefore, to prevent unnecessary cruelty and suffering, cessation and public review of lethal injections is warranted." Anesthesia is given during a lethal injection to minimize suffering. Without it the prisoner would suffocate and experience horrible pain, according to Koniaris. But in their analysis of protocols followed during lethal injections in Texas and Virginia, where 45 percent of executions in the United States are conducted, they found there was no monitoring of the anesthesia. Emergency medical technicians who administered the drugs had no training in anesthesia and there were no reviews after the executions. When the researchers examined data from autopsies done following 49 executions in Arizona, Georgia and North and South Carolina, they found concentrations of the drug in the blood in 43 cases were lower than that needed for surgery. 21 prisoners had drug levels that were consistent with awareness. "We suggest that it is possible that some of these inmates were fully aware during their executions," said Koniaris. An editorial in the journal said if the inmates were awake it would have been a cruel way to die because they would have been unable to move or breathe while potassium burned through their veins. "Capital punishment is not only an atrocity, but also a stain on the record of the world's most powerful democracy," it said. Since 1976, lethal injection had been used in 788 of the 956 executions in the United States, according to The Lancet. (source: Reuters) *************************************** 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: 1st, 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 constitutions 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, its 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) **************************** The Strong and the Weak----The "culture of life" is a simple idea: the strong must protect the weak. "Culture of life" is the new catchphrase among social conservatives' including President Bush. "Because a society is measured by how it treats the weak and vulnerable, we must strive to build a culture of life," the president said in his State of the Union speech this year. And in response to the death of Terri Schiavo, Bush last week said, "I urge all those who honor Terri Schiavo to continue to work to build a culture of life where all Americans are welcomed and valued and protected." Where did the term come from? "To the best of my memory, the pope was the 1st one to use it," Michael Novak, a scholar of religion at the American Enterprise Institute, said about the late Pope John Paul II. "He always saw the connection between abortion and euthanasia. That is, if there's an ability for someone to make a decision about life at the beginning, then it's going to happen at the end - and with modern medicine, all the more so." Rep. Jim Sensenbrenner, R-Wis., echoed the theme on the House floor last month when he defended the bill to transfer jurisdiction in the Schiavo case to the federal courts. "We must build a culture of life that welcomes and defends all human life," the House Judiciary Committee chairman said. "The measure of a nation's commitment to the sanctity of life is reflected in its laws to the extent those laws honor and defend its most vulnerable citizens." For conservative activists, the most vulnerable citizens include both unborn children and disabled persons like Terri Schiavo. Both groups are on conservatives' culture-of-life agenda. Conservatives have won power. And they have made gains in public opinion. In 1994, according to the Gallup Poll, 1/3 of Americans thought that abortions should be "legal under any circumstances." Only 13 % thought abortions should be "illegal in all circumstances." A majority took the moderate position' "legal only under certain circumstances." And now, more than a decade later? A majority of respondents still take the moderate position. But the number who favor legal abortions under any circumstances has dropped 10 points, to 23 %. The number who say abortion should be illegal in all circumstances has increased to 20 %. The 2 groups are now just about equal. Conservatives are broadening the definition of their agenda from "family values" to the "culture of life," and including in it opposition to embryonic stem-cell research. "I will work with Congress to ensure that human embryos are not created for experimentation," Bush said in the State of the Union. He even alluded to the culture of life in a recent radio address when he talked about the school shootings in Minnesota. "To keep our children safe and protected, we must continue to foster a culture that affirms life," he said on March 26. Some in the Republican Party establishment find this agenda threatening. Former Sen. John Danforth, R-Mo., an Episcopal minister, writes, "The problem ... is with a party that has gone so far in adopting a sectarian agenda that it has become the political extension of a religious movement." Even the president might eventually find it troublesome. On March 25, brother Paul O'Donnell, spokesman for the parents of Terri Schiavo, called on Bush: "If he wants to promote a culture of life, then hard times demand tough decisions and tough actions. Save Terri Schiavo!" The issue created an angry and embittered constituency that sees Schiavo's fate as a gross miscarriage of justice. That constituency, which helped Republicans win control of Congress, the White House, and the state of Florida, feels betrayed. The politicians didn't deliver. Even the Republican-appointed judges disappointed this group. "For sure, there's going to be a lot of discussion about how to rein in the judiciary," anti-abortion activist Randall Terry said after Schiavo's death. "That is going to be one of the key elements that come from this." When you create an angry and embittered constituency, one thing you can expect is retribution. Which is what House Majority Leader Tom DeLay, R-Texas, is promising. "Our legal system did not protect the people who need protection most, and that will change," DeLay said in a statement. "The time will come for the men responsible for this to answer for their behavior." Pope John Paul II saw the culture of life as a broad, humanitarian agenda that encompasses opposition to the death penalty and to the war in Iraq. As Michael Novak explained, "The pope had the idea that you can't maintain a democracy, which is the best protection of human rights, and you can't protect a dynamic economy, which lifts up the poor, unless you also have an appropriate culture for it ... a culture of life, meaning an attitude of generosity, an attitude of concern for the weakest among humans." The culture of life is a simple and powerful idea: The strong must protect the weak. To conservatives, that means at the beginning of life and at the end of life. Their critics ask, "What about in between?" One of these critics is the Rev. Jesse Jackson, who showed up in Florida to try to save Terri Schiavo. "There are those who love the fetus and want to starve the babies," Jackson said. "There are those who love Terri and ignore long-term health care." It would seem that the political battle is not over whether the strong must protect the weak - but when. (source: The Atlantic) OHIO: Jury deliberating fate of death penalty defendant The life-or-death fate of Javon Byrd is in the hands of a Hamilton County jury. The allegations against Byrd - accused of shooting one man to death and trying to kill, but only wounding, two others - are "hearsay, innuendo and Lord knows what," defense attorney Herb Freeman told jurors Wednesday. "This is not a death penalty case. It never should have been a death penalty case," Freeman said. "This was an impulsive act, if it happened at all." Byrd could face the death penalty if assistant prosecutors Katie Burroughs and Gus Leon can convince jurors that Byrd shot and killed Shelly "Pee Wee" Hogan Feb. 4, 2004, with prior calculation and design. Byrd, 28, cold-bloodedly shot and killed Hogan after he suggested Byrd should be turned in for shooting another man 4 months prior to that, prosecutors say. Byrd was playing dominos, drinking and smoking marijuana Oct. 20, 2003, with Christopher Fears when the 2 argued and Fears was shot in the leg. Byrd testified that the shooting was accidental after he got Fears in a bear hug, suspecting Fears was going to shoot him. Fears and others testified, though, that Byrd was upset about a missing $1 and shot Fears in retaliation. "Dominos and a dollar. That's what led to the senseless shootings," Burroughs said. Byrd was wanted in that incident when Hogan, who was doing plumbing work for Byrd's father, Randolph Campbell Sr., suggested they turn Byrd in, collect the reward money and use it for a lawyer for Byrd. Campbell told Byrd about Hogan's offer and the next time Byrd was at his father's home in Cumminsville and Hogan showed up, Byrd retaliated, prosecutors said. "(Byrd has) had his plan from the moment that Shelly was on that doorstep," Burroughs said. "That is what sets Javon off, the fact that 'Pee Wee' wants to turn him in." Byrd is accused of shooting and killing Hogan and wounding William Trollinger, who was with Hogan that day. Freeman and Greg Cohen, Byrd's attorneys, attempted to cast the blame elsewhere - including on Byrd's brother and father, who told jurors Byrd admitted to him he'd shot Hogan. Campbell, Freeman noted, is a convicted felon who has been to prison at least twice and admitted lying in the case. Byrd testified a man known only as "Dingo" was the real killer, a claim Leon found dubious. "Would Dad put it on his son if Dingo had been there and pulled the trigger?" Leon asked jurors. "How believable is this Dingo (story) after 14 months and when no one has ever heard of him?" Freeman refused to say his client was guilty of the charges, but suggested to jurors that any finding short of one that could end Byrd's life might be proper. "If he was involved - and we're not conceding that he was - he did something impulsively, something spur of the moment," Freeman said, adding that Byrd wasn't intelligent enough to plan such a killing. If Byrd is convicted of aggravated murder with the death specification, a penalty phase of the trial will convene. The possible penalties include death by lethal injection. (source: Cincinnati Post) CALIFORNIA: Experts: San Quentin Prison Conditions Bad Conditions at California's historic San Quentin prison are so bad that it's dangerous to house new or sick inmates there, according to a report by a team of medical experts. The team also told a federal judge last week that the administration of the San Francisco prison has not complied with a court order requiring improvements in medical care. The report was obtained by The Associated Press in advance of a state Senate committee hearing Thursday on health care at the Department of Corrections. The team of two doctors and 2 nurses found the prison was too dangerous to house people with certain medical conditions or to use as an intake facility for new inmates because it was overcrowded and ''old, antiquated, dirty, poorly staffed, poorly maintained, with inadequate medical space and equipment." Youth and Adult Correctional Secretary Roderick Hickman and other top corrections officials met Wednesday with the experts and U.S. District Judge Thelton Henderson to go over the report. Spokesmen for Hickman and the Department of Corrections said they were working with the courts to comply with the experts' suggestions. The report is the first on the prison system's adherence to last year's court order, but the experts found that "overall compliance ... was nonexistent." Democratic Senate Majority Leader Gloria Romero, who heads two prison oversight committees, reviewed the reports Wednesday and met with the judge and the experts, who told her the conditions at San Quentin were among the worst they had seen nationwide. "It's deplorable, it's abominable," Romero said. "This is cardiac arrest of the health care system in corrections." "Can it be saved?" Romero asked. "We're pouring a billion dollars into health care in corrections. To my mind, that's enough. The question is, where is it going?" Officials have periodically proposed closing the 153-year-old prison that sits on prime waterfront property along San Francisco Bay and houses California's death row. But attempts to move the state's condemned inmates elsewhere have run into opposition. ------ On the Net: California Youth and Adult Correctional Agency: http://www.yaca.ca.gov California Department of Corrections: http://www.corr.ca.gov (source: Associated Press) ALABAMA: Better penalty ideas---Legislative proposals, for the most part, are changes for the better Judicial reform too often means putting more people in prison longer - a mind-set that has Alabama's prisons overcrowded and needing an extra $1 billion for capital improvements, which the state doesn't have. Occasionally, though, legislators find ways to support reforms that make sense. Several are circulating through the Legislature this session. Last weerk, the Alabama House passed a bill that would let some inmates - those who are terminally ill or permanently disabled - go home. This wouldn't include those convicted of capital or sex crimes. And it probably didn't gain support for its abundance of Christian charity. Rather, these are people who the state won't have to support by getting them out of cells. And they will be people incapable of harming others because of their physical conditions. Another bill - expanding the death penalty to those who kill with illegal assault weapons (as defined by the federal government) is more problematic. The idea, basically, is that anyone who uses a banned weapon to kill someone inadvertently could be found guilty of a capital crime, not manslaughter. One problem is that the bill has already been amended so it doesn't include all assault weapons. That's thanks to the lobbying of your friendly neighborhood National Rifle Association. Whether they've been killed with an illegal or legal assault weapon won't matter much to a victim, of course. Another problem is the assault weapon list has been drastically reduced because Congress let a federal ban on 19 such weapons expire last September. A really good bill is one offered by Sen. Hank Sanders, D-Selma, that would put Alabama's death-penalty law in compliance with the U.S. Supreme Court decisions that says states can't execute the mentally retarded or those under 18 years old. State Attorney General Troy King opposes the law. He hopes a more conservative court eventually will overturn those decisions. It's the same old story: part of Alabama's constitution has been ruled illegal, but nobody wants to change it. It's just like the illegal racist language that remains in that document. Alabama should follow the federal law. Pass Sanders' bill. If the Supreme Court decides later to revisit and rescind its rulings on the mentally retarded and those under 18, politicians can make political hay by reinstituting those laws, unless the people's better angels convince the legislators not to. Sanders' proposal to put a moratorium on executions won't get anywhere. Other states have done so because DNA testing has revealed innocent people on death row. This Legislature can't accept that yet. (source: David Prather, for the editorial board, Huntsville Times)
