The Medical Aspect of Execution - page 2

What do you all think of all the medical snafus in State sanctioned Capital Punishment? Who are the people in charge of this and why can't they get their act together? Is it that hard to humanely... Read More

  1. by   Meeshie
    Damn.. that's a lot of missing. I know that IO would suck but at least it's hard to miss with that.
  2. by   hherrn
    This is clearly a competence issue.

    Yes, death row inmates have difficult access. As do thousands of patients every day. But, these inmates are walking and talking and have a measurable blood pressure, etc. In other words, they are far healthier than many patients who get some kind of access- if need be by a competent ICU doc. Or anesthesia.

    I think it is impressive that it is so hard for states to find professionals willing to use their skills and knowledge to assist in an execution. With appropriate equipment, an anesthesiologist could easily and reliably perform an execution. Once access is in place, any ICU nurse could end somebody's life. But, it seems, nobody qualified is willing to do it.

    Given the ethical issues, states who want to execute people should probably switch to a firing squad. Probably easier to find good marksmen who have no ethical or moral issues with state sponsored execution.
  3. by   calivianya
    Agreeing with the people who say we should just use propofol. Knocks people out quick, knocks their respiratory drive out quick, provides total amnesia (most of the time). I've seen people that are hard to put down, but hard to put down means like 80 mcgs/kg/min. Ml/hr wise, I've never seen anyone take spontaneous breaths on 70ml/hr or higher. A whole 100ml bottle run at 999 would do the trick every time. Respiratory drive would likely be totally knocked out in less than a minute.

    I agree that the nitrogen asphyxiation sounds most humane otherwise.
  4. by   KatieMI
    Opioids are not used because of 1) most of these guys have high tolerance level due to years of abuse, so the needed dose cannot be calculated, and, more importantly, 2) "morphine chest syndrome". It is a strange, unpredictable but not uncommon thing which happens if a large dose of opioids injected IV quickly enough and thought to be caused by histamine release. It is described as "chest tightness" in the list of side effects of pretty much each and every opioid which can be given IV, but in reality it is an extremely unpleasant, painful feeling like a very acute and severe asthma attack. When it happens, patients think that they are having heart attack or something. Worse, it produces real "tight chest", up to and including problems with ventilation. All that can interfere with "humanity" of procedure and with monitoring of death.
    Propofol can be AWFULLY painful if given as it is in peripheral IV. It lasts seconds, but I remember it like a shot of molten metal up to my hand. For that reason, it is commonly diluted by lidocaine but for the process of execution they probably wouldn't like it, because lido can induce heart arrest b/o its anti/proarrythmic properties, and so the guy can potentially feel "his heart stopping". Plus, shelf time of propofol is really short.
    Nitrous oxide idea won't fly for long because the obvious association with Nazi's gas chambers and because the person can voluntary prolong process somewhat by restricting his or her breathing for a while. Plus, this gas doesn't actually render people unconscious quickly enough and deep enough. As for many gases, its action is not predictable, especially for severely obese patients with hypoventilation.
    I do not know what was the problem with good 'ole barbiturates. Don't tell me about manufacturing - they are used left and right by vets and the globe doesn't consist of the USA alone.
  5. by   NurseSpeedy
    I feel that a lot of this may be a round about way of dealing with capital punishment versus life in prison being the maximum sentence for the crime committed. I will be the first person to say that if someone did what some of the people on death row did to my family, darn right I want that person to be sentenced to death. I also wouldn't be too worried about how "humane" the method was. After all, there was not anything humane about what they did to end up on death row to begin with.

    Then there is the unfortunate side that is always a possibility in certain cases, especially when convicted with circumstantial evidence and nothing concrete to back it up to say that 100% the person is guilty. There have been a few proven NOT guilty after the fact. We have seen this with rape cases years later. The inmates in these cases didn't have death sentences so when it turned out to prove that they did NOT do it, they we able to be released.

    No matter what the method used this will always be a controversial subject. If someone definitely DID commit some of the horrible things that get a person on death row I find it hard to believe that we are struggling with making it pain free and least traumatic as possible. Then again, if there is even the slightest possibility that years later it's discovered that the person was NOT the perpetrator it's hard to think that we would support capital punishment. Those are the cases that I think really make this whole debate hard (asides from religious beliefs, etc), is the what IFs that are later proven correct after conviction.
  6. by   FolksBtrippin
    We could always just stop killing people. Just sayin.
  7. by   Extra Pickles
    People can sit on Death Row for 10, 20, 25 years, with the average length of time being about 15 years. If there is a concern that medications expire before they can be used I have a bang-up idea, how about executing those who have a death sentence within a REASONABLE time period? 20 years on Death Row seriously?

    The manufacturer of the drugs might not like their drugs being associated with executions but I don't particularly care how they feel about it, they are a producer of a drug that is legally sold and legally purchased. They don't mind making the money from it's production or they'd stop producing it. I don't believe they should be able to dictate who buys it and for what purpose as long as it's a legal transaction.

    I can't believe that inability to get a vein for IV access can be this big of a deal. How many of us have had the nearly-impossible stick for a patient with a history of IV drug abuse or co-morbids that make access very difficult? Yet we get them done, sometimes with a Doppler if you have that ability and sometimes with someone who is just THAT.GOOD at IVs. Surely with the kind of lead time they have for an execution the facility can locate a single human being (or two or three for backups) with this ability?

    There are enough valid options for drugs and methods that kill people. Tussling over whether it's slightly uncomfortable or very uncomfortable is just too much IMHO, they are being executed as capital punishment for goodness' sake they aren't patients who are going to live through this procedure and complain about the staff not being concerned enough about their wellbeing! Yes it should be as comfortable as possible, that's humane. But if the medication burns when it goes in, or requires two or three different drugs with different routes to accomplish I think in the grand scheme of things it's ok. I'm not advocating for cruelty when it can be easily avoided. I do think that we should be remembering that execution isn't about patient care, it's about the carrying out of justice (and if you don't believe it's justice I can respect that but that's a different discussion!).
  8. by   Extra Pickles
    Quote from FolksBtrippin
    We could always just stop killing people. Just sayin.
    True. And we could just stuff more and more murderers into overcrowded prisons and give them great healthcare and education and entertainment for the rest of their miserable lives.

    Nah. I'd rather not. Just sayin'
  9. by   Guy in Babyland
    Why do we need to execute people so they die comfortably and quietly? Maybe I am a horrible person, but did the victims that these people killed die comfortably and quietly? Why are we treating these prisoners with such dignity and respect even though they gave their victims no dignity or respect?

    My proposal is that they are executed in the manner that their victims died.
  10. by   macawake
    Quote from Guy in Babyland
    Why do we need to execute people so they die comfortably and quietly?
    Why are we treating these prisoners with such dignity and respect even though they gave their victims no dignity or respect?

    My proposal is that they are executed in the manner that their victims died.

    Personally I don't think that state sanctioned murders have a place in an evolved society but the answer to your question is; we're supposed to be better than the person who commits violent, brutal crimes. Once we sink to their level, we (in my opinion) as a society forfeit the right to stand in judgment and condemn their actions.
  11. by   Zyprexa
    Quote from hherrn
    This is clearly a competence issue.

    Yes, death row inmates have difficult access. As do thousands of patients every day. But, these inmates are walking and talking and have a measurable blood pressure, etc. In other words, they are far healthier than many patients who get some kind of access- if need be by a competent ICU doc. Or anesthesia.

    I think it is impressive that it is so hard for states to find professionals willing to use their skills and knowledge to assist in an execution. With appropriate equipment, an anesthesiologist could easily and reliably perform an execution. Once access is in place, any ICU nurse could end somebody's life. But, it seems, nobody qualified is willing to do it.

    Given the ethical issues, states who want to execute people should probably switch to a firing squad. Probably easier to find good marksmen who have no ethical or moral issues with state sponsored execution.
    THIS. I'm in favor of the firing squad.
  12. by   offlabel
    All of this BS reflects us wanting to make capital punishment easier on everyone but the condemned. There is no fool proof, neat and tidy way to kill someone. Death is ugly and brutal and attempts to make it otherwise just make it worse. If the decision to kill is made, it should be carried out quicky and decisively without hesitation because anything less is brutally inhumane to the person that dies.

    The idea of condemned prisoners passively accepting a death mask of nitrogen without attempting to irrationally hold his/her breath and struggling in a final panic is absurd. No amount of PO sedation will stop that unless itself is a lethal dose.

    Whether or not to have the death penalty is another question altogether, but if we take this on ourselves for the condemned, we have a moral obligation to think of them first and not ourselves.

    A .308 round travels at around 1500 meters per second while the fastest nerve conduction in humans is 120 m/s and that isn't even pain signal conduction which is a fraction of that.

    Death by firing squad brings about instantaneous unconsciousness followed quickly by death. It's unlikely that the condemned even hear much of the muzzle noise if at all as sound travels at about 340 m/s.

    The problem is that we have a problem with putting people to death.
  13. by   Emergent
    I agree, a firing squad seems like a simple, quick, efficient method. Medicalizing execution is a mistake. Medical personnel would be violating basic principles of our professions by participating. I think this is an attempt to sanitize the whole sordid business.

    Personally, I don't think the death penalty accomplices much. It's not a deterrent, that's been shown in studies. There's always a chance that the person is actually innocent. It's very expensive.

    I think that prisons should be a less cushy experience. In the United States we cater to prisoners too much. But there's no point in killing people, you can never make the justice system totally fair, poor people don't get as good of lawyers, it just isn't necessary to have a death penalty.

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