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Botched Execution, Again

Dr. Imago said:
Lethal injection, when done correctly, is the standard because it is quick, painless, and cheap. The problem is the "done correctly" part, as we've seen as the genesis of this discussion.
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Since you obviously know what you're talking about, could I bother you with a question? (Yes, I did do my homework first, IOW, I googled, but anything related to efficient and humane ways of killing people is very difficult to find on the net. On brutal and inhumane ways, of course, there are uncountable websites, thanks to the US and its second amendment.)

Ever since Belgium legalized euthanasia (that's the term usually used, personally I think "medically assisted suicide" might be closer - it is after all the patient in suffering who makes the decision), I've read about the "euthanasia kits" doctors can get at pharmacies here. But to me, they remain somewhat shrouded in mystery, it's as if non-medically qualified people aren't allowed to know exactly what's in them. It's clearly a combination of different drugs, at least some of which are to be injected. The best thing I can find right now pointing to their composition is this picture:
http://www.dw.de/image/0,,17240560_401,00.jpg
(a Google Images search on "Belgium euthanasia kit" will give you more, but mostly repeated low-res images of the packaged kit.)

Of course, this isn't comparable to an execution, the only people on which these "kits" will ever be used are willing participants in the process. But would, in your expert opinion, the composition of these be something along the lines of the multi-drug sequence of injections you entirely hypothetically and theoretically proposed as a method for carrying out the death penalty humanely?

It's a matter of purely intellectual interest to me at the moment, I'm not planning on either applying for euthanasia or killing myself in any other way right now, and Belgium of course doesn't have the death penalty. But the recent death of both of my parents, who were both members of the organisation that got our euthanasia law on the books for decades before the law was finally passed, and left handwritten living wills predating that law to make sure any needless suffering at the end of their lives wasn't prolonged just because it was medically possible, has made me interested in such matters.
 
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Dr. Imago said:
Certainly, creating an atmospheric condition of 100% nitrogen involves technical costs that would exceed lethal injection costs.
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It doesn't have to be 100% nitrogen. 95% or so would be enough. And given that, you could easily turn any normal room into a "gas chamber" for around $500 (one time) and $30/execution of nitrogen.
 
Bikewer said:
or revive the guillotine, (The Germans had essentially perfected the device and continued to use it well into the 20th century) or whatever.
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I've done small thought experiments on the idea of bringing back the guillotine. On one hand, it is quick and effective. On the other, there's the whole issue of "head rolling around" and "blood everywhere." It wouldn't matter to the condemned, but I can't imagine the public being OK with seeing that.

Bob001 said:
The three-drug protocol starts with barbiturates that are supposed to put the prisoner to sleep (literally). If he is making any sounds, let alone trying to talk, he's not asleep.
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All sleep talkers (myself included) beg to differ with you.


ravdin said:
Bring back the guillotine. It's as quickest and most painless invention for killing a human being that has been devised.

If we're too squeamish as a society to behead prisoners, then perhaps we need to call into question whether we want to continue with state sponsored executions.
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^This.

Dr. Imago said:
It is a real shame that we can't formally be involved in this process, as it would be both more effective and humane... not that I would personally be involved in them regardless. This is purely an academic exercise for me.
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You bring up a valid point. I completely understand why professional medical organizations bar their members from participating in executions. However, it would go a long way to reducing concerns about future botched executions if people who know what they are talking about would be allowed to help plan.

fuelair said:
There are some add ons, but the only ones I will mention involves the imprisonment/execution if anyone involved in the investigation lied/suborned perjury/hid proof/evidence of innocence and related including lawyers with clients they know or suspect actually did the crime who do not make that information available toot suite to the police and the person on trial's attorney.
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*puts on criminal defense attorney hat*

Legal ethics bar me from ever revealing something a client tells me, if it is told to me as part of a legal consolation. (There are some exceptions, but they are not applicable here.) If a client tells me they committed a murder that someone else was convicted of, I can be disbarred for going to the police. There is a reason for this secrecy, and it forms a basis for our criminal justice system. We want clients to be honest with their attorney. It would make defending someone a lot harder if they left out details because those details would incriminate them.

angrysoba said:
Can you really not see the most glaring and obvious results of such policies? Not only would you set up a new layer of attempted prosecution of anybody who even defended suspects - particularly when the suspects have been found guilty in the court of public opinion - you would necessarily have lawyers turning on their own clients to save their own skins regardless of whether the defendant is actually guilty or innocent.

It boggles the mind that some people do not understand principles of the protection of a presumption of innocence and would like to bring in shortcuts to the gallows by threatening anyone who upholds basic principles of justice.

Have you actually thought about these things or do you just reactively call for kangaroo courts whenever you read about the bad things people do in the world?
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The state where I live has a state agency whose only purpose is defending indigent clients who are facing the death penalty. I have a great deal of admiration for the attorneys who work there. (A part of me wants to someday be one of them.) But the system only works because there are attorneys who choose to spend all of their working time defending people accused of horrible crimes.

I was in law school in Florida during the Casey Anthony trial. I cannot imagine any attorney taking Anthony's case if the attorney knew their freedom (or life) were on the line. But because that wasn't the case, an attorney did take Anthony's case - and she was acquitted.
 
Discussing this in a separate (and medical) forum, this came up:

http://s3.amazonaws.com/content.newsok.com/documents/5-1-14 DOC letter re Clayton Lockett.pdf

Understandably, the man did not "cooperate" with the placement of the IV line. Again, I think a contingency plan needs to be in place for such scenarios. For example, many of these medications can be administered intramuscularly (IM) as opposed to intravenously (IV). In that case, I think the protocols should be expanded or adapted to include such scenarios. As was pointed out by a poster on the other forum, for example, intramuscular ketamine could be given. But, I'm fairly certain such creative problem solving is not part of the current prescriptions.

~Dr. Imago
 
Rachel Maddow made the point tonight that the Supreme Court decision authorizing execution by lethal injection made specific, repeated mention of the specific three-drug protocol that has subsequently been used for years. Her point is that the substitution of other drugs not approved by the Supreme Court (necessitated by the unavailability of the approved drugs) in effect is medical experimentation, and that such executions are likely illegal.

She also made the point that when the Oklahoma execution went south and the authorities announced that they were stopping it, in part because they had no more drugs to administer, the curtains were drawn and after six minutes the inmate died "of a heart attack." She wonders what they actually did to him during the six minutes that there were no witnesses.
http://www.msnbc.com/rachel-maddow-...xecution-change-but-dont-improve-242477123723
 
Bob001 said:
She wonders what they actually did to him during the six minutes that there were no witnesses.[/url]
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Implicit in the typical "Maddow musing" is often wild speculation and conspiracy-theory-esque connecting of dots. Likely they did nothing. The drugs just caught up to him. As I mentioned, these drugs can be given various different ways (intramuscular, IV, subcutaneously, orally, rectally... you get the drift). Once they cross a barrier, they will get into your system. It's just a matter of time.

As far as the regulatory requirements, this is part of the problem. While I think the regulations agree and are sensible that the life-ending agent is and actually should remain potassium chloride, there are other ways to ensure amnesia and "comfort", if you will, up to that point - both for the person being executed and those witnessing it.

Unfortunately, the government always has to deal with the lowest common denominator, (at least appear to) treat everyone fairly, and back up any decision with a stack of paper stating that whatever needs to be done is proven to be the right thing to do, because of the inevitable legal challenges. For this reason (among others), the death penalty does not serve its intended purpose and, until this kind of regulatory problem can be surmounted, should be done away with altogether. That's just one man's opinion.

~Dr. Imago
 
Dr. Imago said:
Understandably, the man did not "cooperate" with the placement of the IV line... many of these medications can be administered intramuscularly (IM) as opposed to intravenously (IV). In that case, I think the protocols should be expanded or adapted to include such scenarios.
~Dr. Imago
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Again, just as a veterinary surgeon would do - much easier to get something in IM if the patient is intent on attack. Then, once they're asleep it's a doddle to do the IV - well, not always, as the sedative lowers the blood pressure, but it can be done and it would be impossible without the sedative.

As an aside, It always amuses me in those films where the baddies ambush an unsuspecting but struggling kidnap victim, press a needle and syringe to their arm and push the plunger home without a trace of blood being seen at the hub; following which the victim slumps into blissful and well controlled unconsciousness.

Human IV's must be really easy ;)

Yuri
 
Yuri Nalyssus said:
Again, just as a veterinary surgeon would do - much easier to get something in IM if the patient is intent on attack. Then, once they're asleep it's a doddle to do the IV - well, not always, as the sedative lowers the blood pressure, but it can be done and it would be impossible without the sedative.

As an aside, It always amuses me in those films where the baddies ambush an unsuspecting but struggling kidnap victim, press a needle and syringe to their arm and push the plunger home without a trace of blood being seen at the hub; following which the victim slumps into blissful and well controlled unconsciousness.

Human IV's must be really easy ;)

Yuri
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In much the same way it's apparently really easy to hit someone over the back of the head and render them instantly unconscious without any risk of causing permanent damage.. :)

/derail
 
Gallstones said:
Were the owners present?
I'd have tried intracardiac after the vein blew and the dog was unconscious. But that might be disturbing for the client to witness.
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The client was present, it was a pretty emotional situation and intra-cardiac wouldn't have been appropriate. Having blown both cephalics (one limb very oedematous due to an enormous, ulcerated axillary mass, the second limb slightly oedematous + fat); thanks to a phenomenal veterinary nurse I managed to gain access via the saphenous vein.

I haven't had to use the saphenous for years - not an easy morning's work, a much loved dog and a very sad case.

Yuri
 
More details. This answers why the vein collapse wasn't noticed sooner:

Some of the three drugs used in a botched Oklahoma execution this week didn't enter the inmate's system because the vein they were injected into collapsed, and that failure wasn't noticed for 21 minutes, the state's prison chief said, urging changes to the state's execution procedure.

Medical officials tried for nearly an hour to find a vein in Clayton Lockett's arms, legs and neck before finally inserting an IV into his groin, prisons director Robert Patton wrote in a letter to the governor Thursday detailing Lockett's last day.

By the time a doctor lifted a sheet covering the inmate and noticed the line had become dislodged from the vein, all of the execution drugs had already been administered and there wasn't another suitable vein, the report noted.

"The drugs had either absorbed into tissue, leaked out or both," Patton wrote. "The director asked the following question: 'Have enough drugs been administered to cause death?' The doctor responded, 'No.'"

At that time, Patton halted the Tuesday night execution, but Lockett was pronounced dead of a heart attack 10 minutes later.

Oklahoma's execution rules call for medical personnel to immediately give emergency aid if a stay is granted while the lethal drugs are being administered, but it's not clear if that happened. The report does not say what occurred from when Patton called off the execution at 6:56 p.m. to Lockett being pronounced dead at 7:06 p.m.

The report also indicated that on his last morning, Lockett fought with guards who attempted to remove him from his cell and that they shocked him with a stun gun. After he was taken to a prison infirmary, a self-inflicted cut was found on Lockett's arm that was determined not to require stitches. The report also notes that Lockett refused food at breakfast and lunch.

...

Inserting IVs into the groin area — the upper thigh or pelvic region — is often done for trauma patients and in experienced hands can be straightforward, but injecting in the femoral vein can be tricky because it's not as visible as arm veins and lies next to the femoral artery, said Dr. Jonathan Weisbuch, a physician in Phoenix.
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Linky.

Autopsy results will take 2-3 months.
 
Isn't the whole point of having people watch executions to let them feel revenge and have a properly gruesome show? What's with the squeamishness then - if you don't want to see someone die, then don't watch it.

Also, why the elaborate (and error prone) setups for lethal injection and other execution methods used in the US? You want to kill someone, right? Let's just make it as easy as possible and use a captive bolt pistol as used on larger animals in an abattoir. Quick and painless, no?
 
svenax said:
Isn't the whole point of having people watch executions to let them feel revenge and have a properly gruesome show? What's with the squeamishness then - if you don't want to see someone die, then don't watch it.

Also, why the elaborate (and error prone) setups for lethal injection and other execution methods used in the US? You want to kill someone, right? Let's just make it as easy as possible and use a captive bolt pistol as used on larger animals in an abattoir. Quick and painless, no?
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Welcome to the paradoxes of capital punishment. In a practice tainted with biblical ideas of retribution and an afterlife, but modified by humanistic concerns, the punishment part of it makes the killing only a component and nothing is easy. So we must kill the person, but he must be sane and conscious and know he's being punished, and victims there to watch. But it must be humane, and dignified, and not comparable to how we euthanize pets, and we object to its being messy. So you can't just put them to sleep, and can't just chop off their heads. Even just to call it killing is problematic. And of course since the process is fallible and sometimes corrupt, and mistakes are made, you must protract the process for years and years, but cannot just put them in prison for life, which is cheaper and safer both, and since suicide is a sin, you can't sanction their killing themselves. I seem to recall a case not long ago in which a convicted killer's sanity and fitness for execution was questioned because he acknowledged that he deserved it.

I tend toward opposition to capital punishment, although it's a natural emotional reaction to many crimes to want brutal retribution. But either way the result seems crazy.
 
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