Fentanyl First Used for Lethal Injection

[Captain.Heroin]

https://www.aljazeera.com/news/2018...xecution-opioid-fentanyl-180814185512400.html

Nebraska has carried out its first execution in more than two decades with a drug combination never tried before, including the first use of the powerful opioid fentanyl, which has become the focal point in the US's opioid crisis.

Carey Dean Moore was pronounced dead at 10:47am local time (15:47GMT) on Tuesday. The 60-year-old had been sentenced to death for killing two cab drivers in Omaha in 1979. He was the first inmate to be lethally injected in Nebraska, which last carried out an execution in 1997, using the electric chair.

Witnesses said that there appeared to be no complications in the execution process, which also was the first time a state used four drugs in combination.

At one point while on the gurney, Moore turned his head and mouthed several words to his family, including "I love you."

In his final written statement , Moore admitted: "I am guilty." But he said there are others on Nebraska's death row who he believes are innocent and he said they should be released.

"How might you feel if your loved one was innocent and on death row?" Moore asked.

Tuesday's execution comes a little more than three years after Nebraska politicians abolished the death penalty, only to have it reinstated the following year through a citizen ballot drive partially financed by Republican Governor Pete Ricketts. The governor, a wealthy former businessman, has said he was fulfilling the wishes of voters in the conservative state.

"We're sick of hearing about Carey Dean Moore," Steve Helgeland, the son of one of Moore's victims, said ahead of the execution.

Danielle Conrad, the director of the American Civil Liberties Union - Nebraska, said in a statement on Twitter that Moore's execution is the "most recent dark chapter in the state's troubled history with the death penalty".

Use of fentanyl
Three of the four substances used in Tuesday's execution had never been used for lethal injections - underscoring the difficulty states across the United States have had in obtaining previously employed execution drugs.

The Nebraska drug protocol called for an initial IV dose of diazepam, commonly known as Valium, to render the inmate unconscious, followed by the powerful synthetic opioid fentanyl, then cisatracurium besylate to induce paralysis and stop the inmate from breathing and potassium chloride to stop the heart.

Fentanyl has been one of the main drivers of the opioid epidemic, which has gripped the country in recent years. According to the National Institute on Drug Abuse, more than 115 people die each day in the US after overdosing on opioids, including heroin, prescription painkillers and fentanyl.

After each injection in Moore's execution, prison officials sent saline through the IV to flush out any residue and ensure all the drugs had entered his system.

Diazepam and cisatracurium also had never been used in executions before.

Legal challenges
Moore had faced execution dates set by the Nebraska Supreme Court seven times since he was convicted, but each was delayed because of legal challenges and questions over whether previous lethal injection drugs were purchased legally.

The most recent challenge came last week after a German-based drugmaker tried to halt the execution by filing a lawsuit that alleged the state had illegally procured at least one of the company's drugs.

The company, Fresenius Kabi, argued that allowing the execution to go forward would harm its reputation and business relationships.

But a federal judge sided with state attorneys, who argued that the public's interest in carrying out a lawful execution outweighed the company's concerns. The judge also noted that Moore had stopped fighting the state's efforts to execute him.

A federal appeals court upheld that ruling Monday, and Fresenius Kabi decided not to take the issue to the US Supreme Court.

Harder to get drugs
In recent years, states have had to find alternative means to carry out executions due to a number of lawsuits by pharmaceutical companies that blocked their drugs from being used.

Oklahoma announced earlier this year it would begin using nitrogen gas to carry out its executions.

"We can no longer sit on the sidelines and wait to find drugs," Oklahoma Attorney General Mike Hunter said at the time.

Mississippi and Alabama have also passed legislation that would allow for asphyxiation with nitrogen gas if lethal injection drugs are not available.

According to the Death Penalty Information Center, 31 states, the federal government and US military allow for capital punishment. The centre has documented at least 1,481 executions in the country since 1976. The majority of those - at least 1,305 - were carried out by lethal injection, the centre said.

A mixture of cute and pathetic when the state bewails its own anti-drug policies.

Anyone else disturbed that they're going to use nitrogen gas in lieu of drugs?

 

[Ketamania]

The ultimate form of hypocrisy. There was another guy on row for fentanyl execution and he said “make it strong” lol.

 

[Sturnam]

Anyone else disturbed that they're going to use nitrogen gas in lieu of drugs?

I'm not. The drive to breathe and any panic/anxiety that occurs is due to our body sensing CO2, not oxygen. Nitrogen basically just results in unconsciousness and then death fairly rapidly. As far as I know there's no undue pain or suffering that would occur with death via N2.

EDIT: I believe there's a group in the Netherlands that has created a 'coffin' that fills with nitrogen gas so that people can euthanize themselves if they want (either sick or old). Link Here: https://www.washingtonpost.com/news...al-fair/?noredirect=on&utm_term=.6c4a8c4249e1

I looked up the doses for diazepam and fentanyl for this execution, and it seems like they were not stingy. 2mg/kg diazepam and 25mcg/kg fentanyl. So for a 70kg person (~155 pounds) it would be 140mg diazepm and almost 1.5mg fentanyl. Seems pretty anesthetic to me.

 

[aihfl]

I guess it's ok when the state does it?

Anyone else disturbed that they're going to use nitrogen gas in lieu of drugs?

Statistically, lethal injection is the method which has resulted in the most botched executions, followed by gas, hanging and electrocution (unless you live in Florida, which was using an electric chair from 1923 as late as the late 1990s until they switched to lethal injection when the Florida Supreme Court was about to take the electric chair out of commission). Only a firing squad has a 0% botched execution rate.

 

[Transcendence]

Nitrogen, helium, or noble gas is actually one of the most merciful ways of dying. There's no sensation of oxygen deprivation associated with the build-up of CO2, or (with nitrogen) really any indication at all that you're not breathing normal air until you're unconscious. I'm against the death penalty but it is more humane than even most forms of lethal injection and certainly miles better than other forms of the gas chamber.

Nitrogen has been pushed for consideration for years, but until now states were unlikely to adopt because of the risk of additional legal challenges that could result in another moratorium. Now that pharmaceuticals are being denied, it's apparently an equivalent risk. I am surprised that they don't go back to firing squad, but it goes to show that even people who support this don't have a taste for blood. A bit hypocritical in my opinion but there you go...

 

[Captain.Heroin]

That’s because people are terrible at their jobs.

 

[Ketamania]

I think nitrogen oxide would be a blissful way to die

 

[JessFR]

Agreed. Nitrogen is a good choice if your goal is to give someone a peaceful death.

But that's not the goal of the state, it's at best a secondary objective. The primary objective is to make it LOOK peaceful to any witnesses. If it doesn't look painless, the anti death penalty groups will prey on it and use it for political milage.

And well intentioned as their goals might be, and while I feel sympathetic with their cause, aside from the fact that I think exploiting peoples ignorance in this way is morally wrong, from a more practical stand point, its resulted in a situation where the state is focusing more on how painless a death looks rather than how painless it is. It needs to be appear as painless and least traumatic as possible.

If the goal were really just to give a painless death, we could just shoot them in the head. But that involve blood. It would look bad to witnesses.

 

[Captain.Heroin]

I imagine if you're being put to death and not electing to die, you're probably quite anxious about the experience. I think an overdose of downers would be preferable.

 

[JessFR]

I imagine if you're being put to death and not electing to die, you're probably quite anxious about the experience. I think an overdose of downers would be preferable.

But again, it's about appearance. It might well be preferable and painless from your perspective. But from the witnesses, you might appear to be gasping for breath or any number of other involuntary responses that stupid people imagine are conscious suffering. People just aren't widely educated enough to widely comprehend that someone can be unconscious yet doing things automatically. That it might be painless for them but look unpleasant to a witness.

And as I said, the anti death penalty groups know it and prey on it for as much milage as they can.

So just ODing them on downers isn't enough. This is part of why historically we've used a multi drug cocktail including a paralytic. So it'll appear more peaceful.

I do wonder how anxious someone in this kind of situation really is on average though. It's worth remembering that most such condemned people have been on death row for a LONG time and have had a lot of time to make peace with it. I'm not actually trying to say most of them would or wouldn't feel profound anxiety, I truly don't know one way or the other. All I'm saying is it wouldn't surprise me of a lot of them are less anxious than we might at first imagine.

But, then again, maybe not.

 

[Ketamania]

Downers would be good too captain.

Good point Jess, none of the current methods are messy. Not even in the Wild West- all formal executions were hangings. However, the reason shootings/firing squads may not be implemented is because of the clean up (biological contaminants). Also, there are usually family there to witness and it would be pretty traumatic seeing you son get obliterated.

A better method would be to give em something sedating and then a captive bolt gun to the head (the same kind used to slaughter animals). Less expensive, more effective, and no extra cleanup.

 

[JessFR]

Captive bolt guns aren't 100% effective either. Granted it's mostly because of user error, but we can expect something like that to happen eventually if we did it that way. But there's another problem. The fact that it's so similar to slaughtering cattle, and the incidents of imperfect slaughtering techniques in that instance, will again cause the media and anti-capital punishment groups to say how it could result in an agonizing mistake, or that it's treating people like cattle. Probably throw in some subtle references to the holocaust if they think they can get away with it, since it could be seen as a method intended more for effeciency and mass slaughter than painlessness.

The thing is, the truth is completely besides the point. I mean, look at the situation as it stands. I've seen it argued, repeatidly, here on bluelight, that condemned prisoners have been subjected to the agonizing death of being shot full of opiates. I mean, seriously. It's pretty obvious that reality has little relevence to this situation. It's all about the most superficial appearences. That's the major consideration to the government. Because they have politics to contend with on top of simply ending the lives of condemned prisoners.

If we just wanted to make sure they were killed painlessly, we have lots of options. Firearm technology hasn't advanced in any significant way for about 50 years now. We've perfected the technology of effortlessly and quickly ending someones life. We have guns that kill you in a fraction of a second, drugs that render you unconscious that people painlessly die from by accident all the time. Countries have perfected euthanazia technology, which is fundamentally the same principle, and where people who are trying to avoid suffering as the whole fundamental point, elect to be killed with..

It's only when it becomes about the death penalty that it sudden becomes SOOOOoooooo hard to find a painless method of killing someone. Doesn't seem to make sense does it? It does if you assume that the real goal is to find a way to painlessly kill someone that also looks painless and untraumatic and completely clean to someone with absolutely no medical knowledge, and who already is desperately trying to find a way to make it seem and make it sound as horrible as possible. People see what they want to see, not what's real.

It's all about politics, it's nothing to do with killing people painlessly. That's just the battleground in which the real fight over capital punishment politics is fought. And the anti-death penalty groups are probably more at fault than anyone when it comes to people being executed painfully. Make no mistake, they want capital punishment gone. But until it IS gone, it is in their interests for it to be as painful and bloody as possible. They are like any other political extremists. They come to feel any amount of manipulation or dishonesty is justified so long as it's for their idea of the greater good.

It wasn't the government that chose to stop using the same drugs we have used perfectly to euthanize pets and people for years. It was the anti-capital punishment lobby that caused that outcome. Because they want it to be painful. Because they believe that it's for the greater good and they tell themselves they aren't responsible for the added suffering, in their mind, the state is. But the reality is that they are almost entirely responsible for people experiencing botched executions. The government may be responsible for having the death penalty. But it's the anti-death penalty campaign that made it riskier.

 

[Ketamania]

For such a ‘humane’ cause that the anti-death penalty campaign claims to fight for, you’d think that they’d want it to be as painless as possible until there was no death penalty.

Just cause you can’t have your way doesn’t mean you make things worse than they already are. It’s comparable to a child’s temper tantrum.

 

[JessFR]

Human psychology is complicated. People can 90% believe they're doing one thing, while deep down knowing they're 10% kinda doing something else.

The way they'd probably see it, is that capital punishment is by its nature always inhumane, that it's wrong and needs to be stopped. And to try and accomplish that, they will petition and lobby and do everything they can both to convince the government, convince people to support their cause, and convince anyone helping or enabling the government to stop.

So, they get access to the best, most humane drugs cut off from the state. Under the argument that while they can't make them stop, drug companies don't have to help them. And if they do, they're just as bad.

Now sure, 90% of their mind believes they're just doing what they think is right. Buuut, deep down, they know that the government and capital punishment supporters won't be bullied into backing down like that. That they will find other other, less ideal methods. And to them, that just shows how barbaric they are. But there's also a small part of their mind that realizes how politically useful it is. That in doing so, they can now use these riskier methods of capital punishment to try and convince more people of their beliefs. And make the government and capital punishment advocates look bad.

Most of them probably realize deep down that their actions have actually increased suffering for the condemned, but most of their mind puts the blame for that on the state. They think it's for the greater good.

My point is, I still think it's wrong. Sure, there's complex psychology in how people justify it to themselves. But ultimately, it's still them taking advantage of how they've made things worse for condemned prisoners for political ends.

When someone wants something bad enough, they find mental justifications to make what they gotta to do get it OK. It's just a general rule of human nature.

It's like when anti gun groups, or the NRA on the other side, subtlely distort the statistics and perpetuate convenient lies to try and convince people of their point. Some part of their psyche probably realizes its dishonest, that it's manipulating people. That it doesn't feel right. But they believe so strongly in what they're trying to do, protect gun rights, or conversely protect people from gun violence, that they lie to themselves and make themselves believe that their lies are in service to some "greater truth". It's not. And to some degree they know it's all dishonest. But that's how they justify their actions and keep doing them even when they might fundamentally be opposed to lying to people in a more general sense. Most people don't do bad things because they're just bad people. They find some lie that they can get themselves to 90% believe to justify the behavior. And just try and ignore that 10% that tells them deep down that they kinda know its wrong.