Death Penalty Anesthesia

Just a CRNA · May 27, 2006

hey ... i couldn't give two you know what's about who puts death row prisoners to death...
i just find it ironic that as CRNA's we fight tooth and nail to provide anesthesia - but in this case - some would gladly give it away because they don't agree w/ the death penalty..
all i am saying is whether we provide anesthesia or not should not be determined by your views on what anesthesia is being given for...i understand the whole "do no harm" controversy...that was not my point.

The point is...the state gives the "anesthesia." CRNAs do not. Doctors do not. This thread centered around the ethics of giving anesthesia for the death penalty. Anesthesia is not given, only drugs that also happen to be used in anesthesia. I don't know about you, but my anesthesia practice includes airway management. You don't see that in the world of capital punishment, so I think it is safe to say that this point is rather ridiculous. I think perhaps Yoga had the right idea. See ya,

MmacFN · May 27, 2006

Hey JustaCRNA

I totally see what you are saying. On the other hand, the joint statement from the ASA/AANA almost suggests that only anesthesia providers should be doing it. Im not saying that thats their opinion, just that it could be seen that way.

This has been an excellent discussion and i have learned alot about the rules and actual practice of lethal injection.

The point is...the state gives the "anesthesia." CRNAs do not. Doctors do not. This thread centered around the ethics of giving anesthesia for the death penalty. Anesthesia is not given, only drugs that also happen to be used in anesthesia. I don't know about you, but my anesthesia practice includes airway management. You don't see that in the world of capital punishment, so I think it is safe to say that this point is rather ridiculous. I think perhaps Yoga had the right idea. See ya,

ZASHAGALKA, RN · May 28, 2006

I could do it. I wouldn't lose sleep over it. It would not be the act of an individual (me), but the act of the State. I would only be acting as an agent for the State.

I cannot see how acting as an agent of the State in this manner is a violation of NPA. Both the NPA and criminal statutes are State Laws and therefore, the State can make whatever exceptions it deems fit to either or both laws.

Or, to put it another way, if the State specifically says that I can perform a function, then how can it be a violation of State law for me to do so?

See my sig line, below.

~faith,

Timothy.

athomas91 · May 28, 2006

The point is...the state gives the "anesthesia." CRNAs do not. Doctors do not. This thread centered around the ethics of giving anesthesia for the death penalty. Anesthesia is not given, only drugs that also happen to be used in anesthesia. I don't know about you, but my anesthesia practice includes airway management. You don't see that in the world of capital punishment, so I think it is safe to say that this point is rather ridiculous. I think perhaps Yoga had the right idea. See ya,

first of all - Yoga not posting is a huge loss....and his reasons were completely different from what you are seemingly doing... however...

i understand all of what you are saying... that is still not the point any of my posts were making.... anesthesia practice is more than airway management and more than pushing "anesthesia" drugs... it is a multitude of skills and knowledge that we use to give comfort... my point is... that we fight so hard to be the only ones to use "anesthetic" drugs - but in this case we will just give it to "the state" to push... again - as i posted before - i get the whole do no harm deal...AGAIN.... not my argument... but why should those who have no knowledge of these drugs be using them - don't these individuals deserve comfort as well...i mean they are dying whether they are comfortable or not...i for one believe they should be comfortable. as far as ethics in death penalty anesthesia - we all will have our different beliefs.. again not a point i tried to argue for it is a futile one to start with...

so - to make it clear - i for one am not injecting my personal beliefs - i suppose that is why you are so upset...my point for the millionth time is just that why are non-anesthesia providers providing anesthesia...and why is everyone ok with that....

MmacFN · May 28, 2006

Thomas

Exactly. In any other case (Read: Propofol in the ER) CRNAs are absolutely against the practice. Why now, is it different?

AVM · Jul 3, 2006

thank you for the previous discussion. i would like to add some comments.

some years ago i saw a film "point of no return",1992, of john badham with bridgete fonda in [color=gray]key role, remake of a french movie "nikita". there was short but very shocking and revolting moment of execution of poor girl with lethal injection.

an young lady doctor or a female (!!!) nurse in a white doctor's smock puts a suture needle in a vein of the girl,

connnects it with iv and begins drugging. then she waits when her "patient" closes eyes...

it is difficult to imagine more perverted and deformed like this... as for me it was beyond any understanding.there was no question to discuss whether it was ethic or not, it was monstrous!

may be badham and co sneered at [color=gray]medicine or they purposely[color=gray] attracted our attention to such problem as you have discussed here, i do not know. all my relatives are physician and i always guessed that only saint men and women could be doctors. but now i am seriously disappointed at your "humane " and "democratic" [color=gray]spiritual values when a word "doctor" become synonym of a word "butcher" and "executioner" ! it is very dangerous and abominable bias, even more dangerous than a criminal growth because it confuses incompatible things- treatment for life and "treatment" for death!

Jo Dirt · Jul 3, 2006

Most doctors or other medically trained people refuse to do this procedure so it is often left to wardens and people with no experience. What happens in a lot of cases they suspect that even though it may look like the prisoner is peaceful it is because his muscles have been paralyzed and he/she is really suffocating in agony. The drugs they use here in Tennessee have even been banned from being used to euthanize animals but they are using it on prisoners.

In general, I don't believe I could do it. But I'm a true crime book junkie and there are some people I have read about I believe I would have no trouble doing. Only I think lethal injection would be too kind for them.

dfk, RN, CRNA · Jul 3, 2006

i have to chime in.. as the original post was, was just regarding would you do it, notwithstanding pro/con of death penalty - - this thread sort of got a little out of the way.. anyway, one would/should consider this a 'job', and do the job. end of discussion. personally, it would be a little grim and monotonous for me. so, i would have to say no.

thanks for listening..

I like the idea of "judicial sleep" from a science fiction novel I read recently.
The person judged guilty would not be put to death, but rather put to sleep and maintained for the duration of their sentence on a type of life support that just kept them fed, hydrated, and in good skin condition. Of course, the sentence could be so extensive that they would actually die in their sleep.

and indigo, what type of "punishment" would this be if the guilty are kept comfortably sleeping whilst serving their sentence? most of us would kill for sleep (no pun intended, well, ok, it was) as a student.. you're right tho, don't forget to reposition Q2hrs and prn.. LOL

AVM · Jul 4, 2006

The idea of attracting "doctors or other medically trained people" at such dirty thing as execution is felonious and might be born only in some diseased heads. You have given Hippocratik oath not to be injurious to health of anybody!

Those "medicians" who at least once have done it have not any rules to be called by such high-minded name as a "physicians". I would never come to such "humanic doctor" for any treating and would damn him (her).

soliant12 · Jul 5, 2006

Can someone explain to me why it is unethical to provide anesthetic services to an inmate being executed and performing anesthesia on an organ harvest?

jwk · Jul 5, 2006

We don't provide "anesthesia" for organ harvests.

Zinobile · Jul 6, 2006

I'd do it. Consider the alternative. As far as I'm concerned, if I'm not injecting the lethal drugs but providing the sedation so the patient does not feel pain, that is completely within my realm of practice, theoretically speaking.

I have provided anesthesia services during organ harvests. While it is not customary to provide any type of sedation or analgesia, complete neuromuscular blockade is often used in order to facilitate the surgeons' approach to the target organ(s) and optimize surgical conditions. Additionally, a cascade of events occurs when a patient's brain dies that will lead to the total collapse of the remaining systems if vigilant intervention is not in place. Hence the Organ Procurement Specialists that come in and guide the critical care from determination of brain death to actual organ harvest. The primary goal and a challenging one at that is to maintain perfusion of the target organs. Brain death rapidly deteriorates to vascular collapse without swift intervention. These interventions are ongoing during organ harvest and are the SOLE RESPONSIBILITY of anesthesia services. Once the aorta is cross-clamped, the ventilator gets turned off and anesthesia's role is complete.

Z