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US Execution by Lethal Injection: The Medicine Behind The Headlines


In defiance of the International Court of Justice ordering the US government to grant a stay of execution to five Mexican nationals facing execution, the US state of Texas executed by lethal injection convicted child rapist and murderer, Jose Medellin. President Bush ordered the state of Texas to honor the order of the International Court of Justice but the US Supreme Court ruled that the President overstepped his authority and voted against a stay of execution.

Texas, like most US states, uses a three drug combination for lethal injection, designed to sedate (sodium thiopental), paralyze (pancuronium bromide) and finally, induce cardiac arrest (potassium chloride). The American Medical Association (AMA) and other professional associations consider participation in capital punishment a breach of professional ethics. Killing a human being to serve the interests of the state has been determined to be outside of the scope of practice for health care professionals. Rapid execution has for centuries been considered humane, but there is some debate over how humane the current methods of lethal injection are. Let's just say there has been no Evidence Based study of how to execute someone humanely. At least nothing that is published. So if medical professionals are not assisting at executions, it means that some other employee of the state is inserting the IV catheters used for the procedures.

Anyone with any clinical experience is familiar with the vagaries of IV catheterization experience - will the technician find a patent vein? Will the technician secure the apparatus to prevent infiltration into the surrounding tissues? Will the drugs be flushed through the system adequately to provide sufficient sedation and rapid death? Will the tubes be kept patent and unkinked throughout the procedure? Does everyone know what they are doing? Anesthesiologists have been asked to monitor executions but have declined to participate in them. In 2006, Orin Guidry, MD, president of the American Society of Anesthesiologists (ASA) “Lethal injection was not anesthesiology's idea. American society decided to have capital punishment as part of our legal system and to carry it out with lethal injection. The fact that problems are surfacing is not our dilemma. The legal system has painted itself into this corner and it is not our obligation to get it out.”

The truth of the matter is that physicians do participate in executions, but are not disclosing these actions to the public. The Journal of Legal Medicine reports that physician participation in execution is required in 17 states, but the exact activities of the physicians are not discoverable. Illinois and Kentucky are the only two US states that forbid physicians from participating in state ordered executions. Oklahoma and Georgia are two US states which have enacted laws protecting medical workers who participate in executions.

Thank you jastacey128 for use of image Lethal injection.


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