Tuesday, 18 September 2007

Attention of an anesthesiologist who induces initial unconsciousness

Florida now uses a higher dose of sodium thiopental, 5 grams, than is used in some jurisdictions, which if fully injected into the prisoner`s bloodstream will cause loss of consciousness within seconds and death due to respiratory failure within a few minutes.

The fact that Diaz took over 30 minutes to die and that other Florida executions have taken a longer time than would be expected with an administration of that amount of thiopental indicates two possible alternative conclusions.

First, an error occurred with the chemical delivery system and the inmate has not been adequately anesthetized.

Second, the non-clinical dosage of sodium thiopental may suppress the cardiac function of the body to the extent where it delays the effect of subsequently administered drugs.

1100 (Fla. 2006); Hill v. State, 921 So.2d 579 (Fla. 2006); Diaz v. State, 945 So.2d 1136 (2006).

There is an extensive body of literature describing the lethal injection method of execution.

Briefly, lethal injection is the method of execution used by 37 of the 38 capital punishment states.

The basic procedure used by essentially all of these states, including Florida, is the three drug regimen first developed in Oklahoma in 1977.

The procedure begins with securing venous access, followed by an injection of sodium thiopental (trade name Asodium pentathol, an ultra fast acting barbiturate, to render the prisoner unconscious.5

The prisoner is then injected with a paralytic agent, pancuronium bromide (trade name Apavulon, in sufficient quantities to stop respiration.

Lastly, the prisoner receives an injection of potassium chloride, which induces cardiac arrest and permanently stops the prisoner=s heartbeat.

A saline solution is injected in between each of these steps as a flushing agent.

There is a general medical and legal consensus that the administration of either of the second two drugs in a prisoner who is not adequately anesthetized will cause extreme pain and suffering.

Pavulon causes paralysis and respiratory failure.

Injection of it into an aware subject will cause him to experience slow suffocation while being unable to breathe and unable to show by word or gesture what is happening.

Potassium will cause severe burning in the subject=s vascular system and eventually full cardiac arrest.

Both drugs have important clinical uses. Pavulon is used to relax respiratory function to facilitate intubation of mechanical breathing apparatus and to keep the patient still during the procedure, and potassium chloride is used in heart surgery.

Both require the full panoply of operating room care, including the attention of an anesthesiologist who induces initial unconsciousness, then maintains and monitors the patients plane of anesthesia@ throughout the procedure.

The use of either or both of the drugs on a prisoner who is not adequately anesthetized would be a violation of the eighth amendment`s prohibition of cruel and unusual punishments.

See generally Sims v. State, 754 So.2d 657 (Fla. 2000); Deborah W. Denno, When Legislatures Delegate Death, 63 Ohio St. L.J. 63 18

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