The question of pain relief on execution; An assignment or History been made

Reading the research letter published in the Lancet 1412-1414, Vol365 April 16, 2005 about Inadequate anaesthesia in lethal injection for execution (1) (A study conceived by LG Koniaris and JP Sheldon ). I was amazed by the concept that had always proven correct, (Reach for a taken for granted agreeable theorem and think about it, Challenge it and you are on your way to surprise the world.) Here is a mean of execution in the USA that I had always thought of as most human if compared to the violent Electric chair, Hanging, Gas Champers, or Shooting. DR Koniaris challenged that agreeable concept and researched it to find almost 40% of people executed that way were possibly aware of the horrible feeling of being paralysed and unable to wink, hypoxic and feeling the burning sensation of potassium shot injected into them. It was also revival of the logical debate, Should Doctors be part of execution when we all sworn to maintain life and cause no harm. Or should a doctor who knows so much about reducing human suffering by pharmacological means, Sets on his backside watching Somebody been hanged , shoot or electrocuted, With the scenery of Sadam Hussein not to far back in our memory . Moslem scholars are in agreement about executing the murder and cutting the hand of the violent rubber and dismembering those who spread evil community destructions, Are all just and deterring and by reducing crimes that would establish God kingdom on earth, That had never appealed to westerners, Although some see the logic of it. I personally heard of a highly regarded Islamic Scholar (2) that people by enlarge tends to sympathise with the victims of execution, But they never think how did these victims mange to get to such mischief in the first place , That would make any state determined to want to punish them, Whom did he or she had killed, rapped or violated, True I thought. Back in the hot summer of Al madinna Almunwara (Hejaz, Saudi Arabia)1985 Late afternoon on a Wednesday and following a busy day in the operating theatres,(3 I was called by the hospital director who had given my name as the Anaesthetist who will accompany the ambulance on the next Friday to attend Qesas after Friday mass prayer near by Prophet Mohamed PBUH masjed A yard known as Narring (Qessas) Area,( Where Islamic law punishments were implemented) Oh no not again I nearly shouted with visions of a mans head flying of his body, Brought back as a living memory, It was of a man who had killed his brother 16 years back. And an event that I had witnessed among thousands others not a long time back then. Do you really need an Anaesthetist for that? I asked. And The Director said a senior doctor had to accompany the ambulance for resuscitation should that be necessary, Sir what resuscitation when the head fly away and both Carotids drain like a fountain of blood all over the ground? I so that once and never hoped to ever see it again. No he said it is hands only this time. And I f you care to come to my office I would explain the matter in more details, Well I will be with you shortly. I was a bit excited somehow as I wondered how this going to be and what do I need to take with me who else would be there. I also wondered where would I be on the day of this The question of pain relief on execution; An assignment or History been made 2 of 6 coming Qesas ? Would I have to be so close to those ? And what they might be looking like? As I changed OR cloths and had my lab coat on heading to the director office some more questions came to my head How I wonder the hand would be shopped off? How the Prisoner would takes that? What if he fainted before cutting his hands? What if dies of syncope? Could he bleed to death as the ambulance drive back to the hospital? Now what is all this about I asked as I greeted the Director in his office, and he pressed the button on his desk to order a glass of tea for me. I sat down and he said Dr Hamalawy this is just a routine You are our best Anaesthetist and I believe the doctor who would attend this don’t usually have to do much, You would have the Ambulance service man with you who had witnessed this matter before. The hospital have to be ready to operate on these guys’ after their hands shopped off, Yes I remarked some surgery would be necessary I am sure. The calm director continued some trimming and suturing would be done immediately as they come to the hospital hence we arranged Two theatres to be ready. Why Two I interrupted? So you didn’t know that there will be hand cutting of two people. I started sipping the Tea and Visualising my self in the heart of the incident and wouldn’t like to miss being there I must get some resuscitation stuff with me, I better start thinking of what I must take in the rescue bag and arrange for an extra resident Anaesthetist to be available on Friday afternoon in OR. Well If you need any thing then let me know, commented the director . I thanked him for explaining the matter and back to my office I returned. On a blank sheet I started writing what would I possibly need Laryngoscope several Endotracheal tubes Ampu bag Syringes and needles Adhesive plaster, Bandages, Sphygmo manometer, Stethoscope and Drugs. Adrenalin Atropine Calcium Sodium Bicarbonate and Lignocaine. Lignocaine No I crossed that off then wrote it again and crossed it off again and stopped and wondered for a while why not? Well It is obvious that these people are keen on preserving the criminals life, With all the arrangement Ambulance Operating rooms Surgeons and nurses. And me why? Well if they are keen on their life and on immediate treatment of any fainting why let them faint in the first place? I wondered I reached for the Phone and began to feel privileged to have to be assigned for this task, Now I was already told you are our best Anaesthetist and the child in me was overjoyed. I called the Ambulance services office to enquire about what they would have in the Van on the day and who would answer It was him the very man who would accompany me on Friday. He sounded rather experienced and apparently had been involved in similar episodes , and he was proud that none of the punished prisoners who came under his care had died following their hand chop . You only have to insert a cannula in their left arm and I will put a dressing and loos tourniquet over their right upper arm to be tightened immediately following the cutting. Would you have Oxygen in the Van? I asked. Of course he replied don’t worry, I thanked him and asked to be picked on Friday 11:00 AM from King Fahad Hospital main loopy. The question that kept burning in my head was why Should those people feel the pain of their hands chopped off ?.Isn’t going to be a lost hand for the rest of their life A just reminder of their robbery, Isn’t their communal insult when thousands of people see them punished enough? I wakeup at crack of dawn on Friday with the call for Fagar prayer loud and clear repeating that Prayer was better than sleep, After prayer it was clear that I have some homework to be done. I had just completed my own little Islamic literature home library, Mainly with free books as a gift (4) and some selected important books that I bought from book shops near Haram Shareef. I went through the books of hadeeth searching for something to agree or deny the prisoners the right to have painless punishment. I wasn’t sure where I might find an answer, But I kept reading through relevant matters. God almighty (Rauoof Rheem) Most merciful and compassionate, Well then it was the moment I ,thought I made my mind up, Let them suffer no pain. I know now what they were going to have done The question of pain relief on execution; An assignment or History been made 3 of 6 I spent most of Thursday finding out, It is going to be a kind of Disarticulation at the right wrest And I could help these guys and it seems that their is no obvious Islamic doctorin against it and it is a blessing and compassionate act to help these two not to suffer any pain. Ten O’clock Friday morning I went to the hospital made couple of phone calls and made sure that Anaesthetist as well as theatre would be on a standby ready to receive these Two guys when they arrive to the hospital, I went to check my box that I prepare from Wednesday to make sure that everything was there. A lignocaine 1% plain 100 mills vial was there sealed staring at me , I almost snatched that with punch of spirit swabs and few 20 mills, Syringes and needles, I stuffed it all in my box and called an assistant to take my box to the hospital main loopy. The Grey head Ambulance Palestinian had arrived with an expressionless face, Went to the receptionist asking for the Consultant Anaesthetist who would accompany him. I went straight to him and my assistant walk behind me with the box. The ambulance man gave a surprising laugh yelling where you people think you going, For Heart Transplant Ha, I greeted him and asked if I keep that box in the van with us? Yes, he answered politely and I was thrilled. He looked in the direction of my assistant in a way that indicated that there is no need for him to come, and I agreed. After all this Ambulance man had been there before on similar occasions and knew what he was talking about. Off we went in the Ambulance in the direction of Haram shareef (5) Where Exactly near Haram we going to be? I asked Well the gentleman replied in the big square in front of the (Mezzallat Area by Bab Al salam,)(6) The Ambulance man again briefed me on the details of what we going to see, The van was approaching Haram when few crowds had gathered near that area mentioned above, A traffic policeman waved and directed the Ambulance man as to where exactly he should bark the van. There was a massive queer looking blue Van with Bars and side door slided open and the Ambulance barked next to it. The ambulance man barked the car and looked his door and went straight to the back of the ambulance and brought his bag .turned