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McCarthy: Doctors: Lethal injection often botched, horrific

Published: Saturday, March 29, 2014 12:28 a.m. CDT • Updated: Thursday, April 3, 2014 2:53 p.m. CDT

NEW YORK — Dennis McGuire clearly knew something was wrong. At 10:34 a.m. on Jan. 16, as a crowd at the Southern Ohio Correctional Facility looked on, the convicted murderer began gasping for air.

Then McGuire began to make snorting and choking sounds. For the next 10 minutes, as a combination of midazolam (a relaxant similar to Valium) and hydromorphone (an analgesic related to morphine) coursed through his veins, McGuire’s chest and stomach heaved as the oxygen in his blood dwindled. Death was approaching, but slowly.

Watching a man gradually suffocate may have come as a surprise to some people in the gallery, but it didn’t surprise David Waisel, an associate professor of anesthesia at Harvard Medical School, who had predicted this would happen. Ten days earlier Waisel had presented U.S. District Court Judge Gregory Frost with a nine-page declaration explaining that the state of Ohio planned to use an improper dose of midazolam – a short-acting benzodiazepine that’s often used to induce sedation and amnesia before a medical procedure – to kill McGuire.

Based on his expertise, he felt there was a “substantial, palpable, objectively intolerable risk of experiencing the agony and horrifying sensation of unrelenting air hunger” during the execution, suggesting that “McGuire will remain awake and actively conscious for up to five minutes.” It turns out Waisel may have undershot things; McGuire took nearly 30 minutes to die.

In a matter of minutes, it turns out, a physician with even minimal information (gender, neck size, blood pressure) can determine whether an inmate sentenced to death is likely to suffer.

The problem, of course, is that the state is not compelled to listen. The other issue is that the American Medical Association’s code of ethics bars members from participating in executions. This creates a troubling paradox: The people most knowledgeable about the process of lethal injection – doctors, particularly anesthesiologists – are often reluctant or unable to impart their insights and skills.

Indeed, most of the anesthesiologists I spoke with declined to comment on the record about lethal injection.

Without an expert in the room, states often rely on executioners who don’t really know what they’re doing. As one anesthesiologist told me, “the executioners are fundamentally incompetent. They have neither the technical skill nor the cognitive ability to do this properly.”

Another added, “In medicine, the burden of proof is on the doctor to show that something is safe. We would never give a new drug to a patient until it’s been tested, approved by the FDA, etc. With the death penalty, the burden of proof has been inverted. These compounds, which are clearly causing patients to suffer, are deemed safe until proven otherwise. Yet the department of corrections prevents the release of information pertaining to how the lethal injection is carried out, making it impossible for a lawyer to make a strong case that this method is cruel and unusual.” Georgia is in fact working on a Lethal Injection Secrecy Act.

As our understanding of cruelty continues to evolve – let’s not forget that drawing and quartering was once an acceptable method of execution – future generations may wonder why lethal injection was performed so poorly and carelessly, and with so little oversight.

Part of the problem is the terminology: Words like injection and cocktail and gurney give the illusion that this form of capital punishment is civil. This allows, regrettably, for a softening of the perception of what is actually happening: Medications that were designed to heal have been repurposed to kill.

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