What’s Cruel for the Incarcerated is Cruel for the Terminally Ill: The Connection between Lethal Injection and Assisted Suicide
Jacqueline H. Abernathy
by Jacqueline H. Abernathy, Ph.D., MSSW
In a recent episode of HBO’s Last Week Tonight, comedian and host John Oliver offered a scathing (albeit profane) rebuke of lethal injection as a means of execution in U.S. states with capital punishment. He detailed the issues with the drugs employed and how ineffective they are at killing: essentially torturing the condemned with a prolonged death intended to make the process appear more palatable for everyone else. With each point he made, he always came back to his premise: the lethal means are irrelevant because capital punishment is simply wrong.
I agree completely.
But then he said something quite disturbing: He claimed that assisted suicide is somehow different because terminally ill people are easier to kill.
I’ll give you a moment to try to reconcile that with his larger point. That moment is over, because it doesn’t matter how much time you have. One simply cannot reconcile the two.
Lethal injection supplies the same class of drugs as assisted suicide does. It uses the same means toward the same end: premature and imposed death. How then is killing an ill person any different from killing anyone else?
Since he brought it up, let’s clear up the confusion about how assisted suicide works. He detailed how lethal injections are inhumane, but what distinguishes assisted suicide from traditional euthanasia is that traditional euthanasia is a lethal injection whereas assisted suicide is self-administered oral ingestion of these same drugs. Hence the drugs used in assisted suicide — which have included pentobarbital, the same one that has been used in lethal injection — are an okay option when self-administered by someone who’s dying; just not for those sentenced to death. Because it’s faster or more effective at killing, says Oliver. Only there is one big problem: it’s not.
Oliver mentioned assisted suicide only to demonstrate that it supposedly offers a more humane alternative to lethal injection, which he decried as barbaric and cruel. The show presented harrowing details about how the condemned may remain conscious during their executions since the drug responsible for inducing a coma can often fail. He explained how limited availability of certain lethal drugs can inspire the use of creative alternatives with horrific consequences. Finally, he lamented how long and torturous the process was, lasting not just a few minutes as intended but in one case, nearly two hours.
What Oliver apparently does not know is that every one of his points also apply to assisted suicide.
I can concede the logic that ill people are more fragile than healthy ones, but it doesn’t take a medical degree to know that intravenous delivery of any drug is more effective than oral intake.
Reports indicate that some people who choose assisted suicide vomit their bitter lethal dose before it can be absorbed, which is why anti-nausea drugs often accompany the barbiturate overdose. People do sometimes regain consciousness just like during an execution. Just as drug makers don’t want to be involved in executions, many of them have also inflated their prices to discourage use in assisted suicide. This practice leads many people to choose cheaper drugs with consequences akin to those experienced when the state looks for more readily-available drugs for lethal injections. In both cases, death takes far longer. And while I cringe that executions have taken up to 2 hours, assisted suicide can take up to 4 days.
Oliver mentioned assisted suicide only to make his point, while failing to recognize assisted suicide’s own inhumanity. He also mentioned alternatives to lethal injection like opioid overdose and the problems associated with that. His goal was not to defend any means of killing in executions, as he always circled back to his premise: there is no right way to do a wrong thing. So how then is assisted suicide not also a very wrong thing?
Oliver’s obliviousness is typical of the mental gymnastics required for justifying other forms of legal violence: that the violence he supports is not comparable to what he condemns. So let’s make it comparable. Would he withdraw his opposition to lethal injection if the death row inmates were as ill as those who choose assisted suicide?
The answer is clearly no. It doesn’t become okay to kill a person simply because they’re sick and therefore easier to kill. This suggests a double standard between ill people and inmates, when we actually have mechanisms to treat terminally ill inmates with dignity. This is called compassionate release, and exists at the federal level and in most U.S. states.
There’s hope that the horror stories Oliver highlighted will result in judges ruling that lethal injection is unconstitutional on the grounds that it is cruel and unusual punishment. But explain this: how is what deemed to be inhumane for convicted murderers somehow acceptable for the ill and dying? It clearly isn’t. Oliver was right when he said humane society doesn’t purposefully kill. Yet medical fragility is an exception? If anything, a humane society treats those more vulnerable with greater care rather than using their illness to justify their violent and unnatural end.
Oliver said it best when he concluded: “there is no perfect way for the government to kill people.” What he fails to mention is that there’s also no perfect way for people to kill themselves. I hope John Oliver will rethink his defense of violence toward the terminally ill and extend to them the same concern he has for human beings sentenced to die by execution. Assisted suicide is just as macabre as lethal injection, but less effective at killing. Just as in capital punishment, the means are irrelevant. Killing humans is wrong even if the human is terminally ill. Even if that human is yourself.
================================
For more of our blog posts against euthanasia, see:
How Euthanasia and Poverty Threaten the Disabled by Sarah Terzo
When “Choice” Itself Hurts the Quality of Life by Richard Stith
Figuring out Euthanasia: What Does it Really Mean? by Rachel MacNair
The medical assistance in dying (MAID) is, unlike Lethal Injection at death row, a dignified, evidence-based method for terminally ill patients to die (after intensive assessment at all domains of health – physical, mental, social), with tightly controlled procedures via medically trained professionals. Lethal Injection as John Oliver had explained: 1. is mostly carried out by non-trainees (which in itself is horrendous) 2. uses midazolam (anxiolytic) and forgoes propofol, which is an established procedural medication for sedation in general anesthesia and MAID 3. is definitely not dignified or assessed rigorously by healthcare professionals as we do in MAID. Without propofol, which Oliver had pointed out, an individual is not sedated and therefore can feel trapped in a paralyzed body due to suxamethonium chloride or rocuronium, and most horrendously feel pain due to IV potassium (lethal drug to cause cardiac arrest). It is also against the individual’s wish to die or lack thereof and therefore will inevitably be subjected to the society’s judicial system which is never perfect, as opposed to MAID where a standardized process is in place to assess the patient for their capacity and illness while supporting their decisions.
The distinction between MAID and executions is not as sharp as you think.
First of all, many people who submit to MAID also do not wish to die. They feel they must die to conform to their identity group; they believe it is the only way they can free up money for their family; their insurance companies declare that the only “treatment” they will pay for them includes death-hastening; they have been inundated with propaganda that for them to stay alive is abuse of their loved ones, that to help a person in their condition live is a crime against the economy, and that to stay alive in their condition is a sin.
In many countries, including Canada, if a person cannot or refuses to drink poison, they give him a lethal injection. In Holland, people are given lethal injections as they beg for their lives. And what about the widespread killing of children who have not yet learned that “proper” response to feeling bad is to want to die?
“Careful medical review” before recommending someone for MAID is equivalent to “careful judicial review” before sentencing someone to death.
The implication that to stay alive when in certain medical conditions is undignified, meaning shameful and disgraceful, is equivalent to saying that having people of certain races or religions living among you is shameful.
Abernathy’s article would be even stronger if it recognized that in many places where medical-person-hastened death is the order of the day, including Canada, the killing can and often does take place by lethal injection. That makes it more similar to executions.
[…] What’s Cruel for the Incarcerated is Cruel for the Terminally Ill […]