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An Anesthesiologist/Legislator on Nitrogen Executions

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Oklahoma State Senator Ervin Yen is an anesthesiologist.  According to his official bio:

After completing his residency in 1984, he began practicing as an anesthesiologist. Dr. Yen has worked as a cardiac anesthesiologist at Saint Anthony Hospital and Integris Baptist Medical Center for more than 20 years....He is a past president of the Oklahoma Society of Anesthesiologists and past Chief of the Anesthesiology section at St. Anthony Hospital.
So Senator Yen knows more about pain and its prevention than most legislators, most lawyers, and for that matter most doctors. 

Quinton Chandler has this article and audio report for NPR station KOSU.  The article begins with the usual blather.  "Officials say nitrogen will bring quick, painless deaths, but the research is slim -- and it has never been used in U.S. executions."  What kind of "research" does this refer to?  The effects of breathing pure nitrogen instead of air are well known.  It causes hypoxia.  The effects of hypoxia have been extensively researched, and there is extensive experience from aviation.  Research specifically on use in executions obviously can't be done, so the implication that we have to have such research before a new method can be tried is a Catch-22 constructed by death penalty opponents.  Similarly, the objection that a new method which promises to be better than existing methods has never been used before is nonsensical.  That's what makes it "new," folks.

Senator Yen was a co-sponsor of the bill that authorized nitrogen hypoxia as a method of execution:

He says the inmates would die from "lack of oxygen," not exposure to nitrogen.

Yen says this is not the same as choking to death, during which the "blood level of carbon dioxide would go up drastically." That carbon dioxide buildup is the primary reason for discomfort, Yen said. "Like, anxiety, and you might start sweating, and your blood pressure might go up."

Yen says when a person breathes nitrogen, they're still exhaling carbon dioxide which means they won't feel the same painful carbon dioxide buildup. They'll go to sleep and if they don't get oxygen, they'll eventually die.

In Yen's medical opinion, nitrogen hypoxia would not be painful and it wouldn't fall under the constitutional ban on cruel and unusual punishment.

The headline writer for this story warns ominously, "Oklahoma Officials Endorse Nitrogen Executions As 'Humane,' But Some Medical Experts Aren't Sure."  A person reading the headline would think that the text of the story indicates that the people opposing the practice are more "expert" than the ones supporting it, but that is not the case.

First, the story cites Dr. David Grube, an advocate for physician-assisted deaths.  It says that he "says U.S. doctors that are helping terminally ill patients end their lives would never prescribe inert gas."  Right, because they can get the barbiturates that drug companies have been pressured into cutting off for executions.  In addition, they are helping consenting people, so they can use voluntarily ingested drugs, which obviously won't work for executions.  The fact that inert gas is not used for physician-assisted suicide is therefore based on differences that make it irrelevant to the question.  He also says he does not know if nitrogen gas is painless because he has never used it. 

What is the probative value of the non-opinion of a person who has never used something based only on his non-use?  Suppose I said, "I don't know if marijuana makes a person behave as depicted in Reefer Madness because I have never used it."  How much weight would you give that statement?  Absolute zero?  It's the same here.

The article continues:

Dr. Catherine Forest, a physician who practiced family medicine for over 25 years and teaches at Stanford University School of Medicine in California, where physician-assisted death for patients in their final six months of life is legal, says no matter the method, executions can't be compared with physician-assisted deaths.

Physician-assisted deaths and executions "are very different medical situations," she said. "One is a healthy individual and the other is a dying human being."

Correct.  What is her opinion about the pain potential of nitrogen asphyxiation?  She does not express one.

So the only expert expressing an opinion on the actual point in controversy is Dr./Sen. Yen.  The headline of the article is a serious misrepresentation.

3 Comments

It was my understanding that many of the euthanasia experts had recommended helium as a method for self-assisted euthanasia (aka, suicide).

Helium and nitrogen do the same thing in this context. They displace the oxygen but do not cause any chemical reaction or inhibit the exhalation of carbon dioxide.

Exactly my point. How can it lack research for causing a painless death in one context and lack those properties in another?

The answer is, of course, it doesn't.

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