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Missouri Executions Hit a Roadblock

A few weeks ago I wrote about federal Judge Fernando Gaitan Jr. in Missouri who ordered the cessation of executions in that state due to the "unconstitutional pain and suffering" the inmate may experience from the drug cocktail used, and because the lone doctor mixing the drugs was dyslexic. He gave the Department of Corrections 15 days to find another protocol.

The 15 days is up today. Last night, the Department of Corrections told Judge Gaitan it had failed to find a board-certified anesthesiologist.

In the state's filing last night, officials said they had sent letters to 298 certified anesthesiologists who reside anywhere near the state's death chamber in Bonne Terre, and were turned down by all of them.

"A requirement of using a board-certified anesthesiologist is a requirement that cannot presently be met," Attorney General Jeremiah W. Nixon wrote. "To enforce it may effectively bar implementation of the death penalty in Missouri. Surely that is not what the court intended."

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.

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    Re: Missouri Executions Hit a Roadblock (none / 0) (#1)
    by squeaky on Sat Jul 15, 2006 at 08:08:27 AM EST
    298 doctors out of 298 doctors refusing? Very interesting. I do have a soft spot for dyslexics although this one seems to be unable to distinguish between Hypocritical and Hippocratic. Next step is that the psychiatrists should weigh in on the proponents of the Death Penalty who have either have legislative or judicial power and either properly medicate them or send them to the looney bin until they come to their senses.

    Re: Missouri Executions Hit a Roadblock (none / 0) (#2)
    by roger on Sat Jul 15, 2006 at 08:08:44 AM EST
    Calling Dr Mengele.......... Dr. Mengele...........

    Re: Missouri Executions Hit a Roadblock (none / 0) (#3)
    by Deconstructionist on Sat Jul 15, 2006 at 09:09:32 AM EST
    I haven't followed this particular matter closely but, it seems the Missouri legislature could amend the statute to authorize a method of execution that does not require a doctor's involvement to be administered, and that this is not about prohibiting "capital punishment per se" but merely whther the method selected runs afoul of the "cruel" prong of the 8th. I'm happy the docs don't want to kill people for moral and/or ethical reasons but I see this as doing little more than sending the matter back to the Legislature to authorize a dfiiferent way of killing people if that is what it wants done.

    Re: Missouri Executions Hit a Roadblock (none / 0) (#4)
    by HK on Sat Jul 15, 2006 at 10:24:35 AM EST
    "A requirement of using a board-certified anesthesiologist is a requirement that cannot presently be met," Attorney General Jeremiah W. Nixon wrote. "To enforce it may effectively bar implementation of the death penalty in Missouri. Surely that is not what the court intended."
    This is a thinly veiled threat along the lines of "you are preventing sentences from being carried out, which should be outside of your powers." But is not the judge who is acting outside his duties, but the AG who is failing to recognise that the burden of ensuring that executions can be carried out lies with the Dept of Corrections, not the judge. The judge asked the Dept of Corrections to rectify an unacceptable situation and it has failed. While the simple solution may well be to return to another method of execution, this case and others like it have shown that the lethal injection is not the magic wand it has been made out to be for so long.

    Re: Missouri Executions Hit a Roadblock (none / 0) (#5)
    by scribe on Sat Jul 15, 2006 at 10:58:24 AM EST
    FWIW, when I was a kid, I knew someone who was on a low-sodium diet and used a commercially available salt substitute (that's what the label called it, even). Chemistry fascinated me at the time, and I was big on reading labels and such. The main ingredient in the salt substitute: potassium chloride. It has almost all the same effects on the body as does regular salt, including pain when in an open wound (I tried it). So, when you think about that last shot to stop the heart, remember that they get a big jolt of, effectively, salt running through their veins. Think about how painful that must be. I'm not about to a pun about rubbing in the salt, but you surely get the point. --- Squeaky - good one.

    Re: Missouri Executions Hit a Roadblock (none / 0) (#6)
    by bad Jim on Sun Jul 16, 2006 at 01:01:40 AM EST
    Don't veterinarians just use a giant dose of barbiturates? I think this problem is a perfectly good reason to give up on capital punishment, but to the extent that euthanasia is desirable in certain situations we ought to find a way to do it right.