The slow death of lethal injectionBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2670 (Published 29 April 2014) Cite this as: BMJ 2014;348:g2670
All rapid responses
No form of capital punishment can be humane, given the extreme anxiety experienced by prisoners awaiting execution. However, assuming that they are guilty, these prisoners have committed murder, which is also not humane. If murderers are to be executed, it must be by a method which is quick, certain and painless. Anxiety must be pre-treated with appropriate medications. Addicts should be allowed full and free access to their chosen substances of abuse prior to execution, if that will make it easier for them. Prosecutors and judges should be held personally and professionally liable in full for any misdeeds they commit during trials for capital charges, such as suppression of exonerating evidence. All scheduled executions should be delayed indefinitely until all of these things are done. Otherwise, we forfeit any claim to being just or humane nations.
Competing interests: No competing interests
A chilling article though it is very encouraging that the vast majority of doctors are refusing to participate.
I wonder what lethal drug the enthusiasts for Lord Falconer's upcoming Bill suggest doctors who are prepared to help patients kill themselves might prescribe?
Since this article mentions that the same drug that failed in some of these these heinous botched executions also failed in botched assisted suicide in Orgeon, it had better be foolproof. If it isn't, we all know who will be expected to 'finish the job' properly and it won't be Lord Falconer.
Competing interests: Member of Care Not Killing Alliance
Addendum: Ohio released yesterday (28 April 2014) its review into the January lethal injection of Dennis McGuire. The state's report concludes that the execution was “conducted in a constitutional manner” consistent with policy.
McGuire's prolonged writhing and gasping after receiving a previously untried combination of 10 mg midazolam and 40 mg hydromorphone reignited the national debate on lethal injection.
The review finds that "the bodily movements that were observed were consistent with the effects of the drugs, his obesity and other body characteristics, and involuntary muscle contractions associated with the ending of respiratory function. There is no evidence that McGuire experienced any pain, distress or anxiety."
But the same document announces that in future executions, the dosage of midazolam will be increased from 10 to 50 mg, while the hydromorphone dose will increase from 40 to 50 mg. The Department of Corrections "remains confident that its current drug regimen is sufficient to conduct a humane and constitutional execution, but also sees no reason not to increase the dosage levels to reaffirm that the drugs will, without doubt, cause profound general anesthetic and ventilatory-depressant effects."
As noted in the article, the 10 mg of midazolam administered to McGuire was roughly twice what a man of his weight might receive for conscious sedation during colonoscopy. Florida's midazolam execution protocol specifies a dose 50 times greater.
Following McGuire's death, Ohio postponed until November the execution of Gregory Lott. But with the McGuire review completed, Ohio now plans to move ahead with the previously scheduled 28 May execution of Arthur Tyler.
Competing interests: Writer of this article