Ethical implications of modifying lethal injection protocols

Jun 10, 2008

A team of medical, ethical, and legal scholars argues in this week's PLoS Medicine that in some US states the modification of lethal injection protocols is tantamount to experimentation upon prisoners without the prisoners' consent and without any ethical safeguards.

Drs. Leonidas Koniaris and Teresa Zimmers (University of Miami Miller School of Medicine, Miami, Florida, USA) and colleagues lay out evidence obtained in litigation and from Freedom of Information act requests that suggests that at least 10 states are performing regimens that may be akin to human experimentation.

"The collective practice of lethal injection," say the authors, "has employed invasive testing of different drug protocols and devices, data collection and monitoring, and systematic review with outcome data being used to revise practice." Certain lethal injection inquiries, they say, may therefore constitute human subjects research.

While death row inmates have been stripped of the right to freedom and to life, say the authors, they maintain the right to bodily integrity and the right to refuse to be experimented upon. And yet in these 10 states, Koniaris and Zimmer's analysis finds that inmates were not asked for their consent to be included in lethal injection practices, which are essentially experimental in nature.

Guidelines for the ethical conduct of research involving humans, such as the Nuremberg Code and the Declaration of Helsinki, were developed at least partially as a way of ensuring that medical researchers would not exploit vulnerable prisoner populations. In the US, researchers who conduct studies on humans are required to follow the "Common Rule" (the Federal Policy for the Protection of Human Subjects)., which provides protection for research participants by requiring institutional assurance of compliance with federal regulations, institutional review board (IRB) review, approval, and oversight, and informed consent of the participants. In Koniaris and Zimmers' analysis, none of the ten states undertaking regimens with prisoners being executed followed the Common Rule—for example, prisoners had not given consent to be experimented upon and institutional review boards had not approved the use of what is essentially a n experiment protocol.

Lethal injection for execution has largely replaced other execution methods in the US, in part due to the appearance of a peaceful death. But evidence suggests that some inmates suffer extreme pain—triggering legal challenges against lethal injection on the grounds that it violates the United States' constitutional prohibition against cruel and unusual punishment. (see, for example, a previous PLoS Medicine paper, by Dr Zimmers and colleagues in 2007: Lethal Injection for Execution: Chemical Asphyxiation? PLoS Med 4(4): e156 doi:10.1371/journal.pmed.0040156).

Jurists are now demanding that lethal injection protocols be amended, say Dr Zimmers and colleagues, to comply with this constitutional prohibition. However, even as jurists demand lethal injection protocol changes, say the authors, "corrections officials, governors, and their medical collaborators are left in a legal and ethical quandary—in order to comply with the law and carry out their duties, they are employing the tools and methods of biomedical inquiry without its ethical safeguards."

Given the current guidelines for human experimentation, they say, "it is difficult to conceive of circumstances in which lethal injection research activities could be carried out in a fashion consistent with these ethical norms, and yet those engaged in such research would seem to be required to do so."

Citation: Citation: Koniaris LG, Goodman KW, Sugarman J, Ozomaro U, Sheldon J, et al. (2008) Ethical implications of modifying lethal injection protocols. PLoS Med 5(6): e126. -- medicine.plosjournals.org/perl… journal.pmed.0050126

Source: Public Library of Science

Explore further: Exploring 3-D printing to make organs for transplants

add to favorites email to friend print save as pdf

Related Stories

Report: China to declare Qualcomm a monopoly

1 hour ago

(AP)—Chinese regulators have concluded Qualcomm Inc., one of the biggest makers of chips used in mobile devices, has a monopoly, a government newspaper reported Friday.

Scientists stalk coastal killer

1 hour ago

For much of Wednesday, a small group of volunteers and researchers walked in and out of the surf testing a new form of surveillance on the biggest killer of beach swimmers - rip currents.

Recommended for you

Exploring 3-D printing to make organs for transplants

2 hours ago

Printing whole new organs for transplants sounds like something out of a sci-fi movie, but the real-life budding technology could one day make actual kidneys, livers, hearts and other organs for patients ...

High frequency of potential entrapment gaps in hospital beds

3 hours ago

A survey of beds within a large teaching hospital in Ireland has shown than many of them did not comply with dimensional standards put in place to minimise the risk of entrapment. The report, published online in the journal ...

Key element of CPR missing from guidelines

Jul 29, 2014

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Burnout impacts transplant surgeons (w/ Video)

Jul 28, 2014

Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

Zig158
5 / 5 (1) Jun 10, 2008
I say go back to hanging. It was good enough for the founding fathers so it is good enough for me. If a head comes off once in a wile, so be it.