“Even more surprising was that in 43 percent of cases in those four states levels were consistent with consciousness.”
on asystole. A coroner then signs the death certificate and the procedure is complete. With the IV lines, a cardiac monitor and a medical doctor on standby the execution room is not dissimilar from an acute medical ward. The direct telephone line to the Department of Justice in Washington is perhaps the only giveaway - the President is the sole authority able to grant last-minute clemency.
‘Inhumane execution’ The claim of the lethal injection being the most humane form of capital punishment, is disputed by many. Leonidas Koniaris, professor of surgical oncology at the University of Miami, Florida, writing in The Lancet, suggests evidence that judicial execution by these means is not as humane as death penalty proponents have claimed. Researchers obtained post-mortem toxicology reports from four of the 36 states killing prisoners via lethal injection. The results indicated that levels of sodium thiopental were lower than those required for surgical anaesthesia. Even more surprising was that in 43 percent of cases levels were consistent with consciousness. Determining consciousness levels in prisoners who are paralysed and who will not be resuscitated is both difficult and debatable. This lack of certainty has however prompted the American Veterinary Medical Association to ban the use of neuromuscular blocking agents, such as pancuronium bromide, when putting animals to sleep.
The involvement of doctors The involvement of doctors varies considerably with 35 of the 38 death penalty states that rely on lethal injection allowing doctors to participate, and 17 states requiring it. Participating
“The worst toxicology reports were obtained from states that employed teams qualified only at technician level.”
doctors are required to ensure that the Eighth Amendment of the US Constitution, which prohibits ‘cruel and unusual punishment’ is upheld. It was a doctor who pushed the syringe in Illinois’s first lethal injection execution and in Nevada, doctors are required to examine the condemned for good venous access and to prescribe the fatal drugs. Some states, such as Illinois and South Dakota, have attempted to de-medicalise the death penalty with laws decreeing that the assistance of death does not constitute medical practice. South Dakota’s death penalty statute states that “any infliction of the penalty of death … may not be construed to be the practice of medicine.”
The argument for medical involvement Despite the reluctance of medical professionals to involve themselves many feel their presence is essential for the welfare of the prisoner. Each step of the execution procedure from the dosing of fatal drugs to the pronouncement of death ideally requires a medical practitioner. Where doctors are unavailable these tasks are performed by trained ‘technicians’ but as Koniaris and his team point out the worst toxicology reports were obtained from states that employed teams qualified only at technician level. Death row inmates often have poor vascular access as a result of intravenous drug use or obesity and it is here that the skills of doctors are particularly useful. In Georgia one of the three doctors present in the execution chamber during procedures is an expert in vascular access. Many also use the argument view that healthcare personnel transform the executions from a terrifying to peaceful environment alleviating pain or giving the illusion that pain is being alleviated.
The argument against Firstly doctors argue that they were not asked whether they agreed with the medicalisation of the death penalty prior to its re-introduction in 1976. Many doctors oppose the execution process on ethical grounds. The president of Georgia’s medical school, in a letter to the prison warden, condemned the involvement of doctors saying their presence in the chamber ‘compromised their relationship with the inmate population.’
Junior DR magazine design and layout. Issue 15.