The pharmacology of lethal injection


#1

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#2

Controversial compared to other drugs used for killing prisoners, but not compared to, say, rehabilitation.


#3

Maggie, do you know the pharmacology for euthanasia drugs for sick pets? Is it similar?


#4

I don't. It would be worth messaging David Kroll, though. He might know: https://twitter.com/davidkroll


#5

Serious question. Would a massive, pure heroin dose be both more humane and effective?
What would be any negatives?
Edit: It seems routinely simple(ish) to Anaesthetise someone for major surgery, wouldn't it be relatively simple to then induce a heart-attack from there?
Disclaimer: I'm completely against capital punishment.


#6

Thanks Maggie, but I have given up Twitter. My hope is that animals don't suffer the same inhumanity. But if they don't suffer, then I would question why we couldn't develop a dose appropriate for the size of a human, where they need not suffer either.

I'm editing to add that I'm not a death penalty proponent, but if this is the system we are stuck with, it shouldn't be questionable if it's torture.


#7

Because doctors have this "thing" about being involved with killing people. With physician assistance I imagine it would be pretty easy to do it.


#8

Surely the administers have some form of medical training already.


#9

Everyone always wonders why they use such ineffective and indeed stupid means of killing people. Putting aside annoying questions of morality and the accuracy of the judicial system. I have to admit I wonder at this myself. You'd think gradual anoxia would be a sure means requiring no drugs at all. And of course the firing squad; how can you go wrong with a firing squad? Or the guillotine, for that matter. Surely all these means are better than electrocution or drugs administered by an incompetent phlebotomist.


#10

If only this was true. But unfortunately, a minority of doctors have always been willing and indeed eager to associate themselves with execution and torture systems, as indeed is the case today for both these US government activities. The CIA retains psychiatrists -- medical doctors -- as torture consultants, and the army retains ordinary doctors specialized in pain research for their crowd-suppression weapon system experiments.


#11

My understanding is that they don't really. There's a few hours of training in the procedure, but otherwise it's a non-medical employee of the prison doing the work. At least in Oklahoma.


#12

Ye gods. In that case, they're best off sending in a crack team of crackheads to administer a final farewell. At least it'll be pleasant.


#13

The drugs that I'm familiar with being used to euthanize animals are ketamine, follow by sodium pentobarbital. As the article mentions, sodium pentobarbital by itself would be enough to get the job done in humans, it just takes too long. From what I've seen, it doesn't take all that long when administered to an animal, 5 to 10 minutes at the longest.


#14

They managed to somehow. People miss (intentionally or not) and guns misfire.

Another option would be a large explosion. The kind where the Mythbusters have to visit another state because the Alameda County Bomb Disposal Range isn't big enough.


#15

There was an interesting -- and somewhat stomach-turning -- story about this on NPR this morning: The Messy Legal Road That Led to the Botched Execution in Oklahoma. It included people talking about how emotionally difficult their jobs are. It was hard for me to generate much sympathy.


#16

I think that AMA takes a rather dim view of its members participating in executions, and doing so would put one's certification on the line.

Being an executioner would certainly not be a full time job, and I suspect that the people who would be willing to throw away a lengthy stint studying to become a doctor for a crummy part time job are few and far between, to say the least, even if there is a portion of doctors who would be okay with that role personally. I imagine there would also be quite widespread censure directed at them from both their colleagues and the society at large. Not a winning proposition by any measure.

Compared to that, being a psychologist in one of the CIA torture chambers (or something in the same vein) is a full time job and probably also a state secret of some sort - the personal cost and risk for that is significantly lower than what it would be for a doctor to become a part-time executioner.


#17

Ketamine? You sure? I know the LD50 in humans is fucking huge for ketamine, though animals (even bigger ones, apparently) need smaller doses.


#18

There's more history, and less science, to Jay Chapman's invention of the three-drug cocktail than described in David Kroll's (great) article. Check out this amicus brief from the Berkeley Law death penalty clinic (PDF link, scroll down past the news articles -- page 17 of the amicus brief starts the really relevant bit) and Chapman's own words in an interview with Human Rights Watch.

Briefly, a couple of OK state legislators wanted to come up with a different execution method because it would cost too much to repair the electric chair. They asked Chapman, who was the state medical examiner, if he had any suggestions. Though he was not an expert in anesthesiology, pharmacology, or toxicology (and told the legislators as much at the time), he came up with the three-drug cocktail pretty much off the top of his head. It was quickly adopted into OK state law with little further research (they asked one other guy over the phone, two days before the law passed). Then a bunch of other states just wholesale adopted the OK lethal injection law, with no further questioning or research.

When asked by Human Rights Watch why he chose the drug cocktail he did, Chapman stated

“I didn’t do any research. I just knew from having been placed under anesthesia myself, what we needed. I wanted to have at least two drugs in doses that would each kill the prisoner, to make sure if one didn’t kill him, the other would.”

When asked why he chose to add potassium chloride to the cocktail, he stated

“I didn’t do any research … it’s just common knowledge. Doctors know potassium chloride is lethal. Why does it matter why I chose it?"

I'm pretty sure there is more research and regulation on how we put animals to sleep than on how we put people to sleep. I'm also pretty sure David Kroll, for example, is significantly more qualified to come up with a lethal injection protocol than the guy who came up with the one we use now.


#20

Thanks, but can we really know that the animal doesn't suffer? Please ask your friend.


#21

That is where the propofol comes in. It's a general anesthetic. So for dogs and cats, much the same procedure and drugs used on humans prior to the EU export ban, minus the potassium. The barbiturate overdose reliably causes cardiac failure. I've actually held one of my dogs through this, she was completely out before the pink stuff was given.

Chemical livestock euthanasia apparently is/can be ugly, with seizures and thrashing about, and is not commonly used, but it sounds like that is driven more by cost than concern. The usual method is a "captive bolt", (that thing Javier Bardem has in No Country for Old Men) or a hunting rifle... large animal vet's get training on exactly where you have to aim and at what angle in different animals due to brain location and skull thickness, though apparently ranchers always do it themselves. Neither of us has direct experience to offer on this.