Hundreds of anesthesiologists urged the state of Missouri on Monday not to use propofol in an upcoming execution, saying the fallout could jeopardize the availability of the anesthetic relied on by thousands of U.S. hospitals and clinics.
The Missouri Society of Anesthesiologists statement followed an Associated Press report last week citing possible European export controls if propofol is used in a U.S. execution. Missouri is the only U.S. state where prison officials plan to use the powerful anesthetic for a lethal injection, citing a shortage in the drugs usually used for executions.
Propofol is far and away the most commonly used anesthetic in the U.S., and around 85 percent of it is made in Europe. The European Union opposes the death penalty and is weighing whether to limit export, raising concerns about a potential shortage in the U.S.
"We urge the Department of Corrections not to jeopardize the safety of over 50 million patients who rely on this critical medication for anesthesia during surgery each year," MSA president Dr. Larry Petersen said in a statement.
"A shortage of this medication will take the medical specialty of anesthesiology back 20 years, leading to more complications in the operating room, an increased rate of nausea and vomiting after surgery, and extended time required to wake up from anesthesia after a procedure," he said.
The MSA— which represents more than 800 physician anesthesiologists, along with their residents and assistants—said the debate is not about capital punishment, but simply about propofol.
Messages seeking comment from Missouri Gov. Jay Nixon and the state Corrections Department were not immediately returned.
The German company that makes most of the propofol, Fresenius Kabi, launched a website specifically to address the ramifications of using propofol in a U.S. execution. The Food and Drug Administration has also expressed concern about any move that could affect access to propofol, calling it a "critical need."
Until recently, Missouri and other states with the death penalty used virtually the same three-drug protocol. That changed as drug makers stopped selling the traditional execution drugs to prison officials because they didn't want them used for lethal injections.
Missouri announced in 2012 that it was turning to propofol, though the state provided no explanation. Propofol has never been used in an execution in the U.S.
A European Union regulation limits export of goods used in "capital punishment, torture or other cruel, inhuman or degrading treatment or punishment." A review is under way to determine whether propofol should be subject to that rule, though it isn't clear when a decision will be made.
If propofol is added to the list, supplies to U.S. hospitals and clinics would still be possible, but Fresenius Kabi spokesman Matt Kuhn said the company would have to apply for a separate export license for every shipment, significantly slowing the flow to the U.S. and creating a potential shortage.