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Interesting article I saw today on yahoo. Not so much because of the troubled history of this Missouri anesthesiologist who administers meds for executions, but rather because of the controversial issue it brings up again. It states that Missouri is putting a stay on all executions until it can get a board-certified anesthesiologist for the job. Of course, ASA recently released a statement that anesthesiologist should not be involved in executions.

So how do you guys all feel about this? I have no intention of stirring Capital punishment debate, but I have to say I'm pissed how politicians, who have not helped us much re: CRNAs and scope of practice issues, suddenly covet our services when it comes to a heated issue like execution.

Why not have CRNAs "perform" all executions? We know they have a certain "skill" in killing folks as it is. Kidding. Kind of. ;)

Missouri execution doctor has troubled past: paper Sun Jul 30, 1:35 PM ET

KANSAS CITY, Missouri (Reuters) - A doctor who oversaw dozens of Missouri executions until his questionable practices led a judge to suspend executions in the state, has been sued for malpractice more than 20 times and has a history of making medical mistakes, the St. Louis Post-Dispatch reported on Sunday.

Alan R. Doerhoff, 62, also has been banned from at least two Missouri hospitals and was publicly reprimanded by the state's Board of Healing Arts in 2003 because Doerhoff was trying to conceal malpractice claims from hospitals where he was working, the newspaper reported.

The state Attorney General's Office was aware of the reprimand, but the state Department of Corrections continued to employ Doerhoff to handle lethal injections, the Post-Dispatch reported.

Indeed, the state tried to keep his identity a secret in an appeal earlier this year by inmate Michael A. Taylor, who claimed the heart-stopping drug given in lethal injections can cause excruciating pain if the inmate is not given proper levels of anesthesia first.

Lawyers reviewing execution logs found that the anesthesia Doerhoff had prepared for Taylor's execution before it was stayed in February was only half the amount it should have been, and records of previous executions indicated similar improperly prepared doses.

The doctor then admitted he was dyslexic, sometimes transposing numbers, and last month U.S. District Judge Fernando Gaitan suspended executions until the state hires a board-certified anesthesiologist to ensure that the drugs used in lethal injections were properly prepared.


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The issue here (especially in Missouri) has been that poorly trained and educated people have been put in charge of these things. A lot of these people have no clue what these meds do, how long they take to work, how long they last, and what order to give them in. There are poorly designed protocols in many situations and very little oversight; surprising given the extensive time and effort that goes into securing a death penalty. In at least one state, the protocol was to give the thiopental and potassium in one IV and the relaxant in another (why????) and there was a documented case of an execution where the prisoner's Pentothal/K vein infiltrated (ouch!) and the relaxant went in fine... IV access can be a challenge, as you might expect, in the prison population, so making sure the drugs get in is a common problem.

I am against the death penalty in all cases, so take my bias as you like, but it is neither good for the states executing people to do it poorly or good for our specialty (and our drugs) to be associated with death.

Capital punishment makes no sense anyway given that it is far more expensive than a life sentence and has no deterrent value. It results in overaggressive prosecuting attorneys putting inocent people on death row and results in the sad fact that the darker your skin color, the greater the likelihood that you will get the death penalty for similar crimes. The US is definitely not in good company when it comes to other nations that sanction executions. Look these things up and you will find they are true.
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starsop93 said:
In at least one state, the protocol was to give the thiopental and potassium in one IV and the relaxant in another (why????)

The reasoning behind this is that pentothal and muscle relaxant = rocks in the IV tubing. You don't need separate IV's, just flush prior to injecting the muscle relaxant. Their protocol assures that they avoid the embarrasing precipitated IV line.
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