Assisted Death may be a Cruel Death

Source: Alex Schadenberg Executive Director, Euthanasia Prevention Coalition
Reprinted with permission.

Dr Joel Zivot who is an assistant professor of anesthesiology/critical care at Emory University School of Medicine in Atlanta, was published today in Medpage Today explaining, based on the pharmacology, how an assisted death happens.

Alex Schadenberg writes: “I have written on this topic in the past. If Zivot is correct, assisted death may be torturous not peaceful”.

In his Op-Ed Zivot writes:

As a Canadian physician and anesthesiologist working in the United States, this debate is of interest to me. I was a witness in these Senate hearings because I am an expert in the opposition to lethal injection, the most common form of execution in the U.S. To be clear, my expertise is relevant to MAiD (Medical Aid in Dying) not because it is considered akin to the execution of prisoners in its essence, but because the pharmaceutical and medical methods used are quite similar.

Most often, death by lethal injection is a rather bloodless event. Witnesses can’t see much. I speak from experience: I was witness to an execution at the request of the inmate since I had been an expert in his legal defense, and the death appeared peaceful.

Zivot explains how his research changed his perception:

My perception of this changed, however, when I was given a file of autopsy reports on inmates executed by lethal injection. Upon review, I noticed a striking and surprising finding: almost all autopsies revealed that the lungs had filled with frothy fluid. This occurred if the execution was by an injection of either pentobarbital or midazolam. I reviewed the autopsy of the execution that I had witnessed and found that, although I had seen no outward struggle, the inmate had developed the striking lung congestion I had noted in others.

Since then, I have reviewed a number of published MAiD protocols and found an additional striking factor: MAiD includes the use of a drug that paralyzes the body, making it impossible to breathe or to move. These drugs do not block the sensation of pain or the awareness of being paralyzed. Notably, the use of paralytics in execution by lethal injection generally has been abandoned because of its obvious cruelty.

Zivot explains why certain drugs have become difficult to obtain and then expresses his concern with the use of the drug propofol.

As an anesthesiologist, I have injected propofol into thousands of patients. Very commonly, patients complain of a burning sensation. I learned to block this painful sensation with a prior injection of a local anesthetic. MAiD uses a dose 10 times greater than what I would use in the operating room.

Like pentobarbital execution, propofol will very likely burn its way through the lungs and cause the frothy fluid accumulations seen in lethal injection. The experience of this will be akin to death by drowning. Waterboarding, widely understood as torture, creates the same effect. The injection of a paralytic after the propofol will make every death appear outwardly unremarkable — and according to MAiD proponents, even beautiful in its peacefulness.

Zivot concludes by explaining that an assisted death is not a peaceful death:

Canadians who choose to die by MAiD must be informed of the real possibility that the death they experience may be very different from that which is described by MAiD advocates. It is time to perform autopsies on everyone that dies by MAiD, so we can determine if MAiD protocols produce frothy fluid in the lungs. It is time to cease the use of paralytics in MAiD, so we can be certain we are not covering the potential for a painful death akin to drowning. It is time to accept what the evidence available to date shows: MAiD may very likely provide a torturous death.

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