Tuesday 6 February 2007

Inadequate anaesthesia in lethal injection for execution

The Lancet 2005; 365:1412-1414

DOI:10.1016/S0140-6736(05)66377-5

Research Letters

Inadequate anaesthesia in lethal injection for execution

Dr Leonidas G Koniaris MD email address a Corresponding Author Information, Teresa A Zimmers PhD a, David A Lubarsky MD b c and Jonathan P Sheldon MD d

Summary

Anaesthesia during lethal injection is essential to minimise suffering and to maintain public acceptance of the practice. Lethal injection is usually done by sequential administration of thiopental, pancuronium, and potassium chloride. Protocol information from Texas and Virginia showed that executioners had no anaesthesia training, drugs were administered remotely with no monitoring for anaesthesia, data were not recorded and no peer-review was done. Toxicology reports from Arizona, Georgia, North Carolina, and South Carolina showed that post-mortem concentrations of thiopental in the blood were lower than that required for surgery in 43 of 49 executed inmates (88%); 21 (43%) inmates had concentrations consistent with awareness. Methods of lethal injection anaesthesia are flawed and some inmates might experience awareness and suffering during execution.

Affiliations

a. Dewitt Daughtry Family Department of Surgery, School of Business, University of Miami, Miami, FL, USA
b. Department of Anaesthesiology, Perioperative Medicine, and Pain Management, School of Business, University of Miami, Miami, FL, USA
c. Miller School of Medicine, and Department of Management, School of Business, University of Miami, Miami, FL, USA
d. Law Office of Jonathan P Sheldon, Arlington, VA, USA

Corresponding Author InformationCorrespondence to: Dr Leonidas G Koniaris, Alan Livingstone Chair in Surgical Oncology, 3550 Sylvester Comprehensive Cancer Center (310T), 1475 NW 12th Avenue, Miami, FL 33136, USA

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