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Deborah W Denno - One of the best experts on this subject based on the ideXlab platform.
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physician participation in Lethal Injection
Social Science Research Network, 2019Co-Authors: Deborah W DennoAbstract:On April 1, 2019, in Bucklew v. Precythe, the United States Supreme Court rejected a Missouri death-row inmate’s claim that executing him by the State’s Lethal Injection protocol would violate the Eighth Amendment’s ban on “cruel and unusual punishment” because blood-filled tumors in his head, neck, and throat could rupture, causing him to choke and suffer “prolonged” and “excruciating pain.” In essence, the Court found that Bucklew failed to establish “a feasible and readily implemented alternative method” of execution because he provided so few facts about nitrogen gas, the alternative that Bucklew suggested. In its argument against Bucklew’s claim, the State emphasized that experienced medical personnel, including a board-certified anesthesiologist, would be utilized during the execution to ensure that Bucklew would not face a “substantial risk of severe pain.” Bucklew’s medical expert countered strongly with compelling evidence that Bucklew would suffer greatly. Bucklew is far from the first capital case to rely on physicians’ contributions in the execution process. Indeed, physicians have been participating in executions for more than a century. This participation is particularly troublesome given the wide range of unresolved problems created by Lethal Injection, including drug shortages and untested drugs and protocols. The American Medical Association and other medical organizations have turned a blind eye to this reality or they have blamed the legal system for the current state of affairs. This commentary contends that whatever moral or professional credibility the medical community fears it will lose by engaging in a discussion of physician involvement in Lethal-Injection executions is already imperiled by the increasingly apparent divergence between the community’s words and its actions.
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physician participation in Lethal Injection
The New England Journal of Medicine, 2019Co-Authors: Deborah W DennoAbstract:Physician Participation in Lethal Injection In Bucklew v. Precythe, the Supreme Court decided against a death-row inmate with a rare medical condition. The case reveals to an unprecedented degree t...
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Lethal Injection chaos post baze
Georgetown Law Journal, 2014Co-Authors: Deborah W DennoAbstract:In 2008, with Baze v. Rees, the Supreme Court broke decades of silence regarding state execution methods to declare Kentucky’s Lethal Injection protocol constitutional, yet the opinion itself did not offer much guidance. In the six years after Baze, legal challenges to Lethal Injection soared as states scrambled to quell litigation by modifying their Lethal Injection protocols. My unprecedented study of over 300 cases citing Baze reveals that such modifications have occurred with alarming frequency. Moreover, even as states purportedly rely on the Baze opinion, they have changed their Lethal Injection protocols in inconsistent ways that bear little resemblance to the original protocol evaluated in Baze and even differ from one execution to the next within the same state. States’ continuous tinkering often affects already-troubled aspects of their Lethal Injection procedures. The compendium of these deficiencies has led to some of the most glaring failures in Lethal Injection history. An even more disturbing revelation relates to the Lethal Injection drugs used in these rapidly changing protocols. Recent drug shortages threaten many states’ abilities to carry out executions, and this Article presents evidence of the unfettered substitutions states have made in their desperate attempts to adhere to their execution schedules. These attempts include frequent drug switches that take place quickly, without oversight, and based purely on convenience and
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Lethal Injection chaos post baze
Social Science Research Network, 2013Co-Authors: Deborah W DennoAbstract:In 2008, with Baze v. Rees, the Supreme Court broke decades of silence regarding state execution methods to declare Kentucky’s Lethal Injection protocol constitutional, yet the opinion itself did not offer much guidance. In the six years after Baze, legal challenges to Lethal Injection soared as states scrambled to quell litigation by modifying their Lethal Injection protocols. My unprecedented study of over 300 cases citing Baze reveals that such modifications have occurred with alarming frequency. Moreover, even as states purportedly rely on the Baze opinion, they have changed their Lethal Injection protocols in inconsistent ways that bear little resemblance to the original protocol evaluated in Baze and even differ from one execution to the next within the same state. States’ continuous tinkering often affects already-troubled aspects of their Lethal Injection procedures. The compendium of these deficiencies has led to some of the most glaring failures in Lethal Injection history. An even more disturbing revelation relates to the Lethal Injection drugs used in these rapidly changing protocols. Recent drug shortages threaten many states’ abilities to carry out executions, and this Article presents evidence of the unfettered substitutions states have made in their desperate attempts to adhere to their execution schedules. These attempts include frequent drug switches that take place quickly, without oversight, and based purely on convenience and availability. The resulting unreliability and randomness heighten the risk that the execution process will violate the Eighth Amendment’s Cruel and Unusual Punishment Clause. As that risk increases, so does the tendency for states to retreat into secrecy regarding their Lethal Injection protocols. For a growing number of states, alternative protocols also incorporate the use of compounding pharmacies to produce Lethal Injection drugs. Traditionally, compounding pharmacies are non-FDA regulated, small-scale pharmacies that make customized drugs on an as-needed basis in response to individualized prescriptions. This trend toward using compounding pharmacies is highly problematic. For example, state regulations are paltry. They also tend to differ from one state to the next, making it difficult to ensure that compounded drugs are held to consistently high standards of quality, safety, and effectiveness. Evidence shows, however, that proposed and newly adopted federal legislation regulating these pharmacies may create major obstacles for the use of compounded drugs in executions, leaving states without even this risky recourse. Death-penalty opponents and medical professionals have long objected to Lethal Injection on the basis that the use of drugs to carry out executions links death to the practice of medicine. Ironically, that reliance on drugs may end up accomplishing what countless legal challenges could not: drug shortages have devastated this country’s execution process to an unparalleled degree. Rather than masking the “machinery of death,” the mimicry of medicine may end up dismantling it.
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when legislatures delegate death the troubling paradox behind state uses of electrocution and Lethal Injection and what it says about us
Social Science Research Network, 2011Co-Authors: Deborah W DennoAbstract:This article discusses the paradoxical motivations and problems behind legislative changes from one method of execution to the next, and particularly moves from electrocution to Lethal Injection. The discussion primarily focuses on the author's study of current protocols for Lethal Injection in all thirty-six states where anesthesia is used for a state execution. The study analyzes criteria contained in many protocols that are key to applying an Injection, including: the types and amounts of chemicals that are injected; the selection, training, preparation, and qualifications of the Lethal Injection team; the involvement of medical personnel; the presence of general witnesses and media witnesses; as well as details on how the procedure is conducted and how much of it witnesses can see. According to the study's results, criteria in many protocols are far too vague to assess adequately. When the protocols do offer details, such as the amount and type of chemicals that executioners inject, they often reveal striking errors and ignorance about the procedure. Such inaccurate or missing information heightens the likelihood that a Lethal Injection will be botched and suggests that states are not capable of executing an inmate humanely. The results of this article have been used in constitutional challenges to Lethal Injection across the country. Death penalty attorneys predict many more challenges to come.
Ty Alper - One of the best experts on this subject based on the ideXlab platform.
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the truth about physician participation in Lethal Injection executions
Social Science Research Network, 2009Co-Authors: Ty AlperAbstract:Recent court rulings addressing the constitutionality of states’ Lethal Injection procedures have taken as a given the faulty notion that doctors cannot and will not participate in executions. As a result, courts have dismissed the feasibility of a remedy requiring physician participation, and openly expressed suspicion of the motives of lawyers who would propose such a remedy.This Article exposes two myths that have come to dominate the capital punishment discourse: first, that requiring physician participation would grind the administration of the death penalty to a halt because doctors cannot participate; and second, that advocacy for such a requirement is a disingenuous abolitionist strategy as opposed to a principled remedial argument. As the Article demonstrates through a review of available research and recent litigation, doctors can, are willing to, and in fact do regularly participate in executions, though often not in the manner necessary to ensure humane executions.Lawyers for death row inmates have argued that skilled anesthetic monitoring by trained medical professionals is a necessary component of a constitutional three-drug Lethal Injection protocol. In response, state officials have strategically emphasized the positions of national medical associations (the ethical guidelines of which are not binding on doctors) and exaggerated their inability to find willing doctors. They have also exploited the activism of the death penalty abolitionist movement, which has long decried physician participation in executions. Abolitionist calls for discipline of medical professionals who participate in executions directly undermine the credibility of death row inmates’ litigation, and feed the perception that death penalty lawyers are talking out of both sides of their mouths.Lower courts grappling with how to address Lethal Injection procedures that violate the constitution should know the truth about physician participation. The requirement that trained medical personnel monitor Lethal Injection executions to ensure that inmates do not suffer excruciating pain should remain on the table as a plausible remedy.
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the truth about physician participation in Lethal Injection executions
North Carolina Law Review, 2009Co-Authors: Ty AlperAbstract:In December 2008, a prominent North Carolina doctor and professor of medicine, Charles van der Horst, published an op-ed in the Raleigh (N.C.) News and Observer. 1 The title of the piece was “An Absolute: Doctors Don‟t Kill,” and in it, Dr. van der Horst wrote that doctors “don‟t worry about whether someone is a Jew or a Muslim, an illegal alien or a murderer, whether he has insurance or not. We simply take care of that person in front of us the best way we can, given the resources available. And we do not kill our patients.” 2
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anesthetizing the public conscience Lethal Injection and animal euthanasia
Fordham Urban Law Journal, 2008Co-Authors: Ty AlperAbstract:INTRODUCTION In the late 1970s, when Texas was considering whether to adopt Oklahoma's three-drug Lethal Injection formula for the execution of prisoners, Dr. Ralph Gray, the doctor in charge of medical care in Texas prisons, consulted with a Texas veterinarian named Dr. Gerry Etheredge. (1) Dr. Etheredge told Dr. Gray that veterinarians used an overdose of one drug, an anesthetic called sodium pentobarbital, to euthanize animals and that it was a "very safe, very effective, and very cheap" method of euthanasia. (2) Dr. Etheredge remembers that Dr. Gray had only one objection to using a similar method to execute human beings. "He said it was a great idea," Dr. Etheredge recalled, "except that people would think we are treating people the same way that we're treating animals. He was afraid of a hue and cry." (3) Texas rejected Dr. Etheredge's one-drug, anesthetic-only recommendation and, in 1982, became the first state to actually use Lethal Injection--via the three-drug formula--as a method of execution. (4) This history is almost hard to believe in light of the fact that three decades later, death row inmates in Texas, as well as in nearly every other death penalty state, are challenging the three-drug formula on the grounds that the method is less reliable, and therefore less humane, than the method used to euthanize animals. (5) Rather than objecting to their clients being treated no better than animals, lawyers for the petitioners in Baze v. Rees, the Lethal Injection case pending before the Supreme Court, have essentially asked the Court to require the state of Kentucky to treat them at least as well as the state requires shelter workers to treat animals during the euthanasia process. (6) Veterinarians have testified on behalf of death row inmates in several states, (7) and groups of veterinary experts have filed amicus briefs on behalf of petitioners in the two most recent Supreme Court Lethal Injection cases, Baze (8) and Hill v. McDonough. (9) The three-drug formula that states use to execute people is often misleadingly referred to as a "cocktail." (10) The three drugs are not mixed together like a cocktail; instead, they are administered serially, usually with a saline flush in between each drug, to clear the intravenous ("IV") line. (11) The drugs are, in the following order, thiopental, pancuronium bromide, and potassium chloride. (12) The first drug is intended to anesthetize the inmate so he does not experience the effects of the second and third drugs. (13) The second drug paralyzes him, and the third drug stops his heart, killing him. (14) The use of pancuronium, the second drug, presents a problem that is fundamental to the controversy over the Lethal Injection procedure. Because pancuronium paralyzes the inmate during the execution process, the inmate may experience excruciating pain and suffering but be unable to cry out or even blink an eyelid to let anyone know if the anesthesia has failed. (15) Because pancuronium masks the ability of a lay observer to discern whether the anesthetic drug has been properly delivered, it is very difficult or impossible, in most cases, to know whether the Lethal Injection execution has been "botched." (16) Pancuronium virtually ensures that the execution looks "peaceful" (17) when it may have been anything but. The pain and suffering that an inmate would experience if not properly anesthetized is extreme. Because pancuronium is a paralytic that restricts the ability of the respiratory muscles to contract, it causes asphyxiation. (18) The third drug, potassium chloride, causes excruciating pain that has been likened to the feeling of having one's veins set on fire. (19) Experts who have testified in Lethal Injection cases have unanimously agreed that it would be unconscionable to inject either drug into a person who was not anesthetized, (20) At issue in recent challenges to the administration of this procedure is whether, and to what extent, the public can be sure that prison officials are properly administering the first drug, the anesthetic, and monitoring its continued effect, such that the inmate does not experience the suffocation the second drug causes or the excruciating pain that the third drug inflicts. …
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Anesthetizing the Public Conscience: Lethal Injection and Animal Euthanasia
Fordham Urban Law Journal, 2008Co-Authors: Ty AlperAbstract:Lawyers challenging Lethal Injection on behalf of death row inmates have frequently argued that Lethal Injection protocols do not comport with standard practices for the euthanasia of animals. This article studies state laws governing animal euthanasia and concludes that many more states than have previously been recognized ban the use of paralyzing agents in animal euthanasia. In fact, 97.6% of Lethal Injection executions in this country have taken place in states that have banned, for use in animal euthanasia, the same drugs that are used in those states during executions. Moreover, a study of the legislative history of state euthanasia laws reveals that the concerns raised about paralyzing drugs in the animal euthanasia context are identical in many ways to the concerns that lawyers for death row inmates are currently raising about the use of those drugs in the Lethal Injection executions of human beings. This article takes an in depth look at animal euthanasia and its relationship to Lethal Injection by examining in Part I the history and origins of the paralyzing drugs that veterinarians and animal welfare experts refuse to allow in animal euthanasia; in Part II the standards of professional conduct for veterinary and animal shelter professionals; in Part III, the state laws and regulations governing animal euthanasia; and finally in Part IV, the legislative history that led to the enactment of the various states' animal euthanasia laws and regulations.
Peter A Ubel - One of the best experts on this subject based on the ideXlab platform.
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physicians willingness to participate in the process of Lethal Injection for capital punishment
Annals of Internal Medicine, 2001Co-Authors: Neil J Farber, Elizabeth B Davis, Joan Weiner, Gil E Boyer, Brian M Aboff, Peter A UbelAbstract:According to the results of this survey, many physicians would be willing to be involved in the execution of adults despite medical society policies. The medical profession needs to be better infor...
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physicians attitudes about involvement in Lethal Injection for capital punishment
JAMA Internal Medicine, 2000Co-Authors: Neil J Farber, Elizabeth B Davis, Joan Weiner, Janine Jordan, Gil E Boyer, Peter A UbelAbstract:Background Physicians could play various roles in carrying out capital punishment via Lethal Injection. Medical societies like the American Medical Association (AMA) and American College of Physicians have established which roles are acceptable and which are disallowed. No one has explored physicians' attitudes toward their potential roles in this process. Methods We surveyed physicians about how acceptable it was for physicians to engage in 8 actions disallowed by the AMA and 4 allowed actions involving Lethal Injection. Questions assessing attitudes toward capital punishment and assisted suicide were included. The impact of attitudinal and demographic variables on the number of disallowed actions deemed acceptable was analyzed via analysis of variance and multiple logistic regression analysis. Results Four hundred eighty-two physicians (51%) returned questionnaires. Eighty percent indicated that at least 1 of the disallowed actions was acceptable, 53% indicated that 5 or more were acceptable, and 34% approved all 8 disallowed actions. The percentage of respondents approving of disallowed actions varied from 43% for injecting Lethal drugs to 74% for determining when death occurred. All 4 allowed actions were deemed acceptable by the majority of respondents. Favoring the death penalty ( P P Conclusions Despite medical society policies, the majority of physicians surveyed approved of most disallowed actions involving capital punishment, indicating that they believed it is acceptable in some circumstances for physicians to kill individuals against their wishes. It is possible that the lack of stigmatization by colleagues allows physicians to engage in such practices.
Robert D Truog - One of the best experts on this subject based on the ideXlab platform.
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physicians medical ethics and execution by Lethal Injection
JAMA, 2014Co-Authors: Robert D Truog, Glenn I Cohen, Mark A RockoffAbstract:In the wake of the recent botched execution by Lethal Injection in Oklahoma, a group of eminent legal professionals known as the Death Penalty Committee of The Constitution Project issued a set of recommendations for sweeping legal and administrative reforms of this method of capital punishment. This Article discusses the Committee’s recommendation that medical personnel perform the medically-related elements of Lethal Injection executions. Noting that such involvement is prohibited by the codes of medical ethics of professional societies in every medical profession, this Article argues that significant ethical concerns dictate that medical professionals should refuse to participate in Lethal Injection executions.
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physicians medical ethics and execution by Lethal Injection
JAMA, 2014Co-Authors: Robert D Truog, Glenn I Cohen, Mark A RockoffAbstract:In an opinion dissenting from a Supreme Court decision to deny review in a death penalty case, Supreme Court Justice Harry Blackmun famously wrote, “From this day forward, I no longer shall tinker with the machinery of death.”1 In the wake of the recent botched execution by Lethal Injection in Oklahoma, however, a group of eminent legal professionals known as the Death Penalty Committee of The Constitution Project has published a sweeping set of 39 recommendations that not only tinker with, but hope to fix, the multitude of problems that affect this method of capital punishment.2
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moral fictions and medical ethics
Bioethics, 2009Co-Authors: Franklin G Miller, Robert D Truog, Dan W BrockAbstract:Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a Lethal Injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a Lethal dose of medication. We argue that the differential moral assessment of these two practices is based on a series of moral fictions – motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken.
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physicians and execution highlights from a discussion of Lethal Injection
Social Science Research Network, 2008Co-Authors: Atul A Gawande, Deborah W Denno, Robert D Truog, David B WaiselAbstract:This article constitutes excerpts of a videotaped discussion hosted by the New England Journal of Medicine on January 14, 2008, concerning a range of topics on Lethal Injection prompted by the United States Supreme Court's January 7 oral arguments in Baze v. Rees. Dr. Atul Gawande moderated the roundtable that included two anesthesiologists - Dr. Robert Truog and Dr. David Waisel - as well as law professor Deborah Denno. The discussion focused on the drugs used in Lethal Injection executions, whether physicians should participate, potential alternatives, and some of the legal parameters of Baze.
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physicians and execution highlights from a discussion of Lethal Injection
The New England Journal of Medicine, 2008Co-Authors: Atul A Gawande, Deborah W Denno, Robert D Truog, David B WaiselAbstract:Foreword On January 14, 2008, the Journal hosted a videotaped roundtable discussion of the issues raised by Baze v. Rees, currently before the Supreme Court, that asks whether the three-drug protocol used to carry out the death penalty by Lethal Injection causes unnecessary pain and suffering in violation of the Constitutional ban on cruel and unusual punishment. Moderator Atul Gawande was joined by law professor Deborah Denno, anesthesiologist–ethicist Robert Truog, and anesthesiologist David Waisel. What follows are highlights of their discussion about Lethal Injection, the current protocol, possible alternatives, and the role of physicians and other health care professionals in putting convicted criminals to death. The video, along with a related reader poll and an interactive timeline, can be found at www.nejm.org. The Protocol Dr. David Waisel: The three-drug protocol is based on what was considered a normal induction of anesthesia when it was developed. [The first drug is] thiopental, also known as ...
Neil J Farber - One of the best experts on this subject based on the ideXlab platform.
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physicians willingness to participate in the process of Lethal Injection for capital punishment
Annals of Internal Medicine, 2001Co-Authors: Neil J Farber, Elizabeth B Davis, Joan Weiner, Gil E Boyer, Brian M Aboff, Peter A UbelAbstract:According to the results of this survey, many physicians would be willing to be involved in the execution of adults despite medical society policies. The medical profession needs to be better infor...
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physicians attitudes about involvement in Lethal Injection for capital punishment
JAMA Internal Medicine, 2000Co-Authors: Neil J Farber, Elizabeth B Davis, Joan Weiner, Janine Jordan, Gil E Boyer, Peter A UbelAbstract:Background Physicians could play various roles in carrying out capital punishment via Lethal Injection. Medical societies like the American Medical Association (AMA) and American College of Physicians have established which roles are acceptable and which are disallowed. No one has explored physicians' attitudes toward their potential roles in this process. Methods We surveyed physicians about how acceptable it was for physicians to engage in 8 actions disallowed by the AMA and 4 allowed actions involving Lethal Injection. Questions assessing attitudes toward capital punishment and assisted suicide were included. The impact of attitudinal and demographic variables on the number of disallowed actions deemed acceptable was analyzed via analysis of variance and multiple logistic regression analysis. Results Four hundred eighty-two physicians (51%) returned questionnaires. Eighty percent indicated that at least 1 of the disallowed actions was acceptable, 53% indicated that 5 or more were acceptable, and 34% approved all 8 disallowed actions. The percentage of respondents approving of disallowed actions varied from 43% for injecting Lethal drugs to 74% for determining when death occurred. All 4 allowed actions were deemed acceptable by the majority of respondents. Favoring the death penalty ( P P Conclusions Despite medical society policies, the majority of physicians surveyed approved of most disallowed actions involving capital punishment, indicating that they believed it is acceptable in some circumstances for physicians to kill individuals against their wishes. It is possible that the lack of stigmatization by colleagues allows physicians to engage in such practices.