Torture by Lethal Injection

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Hello everyone,
Mohamed suggested that I post my comment on "the death penalty by lethal injection in the U.S." on our website, which I think is a good idea. Actually I thought of that as a human rights issue but I don't know why I was hesitant to do it. Thanks Mohamed for your encouragement. So please go ahead and post my comment that I re-wrote in more detail.


Death Penalty By Lethal Injection In The U.S.

Yesterday, as I was reading the latest online issue of " The Lancet Medical Journal ",
I bumped into an interesting but pretty disturbing article titled " Medical Collusion in the
Death Penalty : An American Atrocity ". (Collusion means association with unlawful activity,
as defined by Franklin dictionary). A disturbing thing to know is that the death penalty by
lethal injection in the U.S. is carried out by technicians, without supervision of a medical
professional to determine the sufficiency of the doses of the drugs used for the killing.

Death by lethal injection is performed as a means of execution free from cruelty compared
to other methods like hanging, shooting ..etc. However, death by lethal injection in the U.S.
may not be free from cruelty as it is claimed. As it is known, death by lethal injection is
performed by using three drugs given to stop the three major body systems successively :
the brain, followed by the respiration and finally the heart. The effectiveness of the dose of
each drug used is calculated based on parameters, factors as well as the individual's
condition physically and psychologically. Only a medical professional can correctly assess these factors to calculate the effective doses of drugs used in this method of
execution.

The first drug given is sodium thiopental to induce anaesthesia or sleep, followed by the
skeletal muscle relaxant Pavulon (pancuronium bromide) to paralyze all the muscles,
causing the breathing to stop, and finally potassium chloride injection to stop the heart.

As the Lancet article explained, post-mortem studies done on executed inmates in the
U.S. showed that the concentrations of sodium thiopental in the blood of 43 out of 49
executed inmates (or 88%) were lower than those needed to induce surgical anaesthesia.
This leads us to know that those executed inmates were awake during the process of
execution, but totally paralyzed, and in agony of not being able to breathe, awaiting the
final injection to stop the heart ending in death. This could be the most cruel way of
execution, being tortured while awaiting your death.

I recall that during my practice of anaesthesia for surgery, the most important thing that
we should avoid is " awareness under anaesthesia" that happens in practice to many
anaesthesiologists, where the patient could be awake during the surgery but paralyzed
with repeated doses of skeletal muscle relaxants, while he/she can hear everything, and
even feel the pain but unable to do anything. Fortunately, the mechanical ventilation is
a big relief from the agony of being unable to breathe.

If we claim that the execution by lethal injection is done in a humane way, the subject for
execution should be dealt-with the same humane way we deal with surgical patients,
hence, execution by lethal injection should be performed properly and with the help of
a medical professional who will decide when to interfere to support breathing manually
or mechanically till the final injection is given to stop the heart.

We should call for a Human Rights action on this important issue that requires the Human Rights Organization and its affiliates to fight for making the death penalty by lethal
injection more humane than the way it is being done here in the U.S.

Mohammed Magdi Elgadi, MD, Anaesthesiology
( To view the Lancet article click the highlighted link on top of page )