Missouri Lethal Injection Protocol Propofol
The state of Missouri has decided to use propofol for its capital punishment cases. This after prison officials were unable to locate supplies of sodium pentothal to carry out its executions. There are no domestic suppliers of pentothal and foreign imports of the drug were banned by the Federal Drug Administration because they have not been tested for executions.
I wonder how propofol will stand up under the inevitable court challenges by prison inmates. The previous standard three drug regimen was banned after prisoners filed suit stating it was cruel and unusual punishment to be executed with drugs that can cause pain and suffering before it fully takes effect. If that is the case, the courts will have a field day when patients, er, inmates, scream in pain from the propofol burn right before they die. I've had patients who have received propofol in previous operations who liken the pain to having their arm falling off. Many prisoners already have difficult IVs to start with because of their histories of IV drug abuse. Those tiny veins are exceptionally sensitive to the pain from propofol injection.
There is also the contention that the use of propofol for executions is "untested". Says Joseph Luby, an attorney with the Death Penalty Litigation Clinic in Kansas City, "Propofol has no track record in executions." Well that's a kind of circular logic. Propofol would have to be used at least two times in order to form a track record in executions. If nobody is willing to start using propofol, then it will never have a track record. As far as doing a rigorous scientific test for propofol's efficacy in capital punishment, I'd love somebody to figure out how to do a standard double blind study to accomplish that.
It's true that going with a single drug method of execution with propofol probably won't be as quick as the old three drug method. Especially with drug abusers, I've had patients who require hundreds of milligrams of propofol just to keep them sedated. I can't imagine how much some of these inmates will need before they go apneic, and stay apneic until their brains die from anoxia. But of course it can be done. As for Missouri, they've settled on two grams of propofol for an initial bolus. If that doesn't work, it can be repeated one more time. Since there are no scientific studies regarding the proper dosage of propofol for executions, this is pretty much a wild guess.
But we already know propofol will kill its victims if used improperly. Numerous health care professionals have died from propofol abuse. Then of course there is Michael Jackson's sensational death from propofol, which made the drug a household name.