Last year The Lancet published a paper, which found that despite a theoretically lethal dose of the barbiturate thiopental, given before the injection of pancuronium to paralyse breathing muscles and potassium chloride to stop the heart, 21 of 49 executed US inmates had postmortem thiopental concentrations consistent with consciousness (See Lancet 2005; 365: 141214). Now, a Californian judge--Judge Jeremy Fogel--has ruled that the state must either rely solely on thiopental, or else have a qualified individual confirm unconsciousness before the injection of pancuronium and potassium chloride, in order to avoid excessive pain. As a result, Californian officials have had to postpone the execution of a convicted murderer by lethal injection after they were unable to find medical personnel willing to participate. Involvement in executions contradicts the principles of many professional organisations in the US, including the American Medical Association.
The Lancet comments: "This is a pivotal point in history. A moment when individuals, like Judge Fogel, and the anaesthetists who refused to participate, have given voice to their conscience. They have articulated the concerns of an increasing number of Americans, whose support for capital punishment has dropped from 80% to 64% in the past decade. It is a voice to be heeded. As Judge Fogel noted, the Eighth Amendment has been interpreted as prohibiting punishments that are 'incompatible with the evolving standards of decency that mark the progress of a maturing society'. In 2004, China, Iran, Vietnam, and the USA accounted for 97% of the world's executions. From which of these countries will a mature society take the lead, and abolish the atrocity of state execution?"
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
2-Mar-2006