Prisons offer machine as monitor

Officials hope a judge's order concerning lethal injection will be satisfied

******

CORRECTION

Reports on the impending execution of Willie Brown Jr., published on April 11, 13 and 18, incorrectly implied the crimes for which he was convicted. Brown was convicted of the murder and armed robbery of a Williamston convenience store clerk.

******

North Carolina prison officials have proposed using a medical device to make sure death row inmate Willie Brown Jr. is unconscious and does not experience pain during his April 21 execution.

The proposal is in response to an order by U.S. District Judge Malcolm Howard that Brown's execution could go forward only if medically trained personnel were present to make sure Brown is fully sedated before paralyzing and heart-stopping drugs are administered.

Brown's attorneys had raised concerns that inmates have been awake and experiencing pain during executions by lethal injection. They argue that that violates the constitutional ban on cruel and unusual punishment.

Prison officials have proposed using a bispectral index monitor, or BIS monitor, so a doctor and nurse can track Brown's brain waves to determine his level of consciousness. The machines, which federal authorities approved in 1996, are used by health professionals to verify surgical patients have received adequate anesthesia.

State prison officials are proposing something that no other state that administers the death penalty has done.

"This is more medical technology than has ever been applied to an execution in any state as far as I know," said Dr. Jonathan Groner, an Ohio State University surgeon who has written about physician participation in executions. "It's not enough for the execution to look like a medical procedure. Now, they want it to look like an intensive care unit."

One of Brown's attorneys, Don Cowan, said state officials haven't complied with the judge's order, which clearly asked them to provide qualified medical personnel during the lethal injection process. Experts have said only an anesthesiologist or a nurse anesthetist under the supervision of a doctor could satisfy the judge's request.

"They didn't do that," Cowan said. "They gave him a machine."

Cowan has until 5 p.m. Friday to lodge any objections with the judge about the state's proposal.

Brown, 61, was sentenced to death for the 1983 killing of a Williamston convenience store clerk. Brown robbed the Zip Mart, kidnapped Vallerie Ann Roberson Dixon, took her to a logging road, made her lie down and shot her six times. He made off with $90.

Howard's April 7 order has thrust North Carolina into the middle of a national debate about whether medical professionals should be involved in executions. Two months ago, a federal judge required California officials to find doctors to ensure that murderer Michael Morales was unconscious during an execution. No doctors were willing, and Morales has not been executed.

The American Medical Association and American Nurses Association oppose their members participating in executions, based on their professional ethics. State officials acknowledged in court records filed Wednesday that a doctor and nurse at Raleigh's Central Prison observe a heart monitor connected to the inmate throughout the execution. (The professional groups define participation in executions as monitoring vital signs.)

Now the state is proposing that the doctor and nurse observe the inmate's sedation level with a BIS monitor in a room adjacent to the death chamber.

But the BIS monitor does not have widespread approval within the medical community.

When told about the state's proposal, Dr. Richard Pollard of Charlotte, president of the N.C. Society of Anesthesiologists, laughed out loud.

"These monitors cannot guarantee that a patient is asleep," Pollard said.

The company that manufactures the machines isn't pleased that its product may be used for an execution. Scott Kelley, an anesthesiologist and the medical director at Aspect Medical Systems in Newton, Mass., says the company is focused on improving patient care.

"As you might imagine, getting involved in a lethal injection is diametrically opposed to our mission," Kelley said.

He said that the BIS monitor is intended to be used by anesthesia professionals who consider the machine's data in conjunction with their training and other information to determine whether a patient is adequately anesthetized. The American Association of Anesthesiologists considers the machine an emerging technology to be used by an anesthesiologist only on a case-by-case basis.

Other doctors are comfortable with the state's proposal.

"It is my opinion, beyond a reasonable degree of medical certainty, that the utilization of the BIS monitor ... will prevent the possibility of the inmate being awake," wrote Dr. Mark Dershwitz, an anesthesiologist at the University of Massachusetts and the state's expert in the case.

(News researcher Denise Jones contributed to this report.)