Missouri Death Row Inmate’s Dilemma: Potential ‘Surgery Without Anesthesia’

Missouri’s execution protocol allows for “surgery without anesthesia” if the standard method of finding a suitable vein to inject the fatal poison fails, according to lawyers representing a death row inmate in an appeal seeking to save his life.

Brian Dorsey, 52, is slated to be executed on Tuesday for killing his cousin and her husband at their central Missouri home in 2006. His attorneys are pursuing clemency from Gov. Mike Parson and have multiple appeals pending.

A federal court appeal concerns how Missouri administers the lethal dose of pentobarbital. The written procedure calls for the insertion of primary and secondary intravenous lines. However, it does not specify how far the execution team can go to identify a suitable vein, leaving the door open for an invasive “cutdown procedure,” according to Dorsey’s lawyers.

What is a “Cutdown Procedure”?

The treatment requires an incision that may be several inches large and several inches deep. Forceps are utilized to separate tissue from a vein that will become the injection site.

“It’s surgery,” said Arin Brenner, a federal public defender and one of the lawyers representing Dorsey. “It would be surgery without anesthesia.”

According to Brenner, Dorsey’s obesity puts him at a higher-than-average risk of requiring a haircut. His veins may also be weakened as a result of his diabetes and previous usage of IV drugs. A representative for Missouri Attorney General Andrew Bailey declined to comment but referred to the state’s response to the appeal.

“Cut-down procedures are rarely if ever, used under Missouri’s execution protocol,” the statement went on to say. “And if a cut-down procedure were necessary, medical personnel have access to pain-relieving medications.”

Dorsey’s medication would be insufficient, and if the treatment is required, he should be given a local anesthetic, according to Megan Crane, another of his attorneys. “It is extremely painful,” Crane remarked. “Even if given an oral pain relief or an opioid, that will not relieve the pain.”

Dorsey’s lawyers argue that the surgical procedure would violate his constitutional guarantee against cruel and unusual punishment, as well as his right to religious freedom, by preventing him from having meaningful interaction with his spiritual adviser, including the administration of last rites.

The issue is not theoretical. In Idaho, the scheduled execution of serial killer Thomas Eugene Creech in February was stopped after a medical team failed to establish an IV eight times. It is uncertain when, when, or how the state will try again to execute him.

IV lines

Missouri’s execution process is shrouded in secrecy, making it impossible to determine whether or not cutdown techniques were required. No impartial observer observes the IV line being placed. The spiritual adviser does not enter the room until the preparations are completed. Witnesses wait in darkened rooms with drawn curtains until correctional officers open them seconds before the medication is administered.

Dorsey’s lawyers asked if a cutdown method was utilized in January 2023 when Amber McLaughlin was executed. It was thought to be the first execution of an openly transgender individual in the United States.

The Rev. Lauren Bennett of St. Louis served as McLaughlin’s spiritual advisor. She remembered McLaughlin saying, “Ouch, ouch, ouch.” It aches,” McLaughlin murmured, but she couldn’t articulate what was causing her anguish before she died.

Issues with the IV have caused problems in other executions.

In 2014, Oklahoma inmate Clayton Lockett was ruled dead 43 minutes after his execution began, screaming in pain and clenching his teeth throughout. A state inquiry revealed that the execution squad twice failed to implant an IV line into Lockett’s arms, jugular vein, foot, and subclavian vein in the upper chest before finally inserting a line through a vein in his crotch.

The analysis determined that Lockett died after the line became free and the lethal drugs were injected into the tissue surrounding the injection site rather than directly into his bloodstream. There is no evidence in the report that Lockett was ever administered anesthesia.

In 2022, it took more than three hours to execute Joe Nathan James Jr. in Alabama. The authorities stated that the process was delayed due to difficulty in establishing an IV line. Dr. Joel Zivot, an Emory University anesthesiology professor and lethal injection expert who saw the private autopsy, said he found “multiple puncture sites on both arms” as well as two incisions in the middle of the arm, indicating efforts to do a cutdown. It is unknown if he was anesthetized.

On Friday, messages were left with corrections authorities in Oklahoma and Alabama.

What did Brian Dorsey do?

Dorsey, previously of Jefferson City, was found guilty of killing his cousin, Sarah Bonnie, and her husband, Ben, on December 23, 2006, at their house near New Bloomfield. Prosecutors said Dorsey called Sarah Bonnie earlier that day to beg money to pay two drug dealers who were in his apartment.

Dorsey visited the Bonnies’ house that night. Dorsey got a shotgun from the garage after they went to bed and killed them both before sexually assaulting Sarah Bonnie’s body, according to authorities.

Sarah Bonnie’s parents discovered the bodies the following day. The couple’s four-year-old daughter was uninjured.

In the clemency petition, 72 current and former state correctional officials asked Parson, a Republican and former county sheriff, to commute Dorsey’s sentence to life in prison, citing his nearly perfect record of good behavior while incarcerated.

“The Brian I have known for years could not hurt anyone,” one officer wrote. “The Brian I know does not deserve to be executed.” A spokeswoman stated that Parson is still examining the clemency request.

An appeal to the United States Supreme Court focuses on the $12,000 flat charge for Dorsey’s court-appointed trial attorneys. The appeal contends that the flat fee gave his lawyers a financial incentive to settle the issue swiftly. They urged Dorsey to plead guilty but made no demand that prosecutors agree to life in prison rather than the death penalty.

Dorsey’s counsel has requested that the Missouri Supreme Court block the execution because the Department of Corrections’ acting head, Trevor Foley, has not been confirmed by the state Senate and is thus unfit to conduct an execution. The court refused the request on Friday.