Mo. details execution procedures, including use of medical staff

ST. LOUIS -- The state's proposed procedures for executing condemned prisoners would use various medical personnel, but not a board-certified anesthesiologist as required by a federal judge because, Missouri says, it can't find one.

Court documents filed late Friday by State Attorney General Jay Nixon said substituting medical personnel for a board-certified anesthesiologist in state executions is "reasonable under the circumstances."

The state says its proposed procedures would address the court's concerns that condemned prisoners be "sufficiently unconscious" from the first drug, an anesthetic, before two subsequent drugs to paralyze the prisoner and stop his heart, are administered.

The state said that U.S. District Judge Fernando Gaitan Jr. erred when he required that an anesthesiologist assist in Missouri's executions.

"To enforce it may effectively bar implementation of the death penalty in Missouri," the state said. "Surely that is not what the court intended."

Ruling in the case of death row inmate Michael Taylor, of Kansas City, Gaitan ordered the Missouri Department of Corrections last month to make sweeping changes to its execution protocol by Saturday's deadline and halted executions until he was satisfied that Missouri's procedures posed no risk of unnecessary pain and suffering.

Under the judge's ruling, the anesthesiologist would play a central role in carrying out Missouri executions. But court papers suggest the state has run into a major roadblock.

An affidavit by Adult Division Director Terry Moore said that his office sent letters to 298 anesthesiologists in Missouri and southern Illinois requesting their services at executions. None responded.

Anesthesiologists apparently are heeding the advice of the president of the American Society of Anesthesiologists to "steer clear" of state-assisted executions, the state said.

Dr. Orin F. Guidry, president of the 40,000-member group, wrote to his colleagues that doctors shouldn't help put inmates to death by lethal injection or work with the legal system to ensure inmates don't feel pain when they are executed.

"The legal system has painted itself into this corner and it is not our obligation to get it out," he wrote on the society's Web site on June 30. Patients could lose trust in their doctors if they see them as executioners, he wrote.

The Death Penalty Information Center says no other state has been required to employ such involvement by an anesthesiologist in carrying out an execution.

Under Gaitan's ruling, the anesthesiologist assisting in Missouri executions would mix the drugs; administer them or observe those who do; and determine and monitor the inmate's level of consciousness, either by being in the execution room or with the help of monitoring equipment.

The anesthesiologist also would serve as a consultant in drafting the state's protocol, contingency plan and auditing process.

But in the state's plan, an execution team of a physician, nurse, pharmacist and other medical personnel would play a part in executions. According to their expertise, one would prepare the lethal chemicals, another would insert the intravenous lines, monitor the prisoner and supervise the injection.

The four-page protocol also calls for a number of safeguards including physically examining the prisoner to confirm he is unconscious after the first drug.