Execution procedure

| Comments (5) | Misc Pharma
If you want to have an opinion about capital punishment in this country you need to read this NYT article about the sorry state of the procedures used for administering lethal injections:
Over the course of Doerhoff's testimony, Anders uncovered many significant details similar to those uncovered in other states. For instance, Doerhoff testified that executions in Missouri have taken place in the dark, an execution team working by flashlight, and that the execution team routinely consists of "nonmedical people." For most, the day of the execution is "the first time probably in their life they have picked up a syringe . . . so it's a little stressful for them to be doing this." Doerhoff stated that he determined if an inmate being executed had been adequately anesthetized by observing the condemned's face through a window, which others noted was obscured by partly opened blinds. He also told the court that he reduced by half the five grams of anesthetic he had been using after the pharmaceutical company supplying it started packaging it in smaller bottles, which made it tricky to get the five grams in a single syringe. When Anders asked if he used calculations to determine the quantities of drugs to administer, he replied, "Heavens, no."

Later Anders asked, "Is any part of the execution procedure written down?"

"I've never seen it."

"There's no guide that you follow as you're doing it?"

"Absolutely not."

As background, the procedure involves three drugs:

  • Sodium pentothol to sedate the prisoner.
  • Pancuronium bromide (Pavulon) to paralyze him.
  • Potassium chloride to stop his heart.

These are all delivered through an IV. Unfortunately, if you screw up the IV, you might not get some or all of the meds. So, for instance you might be paralyzed but not sedated, which is no doubt terrifying and then quite painful when the KCl is injected. Now, you may be of the opinion that it's a good thing for those who are being executed to be in pain and terrified (I'm not) but surely that should be done intentionally, not just because we don't have competent procedures. However, in practice the procedures seem to be almost entirely ad hoc. Here's Chapman, who designed the Texas procedure:

It never occurred to me when we set this up that we'd have complete idiots administering the drugs.
The rest of the article is equally disturbing.


I find it's safe to assume that people unfamiliar with a procedure are going to be following the instructions (a softer version of Chapman's comment).

Seriously, I would have thought this would be over-documented, if anything. State-sanctioned execution is contentious enough as it is, now we need to worry about botched execution at the very end of the process.

I don't know if I want to read the article or not.

I read (probably in other blog coverage) that "the manual" contained materials left over from when the execution method was electrocution, rather than injection. So, for example, the condemned needs to have his head shaved as part of the procedure. Nice QA there, folks.

It's funny. If you ran an IT shop the same way, where the manual didn't come close to what made sense, where the experts (in this case, MDs) were precluded by their own canon of ethics from participating, where documented procedures were ignored, and where measured outcomes were spotty at best, your auditors would take you apart.

Not so when it involves life and death.

I'm no more in favor of botched executions than the next guy, but of all the arguments against capital punishment in general, this seems to me to be one of the weakest. First of all, it seems relatively addressable--perhaps by switching to nitrogen asphyxiation as an execution method. Second, the risk of brief extra suffering inflicted during execution, while certainly undesirable, pales in comparison with risks like the very real possibility that an entirely innocent person might be convicted and then executed. And finally, if the claim is that governments cannot be trusted to be competent enough not to inflict severe suffering unnecessarily when given the opportunity, then the usual proposed alternative to capital punishment--imprisonment for life without parole--should in fact be considered far, far more worrisome than the death penalty. After all, the opportunities for cruelty to prisoners during a lifetime of incarceration are much greater than during the duration of even a monumentally incompetent execution.

I have to agree with Dan here (urrrrrrgh!). I have a lot of trouble coping with the concept that the state should kill people. But if I were in the position of the convict I would much rather be killed than spend the rest of my life in prison, being mistreated by prisoners and guards, and who knows what else.

I do like the Neil Young reference in the article's title, though. (On the other hand, it detracts from the gravity of the article. One can be too clever.)

paul: you've clearly never provided technical support to anyone. The last thing *anyone* ever does is RTFM.

dan: remember that jurors are likely about on par with the folks who are administering these lethal injections. Except that on a jury there's probably more judgment and reasoning involved than when merely injecting 3 syringes of liquid into someone.

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