On Executions

I live in the state of Texas. The state executes more individuals than any other state in America. The fact that I have not thought a great deal about this is related more to the fact that I try to live my life so that the ultimate penalty is not a factor in my life, rather than my not thinking much about it. However, with the number of executions in America being performed with differing and alternate drug cocktails, and the number of people commenting on the length and apparent 'painfulness' of the death of inmates, I thought to make a few comments. While I have not observed any such executions, the description of inmates 'gasping' for minutes to hours after receiving the 'lethal' injection sounds like agonal breathing. Agonal breathing occurs when an unconscious person suffers ischemia or hypoxia, and is the last stage of respiration before apnea, or complete lack of breathing. The method that executioners use to kill someone is to stop the executioners breathing, so that the body dies of lack of oxygen. The fact that these 'alternative' cocktails seem to take so long is a testament to their inefficiency, not their methodology. My understanding is that physicians (ie MDs and DOs) will not participate in an execution, due to their oaths to protect life. So you have individuals with less than complete medical training and understanding planning and performing the execution on behalf of the state. Then there is the issue of obtaining the specific drugs that would perform the most 'efficient' execution, where execution is measured, I guess, by the duration from injection to death. The published story of the latest execution in Arizona indicated the inmate was injected with a mixture of a benzodiazepine to cause unconsciousness, followed by an opiate to induce respiratory depression. The inmate took more that several hours to die, and exhibited 'gasping' breath types. While the choice of the two medications might have been made strictly by the availability, it is a reflection of the lack of medical knowledge by those individuals to try to execute someone with that drug combination. Opiates, while causing respiratory depression, are a poor choice for a drug to cause apnea and brain (and therefore body) death. While many people die of opiate overdose, it has rarely been proven that the opiate was the cause of death. Many times, the death is a result of other drugs taken with the opiate, such as alcohol. Opiates are a poor choice to kill someone. As I mentioned earlier, I have not pondered deeply the right of the state to execute an individual. When I was practicing medicine, which I did only for a short time, there where procedures I would not have participated in due to personal beliefs, one being performing an execution. However, if the state is going to insist on performing an execution, I think that it should at least learn how to do in the "best" way possible, if such a thing exists. When a patient is undergoing a surgical procedure, say for thoracic surgery, the anesthesiologist induces deep unconsciousness and then paralyzes the skeletal muscle system. This renders the patient unable to breathe on their own, and the anesthesiologist places the patient on a respirator to breathe for the patient. Without the respirator, the patient will die within 4-7 minutes from anoxia. This is exactly the method that the state should use to execute an inmate, if they wish to be "efficient" and merciful. (If you can call executing someone merciful.) These drugs are used in hospitals daily. There are alternative drugs for causing muscular paralysis. There are alternative drugs for inducing unconsciousness. I have to ask, if the state is so powerful that it can take the life of one of their members, is it so weak that it can't procure the necessary drugs to so in a proper fashion? Or are its workers so incompetent or lazy that they can't execute the power of the state properly? This article in the Royal Society of Chemistry, outlines the triple drug cocktail that mimics surgical anesthesia for inducing unconsciousness, muscle paralysis, and heart stoppage. It notes that as far back as 2007, executions by this method caused external signs, such as 'gasping', that caused observers to question the method of execution. Here's another article, an interview with an anesthesiologist. Now, with states deviating from the most ideal drug combination, is it any wonder that people question the methods being used? Also, in a Florida cases, the executioners couldn't even place the catheter properly into a vein, so that the drugs could speed directly to the heart and brain, the site of their action. Surely this is a sign of true incompetence of the state to perform its function. I have had trouble placing a needle into a vein in patients, but I never injected a drug without first drawing back and ensuring the needle was in a vein and had free flow of blood. If an airline pilot could't land a plane, he wouldn't be allowed to fly. If bus driver couldn't keep his bus on the road, he would lose his license. The state is responsible to see that individuals that can hazard life by their performance due so properly. Likewise, the state is responsible for seeing that the executioner, even when taking a life, does so properly. Inmates scheduled to die have the right to a merciful death. Otherwise is cruel and unusual punishment, outlawed by the Constitution. One thing that is interesting is that here in Texas, dogs and cats can't be executed except by sodium pentobarbital. Furthermore, there are mandatory training programs that are required for individuals euthenising a dog or cat in Texas (Sec. 821.055). Could it be that we have better standards of care for our animals then our inmates?