Post by Anja Nieser on Oct 1, 2006 6:27:12 GMT -5
Sedative's Efficacy in Executions Questioned----Judge is 'troubled' that
anesthetic used in lethal injections has failed to quickly halt breathing.
In San Jose, a federal judge deciding the future of lethal injection in
California said Thursday that he was "troubled" that one of the drugs used
during several executions had failed to quickly end inmates' breathing.
During the 3rd day of a trial on the constitutionality of lethal
injection, U.S. District Judge Jeremy Fogel asked the state's
pharmacological expert how long a person should continue to breathe after
being given 5 grams of thiopental sodium, the anesthetic that is the 1st
of 3 drugs used for executions.
Some medical experts say the persistent breathing suggests that inmates
were not properly anesthetized during an agonizing death, comparable to
drowning.
"Not very long," replied Brent Eakins, the state's expert. "Say a minute
or less."
Then why, Fogel asked, have several inmates continued breathing much
longer after receiving that massive dose? Fogel said that doctors observed
Jaturun Siripongs, who was executed in 1999, breathing for 5 minutes after
receiving the sedative.
The judge said he was not drawing any conclusions, but added: "This is
just an anomaly that has troubled me ever since I came across it. The
doctors say they saw actual breathing."
Medical experts who testified previously in the case have said the large
dose of anesthetic should rapidly stop breathing, although an inmate could
continue to live for 20 minutes or longer. Critics of lethal injection
have suggested that in the absence of proper sedation, the second drug,
which paralyzes inmates' muscles, masks the pain of the third drug,
potassium chloride, which shuts down the heart.
Fogel is presiding over a legal challenge to lethal injection brought by
Michael Morales, who was condemned to die for the 1981 murder of Terri
Winchell, a 17-year-old high school student from Lodi. The judge must
assess Morales' claim that the state's lethal injection procedures present
an unnecessary risk of "cruel and unusual punishment" in violation of the
8th Amendment to the U.S. Constitution.
Thursday was the state's turn to have its experts counter earlier
testimony suggesting that execution teams may have failed to properly
administer the drugs in the past, subjecting inmates to severe suffering.
Pursuing his questioning, Fogel wondered aloud why inmates were not
immediately killed by the prescribed dose of the potassium chloride, which
he said was supposed to be "a lethal dose 100% of the time."
In the executions of Robert L. Massie in 2001 and Clarence Ray Allen
earlier this year, 2nd doses of the deadly heart-stopping drug had to be
administered, Fogel said.
"Assuming proper delivery, a person should die within seconds?" Fogel
asked.
Eakins agreed and then questioned whether Massie was experiencing
"effective" heart beats or just simply "agonal rhythm," a slow and
irregular beat as the heart dies.
Fogel persisted. With Allen, the final drug was given at 12:31 a.m., but
Allen did not "flat line" on an electrocardiogram until 7 minutes later,
according to records of the execution at San Quentin State Prison. Fogel
noted that Allen had to be given a 2nd dose even though he was 76, a
diabetic with a bad heart and confined to a wheelchair.
Eakins suggested that the inmate's circulatory system might have been "in
shock," making delivery of the drug to the heart less effective. "There
are a number of things that could be happening," he said.
Fogel then wanted to know the degree of pain that would be inflicted by
the final drug if a person were not anesthetized. The judge has said the
Constitution does not demand a painless execution but one free of "severe
degrees of pain."
Eakins replied, "It should be very painful," and described it as possibly
producing a "burning sensation."
Eakins also acknowledged that it would be best to have an anesthesiologist
present at the executions to ensure the inmates are properly sedated.
"That would be ideal but that won't happen in the U.S., because the AMA
has prohibited that from happening," Eakins said, referring to the
American Medical Assn.'s position that it would be unethical for a doctor
to participate in an execution.
Lawyers for the state have suggested that requiring an anesthesiologist to
be present would end lethal injection executions, because it would be
extremely difficult, if not impossible, to find one willing to
participate.
Underscoring that point, the state called Dr. Robert Singler of Napa,
Calif., an anesthesiologist who testified that he thought the state's
system for executing people was adequate to bring death without suffering.
But he added that he would not participate because of ethical concerns.
Singler was 1 of 2 anesthesiologists who had agreed to be present at
Morales' execution, which was scheduled for Feb. 21, after Fogel said the
state had to either have a doctor present or change its protocol to one
drug only a heavy dose of barbiturate. The execution was called off after
the physicians backed out.
Even though he was a witness for the state, Singler was hardly championing
executions. He said he thought he could play a useful role at the Morales
execution by replicating, as much as possible, hospital conditions "to
make sure the execution was a humane process." He said he participated in
2 rehearsals 3 days before the execution was to have taken place and made
one suggestion about how to administer the drugs.
"Based on my clinical experience, I knew [Morales] would have felt no
pain" if the procedure was carried out correctly, he said.
However, just a few hours before the execution was to go forward, Singler
said Senior Assistant Atty. Gen. Dane Gillette, the state's lead
death-penalty lawyer, handed him a court order saying that if the doctors
discerned that Morales was regaining consciousness, "they need to take all
medically appropriate steps to make sure that Morales remains
unconscious."
"The way the outside world would view it was that I would have a
responsibility to rescue a botched execution even though I knew it
couldn't happen," Singler said. "That was beyond my limit."
Earlier in the day, Fogel asked Columbia University anesthesiologist Mark
Heath, who has lambasted the state's execution procedures, how they could
be improved.
Fogel couched a number of his questions in terms of "large mammals,"
acknowledging that he understood that Heath might not respond if he asked
directly how to kill a human. For example, the judge asked Heath, "Assume
I wanted to euthanize a large primate in a reasonably short period of
time, what would be the best barbiturate?"
Heath told the judge veterinarians typically use pentobarbital and
suggested that a member of that profession could best address the question
of dosage.
The judge's questions suggest that he believes information based on what
happens to animals being euthanized is relevant to the challenge. That
could be significant in this case, because lawyers for the state attorney
general's office have argued forcefully that animal studies should be
disregarded.
(source: Los Angeles Times)
anesthetic used in lethal injections has failed to quickly halt breathing.
In San Jose, a federal judge deciding the future of lethal injection in
California said Thursday that he was "troubled" that one of the drugs used
during several executions had failed to quickly end inmates' breathing.
During the 3rd day of a trial on the constitutionality of lethal
injection, U.S. District Judge Jeremy Fogel asked the state's
pharmacological expert how long a person should continue to breathe after
being given 5 grams of thiopental sodium, the anesthetic that is the 1st
of 3 drugs used for executions.
Some medical experts say the persistent breathing suggests that inmates
were not properly anesthetized during an agonizing death, comparable to
drowning.
"Not very long," replied Brent Eakins, the state's expert. "Say a minute
or less."
Then why, Fogel asked, have several inmates continued breathing much
longer after receiving that massive dose? Fogel said that doctors observed
Jaturun Siripongs, who was executed in 1999, breathing for 5 minutes after
receiving the sedative.
The judge said he was not drawing any conclusions, but added: "This is
just an anomaly that has troubled me ever since I came across it. The
doctors say they saw actual breathing."
Medical experts who testified previously in the case have said the large
dose of anesthetic should rapidly stop breathing, although an inmate could
continue to live for 20 minutes or longer. Critics of lethal injection
have suggested that in the absence of proper sedation, the second drug,
which paralyzes inmates' muscles, masks the pain of the third drug,
potassium chloride, which shuts down the heart.
Fogel is presiding over a legal challenge to lethal injection brought by
Michael Morales, who was condemned to die for the 1981 murder of Terri
Winchell, a 17-year-old high school student from Lodi. The judge must
assess Morales' claim that the state's lethal injection procedures present
an unnecessary risk of "cruel and unusual punishment" in violation of the
8th Amendment to the U.S. Constitution.
Thursday was the state's turn to have its experts counter earlier
testimony suggesting that execution teams may have failed to properly
administer the drugs in the past, subjecting inmates to severe suffering.
Pursuing his questioning, Fogel wondered aloud why inmates were not
immediately killed by the prescribed dose of the potassium chloride, which
he said was supposed to be "a lethal dose 100% of the time."
In the executions of Robert L. Massie in 2001 and Clarence Ray Allen
earlier this year, 2nd doses of the deadly heart-stopping drug had to be
administered, Fogel said.
"Assuming proper delivery, a person should die within seconds?" Fogel
asked.
Eakins agreed and then questioned whether Massie was experiencing
"effective" heart beats or just simply "agonal rhythm," a slow and
irregular beat as the heart dies.
Fogel persisted. With Allen, the final drug was given at 12:31 a.m., but
Allen did not "flat line" on an electrocardiogram until 7 minutes later,
according to records of the execution at San Quentin State Prison. Fogel
noted that Allen had to be given a 2nd dose even though he was 76, a
diabetic with a bad heart and confined to a wheelchair.
Eakins suggested that the inmate's circulatory system might have been "in
shock," making delivery of the drug to the heart less effective. "There
are a number of things that could be happening," he said.
Fogel then wanted to know the degree of pain that would be inflicted by
the final drug if a person were not anesthetized. The judge has said the
Constitution does not demand a painless execution but one free of "severe
degrees of pain."
Eakins replied, "It should be very painful," and described it as possibly
producing a "burning sensation."
Eakins also acknowledged that it would be best to have an anesthesiologist
present at the executions to ensure the inmates are properly sedated.
"That would be ideal but that won't happen in the U.S., because the AMA
has prohibited that from happening," Eakins said, referring to the
American Medical Assn.'s position that it would be unethical for a doctor
to participate in an execution.
Lawyers for the state have suggested that requiring an anesthesiologist to
be present would end lethal injection executions, because it would be
extremely difficult, if not impossible, to find one willing to
participate.
Underscoring that point, the state called Dr. Robert Singler of Napa,
Calif., an anesthesiologist who testified that he thought the state's
system for executing people was adequate to bring death without suffering.
But he added that he would not participate because of ethical concerns.
Singler was 1 of 2 anesthesiologists who had agreed to be present at
Morales' execution, which was scheduled for Feb. 21, after Fogel said the
state had to either have a doctor present or change its protocol to one
drug only a heavy dose of barbiturate. The execution was called off after
the physicians backed out.
Even though he was a witness for the state, Singler was hardly championing
executions. He said he thought he could play a useful role at the Morales
execution by replicating, as much as possible, hospital conditions "to
make sure the execution was a humane process." He said he participated in
2 rehearsals 3 days before the execution was to have taken place and made
one suggestion about how to administer the drugs.
"Based on my clinical experience, I knew [Morales] would have felt no
pain" if the procedure was carried out correctly, he said.
However, just a few hours before the execution was to go forward, Singler
said Senior Assistant Atty. Gen. Dane Gillette, the state's lead
death-penalty lawyer, handed him a court order saying that if the doctors
discerned that Morales was regaining consciousness, "they need to take all
medically appropriate steps to make sure that Morales remains
unconscious."
"The way the outside world would view it was that I would have a
responsibility to rescue a botched execution even though I knew it
couldn't happen," Singler said. "That was beyond my limit."
Earlier in the day, Fogel asked Columbia University anesthesiologist Mark
Heath, who has lambasted the state's execution procedures, how they could
be improved.
Fogel couched a number of his questions in terms of "large mammals,"
acknowledging that he understood that Heath might not respond if he asked
directly how to kill a human. For example, the judge asked Heath, "Assume
I wanted to euthanize a large primate in a reasonably short period of
time, what would be the best barbiturate?"
Heath told the judge veterinarians typically use pentobarbital and
suggested that a member of that profession could best address the question
of dosage.
The judge's questions suggest that he believes information based on what
happens to animals being euthanized is relevant to the challenge. That
could be significant in this case, because lawyers for the state attorney
general's office have argued forcefully that animal studies should be
disregarded.
(source: Los Angeles Times)