Gov. Nixon received health concerns over execution drug

JEFFERSON CITY, Mo. -- Health-care workers, medical groups and even a few patients pressured Missouri Gov. Jay Nixon before he halted what would have been the first execution with the anesthetic propofol.

The anticipated use of propofol in administering the death penalty fueled concerns that the anti-death penalty European Union could limit its export. Before he halted a planned October execution, Nixon's office received several dozen letters and messages asking him to put off the execution and to order development of a new death penalty protocol.

Nixon's office provided The Associated Press with correspondence it received before the decision. Many messages to the governor took little position on the death penalty and instead focused on propofol. The state Department of Corrections announced Tuesday executions now will use the sedative pentobarbital, which the Death Penalty Information Center says is used by 13 states.

The Missouri State Medical Association said in a letter to Nixon that propofol is a "critically important medicine" that the American Society of Anesthesiologists estimates is used in 95 percent of surgical procedures requiring an anesthetic. The medical association said tens of millions of Americans benefit annually from it.

"We are compelled to express our concern that the state's planned use of propofol in lethal injections ... could well result in a catastrophic nationwide shortage of the single-most safe and effective anesthetic available to physicians and their patients," executive vice president Tom Holloway wrote.

The Missouri Society of Anesthesiologists also registered concerns about using propofol, and the medical school dean at Washington University in St. Louis said 1,242 physicians at the school performed 871,771 procedures and 53,733 surgeries last year and that nearly all requiring anesthesia used propofol. The dean said in his Oct. 7 letter there are not acceptable substitutes if propofol no longer was available.

Roughly 85 percent of the U.S. supply of propofol is made in Europe by the German company Fresenius Kabi. The EU bans trade in goods that can be used for executions and was reviewing whether to make propofol subject to the rule.

Markus Loning, human-rights commissioner for the German federal government, wrote a Sept. 30 letter urging Nixon to refrain from using the drug. Loning said turning to propofol for an execution would "almost certainly lead to strict export controls. Subsequently there would also be a severe shortage of Propofol in the United States for medical purposes."

Nixon, who supports the death penalty, halted the scheduled Oct. 23 execution of Allen Nicklasson using propofol. Missouri's next execution is scheduled in November for Joseph Franklin, who was convicted of the 1977 sniper shooting of Gerald Gordon as a crowd dispersed from a bar mitzvah in suburban St. Louis. Two others were injured. Franklin has said he tried to start a race war by traveling the country shooting people, and when he confessed in 1994, he was serving several life sentences in a federal prison for the killing of two black joggers in Salt Lake City and an interracial couple in Wisconsin and the bombing of a synagogue in Tennessee.

The governor said he considered public health and public safety in his decision.

"Public safety obviously means that we're going to continue to move forward to carry out the necessary responsibilities of the ultimate punishment," Nixon said. "When the public health side came in here and you saw a growing concern about the ability to effectively administer what's been a useful medication for many folks in surgery, it became apparent to me that we needed to change."

Missouri's planned use of propofol also attracted attention elsewhere. Several messages voicing concerns were written by people identifying themselves as anesthesiologists and nurses from Minnesota.

Others who contacted Nixon said they had received propofol in medical procedures.

Ed LaTour, of St. Peters, said using the drug for an execution seems an easy way out for someone who caused pain and suffering. He has been operated on 13 times and has received propofol.

"Simply put, the use of Propofol is the best drug ever invented for surgery and having it used on me so many times, I promise you, is the best way to go for surgery of any kind," LaTour wrote.