Medical facilities follow specific protocols for allowing euthanasia
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Available sources briefly mention protocols related to animal care and Netherlands physician-assisted euthanasia, but do not comprehensively support the broad claim that medical facilities generally follow specific protocols for euthanasia.
tal mice based on age ( Pritchett et al. 2005 ). For these reasons, it may be necessary to require increased exposure times or include a secondary method of euthanasia, such as bilateral thoracotomy, cervical dislocation, or decapitation, following CO 2 euthanasia of neonatal rodents. In either case, the amount of time spent by staff performing euthanasia may increase, but is necessary to ensure complete and humane euthanasia in accordance with the guidelines. Euthanasia training programs should take into account the potential for significant variation in learning styles among those who work in laboratory animal facilities. Age, cultural or socioeconomic differences, educational levels, and English as a second language may affect the way an individual processes and retains information ( Kennedy 2002 ). Presenting information in multiple formats may be useful during training sessions. These may include verbal presentation, providing written materials, demonstrations by the trainer, and hands-on practice by trainees. This will allow the manager or trainer to confirm proficiency prior to allowing individuals to perform the procedure without observation. This is particularly important when training personnel on procedures that have a direct impact on animal welfare, such as euthanasia techniques. Even with significant training on proper technique, performing euthanasia can be difficult for some animal facility personnel. They may find it difficult to euthanize specific animals for which they have cared or may be uneasy performing certain euthanasia methods. It is recommended that the chosen methods of euthanasia take into account the effects of the method on personnel ( Artwohl et al. 2006 ; AVMA Panel on Euthanasia 2013 ). The use of CO 2 for the euthanasia of rodents may be less distressful to personnel than physical methods ( Pritchett et al. 2005 ), such as decapitation or thoracotomy. The manager should discuss concerns regarding euthanasia practices with personnel
Follow-up and resolution may include discussion with the investigator or laboratory staff regarding following approved endpoints, and in some cases, Institutional Animal Care and Use Committee (IACUC) involvement may be required to resolve the issue. In all cases, the veterinarian or manager should follow up with the animal care personnel to communicate the outcome. Depending on the information discovered during investigation, this could involve a discussion about the specific study and why the approved endpoints are appropriate.
Although that may not completely resolve the ethical concern for the employee, understanding why that endpoint is important to fulfill the scientific objectives of that particular study may relieve some of the concern. Regulatory Expectations There are several laws, regulations, and guidelines that provide guidance to the research community regarding the appropriate care and use of animals. Many of these outline specific expectations for adhering to humane endpoints and euthanasia procedures.
The 1985 amendments included specific changes promoting laboratory animal welfare. Some of these changes included establishing an IACUC and the minimization of pain and distress. The importance of appropriate endpoints and euthanasia methods is highlighted in the AWR. They state that during the protocol review process, the IACUC shall determine that the proposed activities or significant changes in ongoing activities meet several requirements. One of the requirements is that animals that would otherwise experience severe or chronic pain or distress that cannot be relieved will be painlessly euthanized at the end of the procedure or, if appropriate, during the procedure.
These may include verbal presentation, providing written materials, demonstrations by the trainer, and hands-on practice by trainees. This will allow the manager or trainer to confirm proficiency prior to allowing individuals to perform the procedure without observation. This is particularly important when training personnel on procedures that have a direct impact on animal welfare, such as euthanasia techniques. Even with significant training on proper technique, performing euthanasia can be difficult for some animal facility personnel. They may find it difficult to euthanize specific animals for which they have cared or may be uneasy performing certain euthanasia methods.
For instance, animal care technicians or technologists who routinely perform CO 2 euthanasia of rodents but are uncomfortable performing a secondary method per facility or institutional
It is recommended that managers discuss animal use protocols in detail with facility personnel, including the necessity for euthanasia ( Wolfle 1985 ; Overhulse 2002 ). Principal investigators or their research staff may also be requested to speak to animal facility personnel regarding the goals of their research and the importance of the animal caretakers to their work.
Multiple studies have been conducted to evaluate the psychological impact of euthanasia on personnel from animal shelters, research facilities, and veterinary clinics. Reeve et al. (2005) sought to determine the extent of euthanasia-related strain among shelter workers and its effects on overall employee well-being. The results showed evidence that animal euthanasia was an important source of job strain for employees and was associated with increased levels of general job stress, work and family conflict, and somatic complaints.
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certain death. In the Netherlands, for example, where physician-assisted euthanasia is permitted, the Royal Dutch Society for the Advancement of Pharmacy recommends
They nevertheless contend that the lethal injection protocol is unconstitutional under the Eighth Amendment's ban on "cruel and unusual punishments," because of the risk that the protocol's terms might not be properly followed, resulting in significant pain. They propose an alternative protocol, one that they concede has not been adopted by any State and has never been tried. The trial court held extensive hearings and entered detailed findings of fact and conclusions of law.
to Brief for United States as Amicus Curiae 1a–6a (lethal injection protocol used by the Federal Bureau of Prisons). [p. 44] Of these 36 States, at least 30 (including Kentucky) use the same combination of three drugs in their lethal injection protocols. See Workman v. Bredesen , 486 F.3d 896 , 902 (CA6 2007). The first drug, sodium thiopental (also known as Pentothol), is a fast-acting barbiturate sedative that induces a deep,
Between injections, members of the execution team flush the intravenous (IV) lines with 25 milligrams of saline to prevent clogging of the lines by precipitates that may form when residual sodium thiopental comes into contact with pancuronium bromide. Id. , at 761, 763–764. The protocol reserves responsibility for inserting the IV catheters to qualified personnel having at least one year of professional experience. Id. , at 984. Currently, Kentucky uses a certified phlebotomist and an emergency medical technician (EMT) to perform the venipunctures necessary for the catheters. Id. , at 761–762.
That is because, as counsel for petitioners admitted at oral argument, proper administration of the first drug, sodium thiopental, eliminates any meaningful risk that a prisoner would experience pain from the subsequent injections of pancuronium and potassium chloride. See Tr. of Oral Arg. 5; App. 493–494 (testimony of petitioners' expert that, if sodium thiopental is "properly administered" under the protocol, "[i]n virtually every case, then that would be a humane death").
See supra , at 42–43, and n. 1. This broad consensus goes not just to the method of execution, but also to the specific three-drug combination used by Kentucky. Thirty States, as well as the Federal Government, use a series of sodium thiopental, pancuronium bromide, and potassium chloride, in varying amounts. See supra , at 44. No State uses or has ever used the alternative one-drug protocol belatedly urged by petitioners. This consensus is probative but not conclusive with respect to that aspect of the alternatives proposed by petitioners.
A [ edit ] Petitioners contend that there is a risk of improper administration of thiopental because the doses are difficult to mix into solution form and load into syringes; because the protocol fails to establish a rate of injection, which could lead to a failure of the IV; because it is possible that the IV catheters will infiltrate into surrounding tissue, causing an inadequate dose to be delivered to the vein; because of inadequate facilities and training; and because Kentucky has no reliable means of monitoring the anesthetic depth of the prisoner after the sodium thiopental has been administered. Brief for Petitioners 12–20.
Kentucky has put in place several important safeguards to ensure that an adequate dose of sodium thiopental is delivered to the condemned prisoner. The most significant of these is the written protocol's requirement that members of the IV team must have at least one year of professional experience as a certified medical assistant, phlebotomist, EMT, paramedic, or military corpsman. App. 984. Kentucky currently uses a phlebotomist and an EMT, personnel who have daily experience establishing IV catheters for inmates in Kentucky's prison population. Id. , at 273–274; Tr. of Oral Arg. 27–28.
Moreover, these IV team members, along with the rest of the execution team, participate in at least 10 practice sessions per year. App. 984. These sessions, required by the written protocol, encompass a complete walk-through of the execution procedures, including the siting of IV catheters into volunteers. Ibid. In addition, the protocol calls for the IV team to establish both primary and backup lines and to prepare two sets of the lethal injection drugs before the execution commences. Id. , at 975.
And, in any event, merely because the protocol gives the IV team one hour to establish intravenous access does not mean that team members are required to spend the entire hour in a futile attempt to do so. The [p. 56] qualifications of the IV team also substantially reduce the risk of IV infiltration. In addition, the presence of the warden and deputy warden in the execution chamber with the prisoner allows them to watch for signs of IV problems, including infiltration. Three of the Commonwealth's medical experts testified that identifying signs of infiltration would be "very obvious," even to the average person, because of the swelling that would result. App. 385–386. See id.
1996). That concern may be less compelling in the veterinary context, and in any event other methods approved by veterinarians—such as stunning the animal or severing its spinal cord, see 6 Tr. 758–759 (Apr. 20, 2005)—make clear that veterinary practice for animals is not an appropriate guide to humane practices for humans. Petitioners also fault the Kentucky protocol for lacking a systematic mechanism for monitoring the "anesthetic depth" [p. 59] of the prisoner.
§29–2532 (1995), but the Nebraska Supreme Court recently struck down that method under the Nebraska Constitution, see State v. Mata , 275 Neb. 1, 39, 745 N.W.2d 229 , 278 (2008). ↑ . The difficulties inherent in such approaches are exemplified by the controversy surrounding the study of lethal injection published in the April 2005 edition of the British medical journal the Lancet.
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