OK, so we’re behind on our NEJM (maybe we’d read it more if it were called New England Journal of Medgadgets). But we were impressed with this editorial by Dr. Robert Steinbrook, which followed up on an Atul Gawande piece on physician-monitored executions. Steinbrook’s essay focused on the technology used in physician monitoring of government-sanctioned killing — specifically, a special EEG:
The EEG device used during Brown’s execution was a bispectral index (BIS) monitor. Made by Aspect Medical Systems of Newton, Massachusetts, it works by means of a proprietary algorithm that converts the raw EEG, which is difficult to interpret in real time, into an index of hypnotic level. The compact device is used in operating rooms and intensive care units as an adjunct to other methods for monitoring the effects of anesthetics and sedatives. Depending on the model, it costs $5,000 or $8,500. A single-use sensor – a four-electrode array that is applied to the forehead to record EEG signals – costs about $17.50…
…During an execution by means of lethal injection, three agents are usually given: first the anesthetic sodium thiopental, then the paralytic pancuronium bromide, and finally a fatal dose of potassium chloride. The concept behind the monitoring is to confirm that the sodium thiopental has rendered the inmate sufficiently unconscious that he or she will have no awareness of the subsequent injections and their effects. The supposition is that, if necessary, someone other than an anesthesiologist or other physician could rely on the BIS monitor to assess a prisoner’s level of consciousness and help to ensure that an execution meets constitutional standards.
Aspect Medical does not want their devices to be used in executions, and in fact requires prisons to sign a statement that they will not be used in such a manner.
More from Aspect Medical Systems…
Flashback: Anesthesiology Group: No Widespread Use of Brain Devices Needed
