Saturday, 10 November 2007

UTHSC Doctor Presents Lethal Injection Debate

Dr. William Girard

Staff Writer

Animals euthanized by veterinarians are treated more humanely than inmates killed by lethal injection.

Dr. William Girard, professor at the University of Texas Health Science Center at Tyler, presented this and other findings on Friday supporting insufficient lethal injection protocol in U.S. prisons.

“There is adequate evidence of deeply disturbing systematic flaws,” he said.

A moratorium has been placed on all lethal injection executions, “even in Texas,” until the U.S. Supreme Court in January considers its constitutional integrity, Girard said.

Recent lawsuits filed by death row inmates claiming lethal injection is cruel and unconstitutional spurred state and now federal judicial reaction.

It also caused Girard to question the complaints’ legitimacy. What he found was shocking, he said.

As a state function, lethal injection —a “three-drug cocktail” consisting of an anesthetic, a paralyzing agent and potassium chloride that stops the heart — is not administered by doctors or medical professionals, but instead inadequately trained prison officials, Girard said.

Serious delays, complications and traumatic deaths have resulted.

“There are many instances … difficulty finding a vein, equipment failing, choking and heaving, the needle becoming lodged, or is pointed in the wrong direction,” Girard said, “definitely (allowing for) the possibility of agony or suffocation during a period of time before death.”

In May, prison officials in Ohio stuck Christopher Newton at least 10 times with needles, delaying his execution more than an hour, as they struggled to place shunts in his arms to administer the fatal doses.

Newton — who took a bathroom break during the delay — was executed for beating and choking his cellmate Jason Brewer, 27, to death in 2001 for bad chess etiquette.

Death also came slowly for Stanley Tookie Williams — co-founder of the violent Crips street gang — in 2005, when San Quentin State Prison officials couldn’t find a vein in his left arm for 20 minutes and didn’t pronounce him dead for 34 minutes after injection.

Girard said poor training, cramped facilities and the absence of health officials lead to complications and mishaps.

The injection itself is also flawed, he said.

Inmates can die quietly in pain when the anesthetic wears off too quickly and the paralyzing agent renders them unable to speak or move, Girard said.

A state review of San Quentin (in California) found that some 6 of the last 18 lethal injection cases did not lose consciousness before potassium chloride was injected, he said.

Officials agreed this was terrifying, and executions at San Quentin are on hold following the review.


Girard compared egregious lethal injection conduct to the careful, expertly way veterinarians administer euthanasia.

While lethal injection protocol varies by state, the American Veterinary Medicine Association issues and frequently updates a 39-page guideline for euthanasia.

The most encouraged form of euthanasia involves one ingredient: a long-acting anesthetic called sodium pentobarbital.

The animal is given a high dose which pushes them past loss of consciousness into apnea and then into cardiac arrest.

Using an anesthetic assures vets that the animal is completely asleep when its heart stops.

But, lethal injections used on inmates contain a short-acting anesthetic called thiopental, Girard said.

And unlike lethal injections, vet guidelines discourage the use of a paralyzing agent, saying it could lead to death by asphyxiation which isn’t even appropriate once an animal is unconscious.

“I concluded that the paralyzing agent is used in lethal injection for the benefit of the viewers, to keep the inmate from squirming if the anesthesia isn’t adequate,” Girard said.

“Notice the vets’ emphasis on regularly training personnel to knowledgably assess anesthetic death.”


In comparison, the use of lethal injection has had no medical oversight since its implementation in 1977, Girard said.

Texas was the first to use it in 1982 on Charles Brooks Jr. who took seven minutes to die — witnesses said he didn’t die easily.

But during its development in the late 1970s, doctors refused to be involved in crafting the lethal dose.

That attitude continues today — the American Medical Association explicitly discourages physicians from advising over, monitoring, preparing or administering lethal injections.

Girard calls this a foundational dilemma.

“Lethal injection moved execution into the medical environment,” he said. “It now requires the input and expertise of medical personnel. But are medical practitioners ready to be involved?”

North Carolina’s medical board says no, which earlier this year threatened discipline on any doctor who participates in lethal injection.

A N.C. state court that ruled for medically-trained assistance with executions revoked its ruling saying it had overstepped its authority.

It’s a stalemate, Girard said.

Besides aggressive medical boards, finding medical professionals who will participate in lethal injection practices could be difficult.

Some UTHCT doctors seemed to agree.

“There’s no way a physician would not sully (himself) by participating in this process,” said Dr. James Stocks, director of UTHCT’s Center for Sleep Disorders.

Stocks compared it to the German doctors who were a “vigorous part” of the extermination of the Jews during the Holocaust.

Girard, who doesn’t agree with the death penalty, suspects the U.S. Supreme Court won’t eliminate the use of lethal injection.

But they could require more trained supervision, and perhaps consider different injection ingredients and modes of administration.

“It will be an interesting dilemma,” he said.

Facts About Lethal Injection:
- Texas leads nation in the number of executions since the death penalty was reinstated in 1976.

- Lethal injection consists of: sodium thiopental (anesthetic), pancuronium bromide (muscle relaxant - collapses diaphragm and lungs), potassium chloride (stops heart beat).

- Inmates are usually pro-nounced dead about 7 minutes after the lethal injection begins.

- Cost per execution for drugs used : $86.08

- Average time on Death Row prior to execution: 10.26 years

Source: Texas Department of Criminal Justice

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