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St. Louis Public Radio's Chris McDaniel and Véronique LaCapra have been investigating Missouri's execution process and the legal and ethical questions around how the state is obtaining its execution drug. Since most drug manufacturers don’t want their products used for lethal injection, Missouri has had to go to great lengths to find a supply. Read their extensive reporting below and related stories from the St. Louis Public Radio newsroom.

Missouri's new execution drug: no silver bullet

(Propofol: Wikimedia commons, Gurney: via Wikimedia Commons/Noahudlis, Needle: Flickr via prashant_zi)

Missouri is the first state in the nation to change its protocol for executing prisoners from a three-drug cocktail to the single drug Propofol. The switch is due to a shortage of a key drug, which has stalled lethal injections across the country.

Other states may eventually follow Missouri’s lead, but as St. Louis Public Radio’s Joseph Leahy reports, the drug known recently for killing pop star Michael Jackson is no silver bullet either.

"I just thought it was a good idea"

There is certainly no shortage of the drug Propofol. The anesthetic manufactured in Europe is used to sedate or induce sleep for all kinds of medical procedures from hip replacements to colonoscopies.

Deb Baysinger has pushed the white liquid into the veins of numerous patients as a nurse at St. Luke’s Hospital in St. Louis. She says she was surprised to learn Missouri would be the first in the nation to use Propofol for lethal injections.

“You know it’s not a drug that I’d thought of either,” she said. “You know I had been following some that they’d used in Texas and Oklahoma – you know, those drugs. And to hear Propofol come up – I just thought it was a good idea.” 

Baysinger’s daughter, Joanna, was murdered 14 years ago during a robbery in Columbia, Mo. But a shortage of the drug sodium thiopental used in Missouri’s lethal injection protocol has held up the execution of Earl Ringo – the man convicted for Joanna's death. 

Baysinger says Missouri’s decision to use Propofol could finally mean closure for her and her family.

“To have the execution carried out, see it done, would be like: Joanna, we got you Justice,” she said.

Cruel and unusual punishment?

But, Propofol is known to sometimes cause a localized burning sensation and Missouri’s new protocol calls for an injection of about 15 times an average hospital dose. Some argue the pain could be that much worse.

To offset the risk, the protocol includes 10cc of Lidocaine – a local anesthetic – but there are no tests to prove its effectiveness with such a large dose of Propofol.

John William Simon is a St. Louis attorney specializing in Constitutional advocacy. He says the new protocol violates the 8th amendment of the Constitution that forbids cruel and unusual punishment.

“How, how would one test a form of execution? This is not the kind of thing on which medical scientists conduct clinical trials,” he said.

Simon’s client, Earl Ringo, is one of 21 Missouri death row convicts now suing the Department of Corrections over this issue.

Ringo’s case includes affidavits from two medical experts asserting that the two grams of Propofol called for in Missouri’s protocol would almost certainly cause pain.

A spokesman for the department declined comment on the pending litigation.

Simon believes if the lawsuit fails, things may go wrong.

“There will begin to be botched executions,” Simon said, “that will be a gross embarrassment for the people who foisted this policy on the state of Missouri and no state will go within a country mile of adopting Propofol.”

Still, Missouri appears intent on resuming capital punishment sentences. Only two men have been executed in the state since 2005. A week after Missouri’s Department of Corrections changed its lethal injection protocol, Attorney General Chris Koster called on the Missouri Supreme Court to set execution dates for 19 death row inmates.

"It's time to move this process forward"

Koster says justice has waited long enough.

“The single drug protocol that has been developed by the Department of Corrections will probably come under scrutiny over the next several months,” Koster said. “But it is time to move this process forward and silence on the issue is really not an option.”  

That scrutiny won’t be limited to the courts, however. Lawmakers in the United Kingdom announced plans on Wednesday to ban export of the drug to the US due to Missouri’s new lethal injection protocol.

It was a similar ban on sodium thiopental in 2010 that eventually led other European countries to ban its export as well. For now, there is a steady supply of Propofol to the US, though the Missouri Supreme Court has yet to set any execution dates.

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