Lethal injection stirs new debate
Published: Monday, January 23, 2006 at 6:01 a.m.
Last Modified: Sunday, January 22, 2006 at 10:40 p.m.
Clarence Hill won't feel potassium chloride burning through his veins before it stops his heart, according to the state of Florida.
He'll first be given a drug to render him unconscious during the execution, scheduled for Tuesday at Florida State Prison near Starke. But a second drug will paralyze him, making it impossible to tell if he accidentally wakes before being injected with the chemical that kills him.
Death penalty proponents say Hill will fare better than the Pensacola police officer he shot to death during a bank robbery. But Hill's attorney argues the procedure is unconstitutionally cruel, citing a study by University of Miami medical school doctors who determined inmates could wake and feel pain before dying.
"The system has been set up to fail on occasion," said Dr. David Lubarsky, chairman of the school's anesthesiology department and study co-author.
Printed in the British medical journal The Lancet, the study found that 21 of 49 executed inmates in other states had so little anesthetic in their blood they could have been conscious when killed.
The study blamed the problem on the lack of medical involvement in developing the lethal injection method and monitoring the procedure.
The Florida Supreme Court rejected Hill's appeal last week, sending the case to the U.S. Supreme Court. Deborah Dunno, a Fordham University law professor and expert on lethal injection, said the nation's highest court has never ruled on the constitutionality of an execution method.
But California's execution of Clarence Ray Allen last week is an example of flaws in the lethal injection process, she said, which might lead the court to consider its constitutionality. Allen, 76, needed an extra injection of the lethal drug to stop his surprisingly healthy heart.
"Every time they inject an inmate, there's an experiment going on," Dunno said.
The reason, she said, is because Oklahoma first developed the lethal injection procedure in 1977 with little medical involvement. Florida and 35 other states with the death penalty follow a nearly identical process, with Nebraska being the only holdout exclusively using the electric chair.
In Florida, inmates are first offered a Valium to calm their nerves, but the rest of the procedure is essentially the same as other states. The inmate is first injected with sodium thiopental, a common anesthetic. The next drug injected is pancuronium bromide, which paralyzes the muscles.
Lubarsky said the paralyzing drug "does nothing but make (the execution) look painless."
The American Veterinary Medical Association bans the use of such drugs in euthanizing pets because they could wake without anyone being able to tell.
Finally, potassium chloride is injected to stop the inmate's heart. Hill's appeal cited the Miami study in arguing there's a good chance he could be awake and feel the chemical burn through his veins before killing him.
The study looked at toxicology reports from executions in four states - though not Florida - and found post-death blood concentrations of the anesthetic were lower than required for surgery in 43 of 49 inmates. Twenty-one of those inmates had levels consistent with awareness.
The two grams of anesthetic injected in Florida inmates is four times the amount used when a typical operation is done, said Dr. Nikolaus Gravenstein, anesthesiology department chairman at the University of Florida's medical college. The amount should be enough to reliably keep the inmate unconscious for at least five minutes, he said.
But while it should be "extremely unlikely" that an inmate would wake, he said, the lack of professional medical involvement in the procedure makes it possible.
The problem is most doctors won't take part in executions, said Dr. William Allen, director of UF's bioethics, law and medical professionalism program. The reason is due to ethical guidelines and public perception of a doctor's role, he said.
"Physicians have wanted to be seen as healers," he said.
Allen, an attorney as well as doctor, said lethal injection appears to be the least cruel means of execution and he doubts arguments to rule it unconstitutional will be successful.
Florida instituted lethal injection as its main method of execution in 2000 due to questions about the constitutionality of the electric chair. Nicknamed Old Sparky, the chair caused flames to shoot from inmates' heads in executions in 1990 and 1997.
Even after blood came from an inmate's head in an execution in 1999, the Florida Supreme Court found the method constitutional. The U.S. Supreme Court was poised to rule on the issue when the state decided lethal injection must be used, unless the inmate asks to be electrocuted. Fifteen inmates since executed have all received lethal injections.
Lubarsky said there are too many questions about the procedure to be sure inmates aren't suffering. No matter what a person's stance on the death penalty, he said, society should be against causing deliberate pain to its prisoners.
"What separates us from criminals is we don't torture human beings," he said.
Nathan Crabbe can be reached at 338-3176 or crabben@ gvillesun.com.
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