This is not surprising, given that the AMA and The American Society of Anesthesiologists both advise doctors against participating in executions due to the Hippocratic Oath.

What happens now? The Department of Corrections has proposed an alternative.

Missouri officials said they would instead use "medical personnel in roles appropriate," like a physician, nurse or pharmacist preparing the drugs.

Other states have faced similar problems.

In April, a federal judge permitted an execution in North Carolina without an anesthesiologist, saying the state could use a brain wave monitor to ensure that the prisoner would be unconscious and unable to feel pain.

The Supreme Court has recognized the right of an inmate facing execution to challenge the three drug cocktail method.

Like most states that use lethal injection, Missouri requires three drugs in a row: Sodium pentothal, the anesthetic, is administered, followed by pancuronium bromide, which, as a paralytic, prevents movements of the body, and then potassium chloride, which stops the heart.

If a person has not received sufficient amounts of the anesthetic, the final drug is likely to be deeply painful, medical experts say, but the paralytic agent may prevent the person from revealing that pain.

Back to the dyslexic doctor. This is simply chilling:

Initially, Missouri Department of Corrections officials testified that the condemned consistently receive five grams of the anesthetic. But state logs of the most recent six executions revealed that only 2.5 grams had been prepared and used in at least one recent execution.

In his deposition, the doctor, John Doe I, defended the use of less than five grams, emphasizing that nearly all people would be fully anesthetized at a far smaller dose and that most other states use only two grams. In addition, the doctor said, he was able to determine whether the anesthesia had taken effect by looking at the inmate's facial expression.

But Judge Gaitan, who viewed a videotape of the execution chamber, questioned whether the doctor could see the inmate's face at all. On the gurney, the inmate faces away from the darkened room where the doctor is observing through a partly closed window, the judge wrote.