Stephen Vasciannie
THE NEW York Times has recently reported on medical developments that have implications for both ends of life - abortion relying on the RU-486 pill and lethal injection in carrying out the death penalty. Naturally, both developments touch and concern issues of life and death in Jamaica.
At the starting point of life, the news is rather grim. Reports are that RU-486 (also known as Mifeprex) appears to be far more likely to cause death or to prompt medical complications than surgical procedures for abortion. According to the American Food and Drug Administration, six women in that country have died using RU-486; that figure has recently been questioned, but if it is correct, the risk of death using RU-486 would be in the region of one in 100,000. For surgical abortion, the risk of death is reported to be one in a million.
ADVANTAGES?
Of course, many Jamaicans maintain that abortion is murder; and for them, the method of inducing abortion will have no bearing on this basic standpoint. For others, however, the statistics will be disappointing.
RU-486 has been regarded as a means of allowing abortions to be carried out with greater privacy, at home, with limited third party intervention. Its use would also, arguably, not fall afoul of aspects of Jamaica's Offences against the Person Act. But if it is more dangerous than the surgical procedure, these putative advantages may be largely meaningless.
It is not yet time, however, to say that RU-486 cannot work. Some experts suggest that one problem with RU-486 concerns the way it has been administered.
The drug is apparently meant to be taken orally, but in practice, some women in the United States have been advised to insert it vaginally. Persons relying on the latter approach seem to be subject to more significant risk factors than those taking RU-486 orally.
INJECTIONS
At the other end of life, there have been renewed arguments about the death penalty and, in particular, about lethal injection. The Times reports on at least two issues that have recently arisen. First, in California, in February, two medical professionals (anaesthesiologists) refused to assist in court-ordered death by lethal injection because this would, in their view, have amounted to harming a patient contrary to the Hippocratic Oath and other core medical principles.
LETHAL DRUG
The professionals had been required by the judge to administer the lethal drug - sodium thiopental - in the death chamber, in the presence of witnesses.
Prior to this case, lethal injection in California had normally been administered by an unseen technician, and medical doctors were required only to certify the fact of death.
The second and related issue calls more fully into question whether lethal injection, as currently administered in the United States, amounts to cruel and unusual punishment. When lethal injection is carried out, three chemicals are usually relied upon. These are: (a) the aforementioned sodium thiopental (to bring about unconsciousness), (b) pancuronium bromide (to paralyse the body), and (c) potassium chloride (to stop the heart).
The argument is, however, that this combination sometimes causes excruciating pain for the convict, and even as the cruelty persists, the convict cannot indicate the degree of suffering, for (s)he is paralysed.
This is said to be especially true when the sodium thiopental is not properly administered, leaving the other two drugs to torture the convict.
This development is painfully ironic. The method of lethal injection was introduced in 1977 largely as a device to make execution more humane and less barbaric. At the very least, it looks less painful in administration than, say, hanging, the electric chair or lithocide; and it must certainly be less uncivilised than the guillotine which has added new dimensions to the idea of 'heads rolling'.
But perhaps the problem should not be overstated. Doctors cannot be ordered to harm patients, so non-medical technicians should do the work.
And, if the current combination of chemicals causes undue physical agony, it should be changed to less painful means.
But these difficulties should not create discrete arguments for the abolition of the death penalty; for this would allow medical doctors, independently of the rest of society, to abolish this form of punishment.
Stephen Vasciannie is a professor at the University of the West Indies and a Deputy Solicitor General.
