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卫生保健工作者要求各州交出抗击COVID-19大流行所需的死刑药物

2020-04-11 11:08   美国新闻网   - 

根据乔尔·齐沃特博士和他的签署者同事的研究,目前在披露这一信息的州储存的死刑药物数量可用于治疗约137名COVID-19患者。

一群医生、药剂师和一线医务人员发表了一封致州监狱系统的公开信,呼吁管理人员交出用于死刑的药物,这些药物在打击COVID-19的斗争中也至关重要。

致命注射协议中使用的许多止痛药、镇静药和麻痹剂都是使患者镇静所需的相同药物,以便将他们连接到需要插管的呼吸机上。

信中写道:“这些药物从未被制造或研发出来导致死亡——相反,许多药物被配制成将患者连接到救生呼吸器上,并减轻插管的不适。”。

根据美国医院药剂师协会(ASHP)的说法,咪达唑仑是一种常用的镇静剂,也是一些死刑协议的一部分,目前面临着几种短缺。美国医院药剂师协会是一个与制造商定期沟通的行业协会。阿库恩公司和弗雷森尤斯·卡比公司的药品供应“由于需求增加”正面临短缺制药巨头辉瑞正在经历生产延迟。

据美国食品和药物管理局称,芬太尼柠檬酸盐,一种据报道司法部在恢复联邦死刑时曾考虑过的阿片类药物,也正面临短缺。

这些药物是可能掌握在州矫正项目手中的几种药物中的一种——众所周知,州矫正项目对致命注射协议保密——医护人员发现在COVID-19爆发的第一线越来越难获得这些药物。

“病人数量是前所未有的。麻醉学副教授乔尔·兹沃特博士以个人身份在信上签名,他告诉记者:“我们正尽最大努力为尽可能多的人服务。”新闻周刊。“所有正常情况下应该到位的供应都被压缩了。我认为我们所有人都在努力利用我们所拥有的,以最好的方式利用我们所拥有的。但一切都是需要的。”

根据Zivot和他的共同签署人的研究,目前至少有三个州储存的药物总量可以用来治疗大约137名患者,这些药物披露了这些信息。

但是卫生保健专业人员认为,当与其他可能有类似供应的州的库存相结合时,“潜在的数百名”COVID-19患者将受益。

Zivot不认为药物应该“作为国家惩罚的一种手段”。然而,他说他起草这封信的目的不是削弱死刑的准备,而是仅仅帮助尽可能多的病人。

近年来,关于拙劣处决的报道和要求废除死刑的公众压力越来越大,使得各州争相采购必要的药物或修改致命注射协议。

许多制造商发誓反对向各州提供任何将被用于死刑的药物。

根据死刑信息中心,有28个州允许死刑,但是其中三个州——加利福尼亚、俄勒冈和宾夕法尼亚——的州长已经暂停了死刑。

2019年7月,司法部宣布将在联邦案件中重新确立死刑,这是近20年来的第一次。

在这张讲义照片中,2019年3月13日,加州圣昆廷,圣昆廷州立监狱拆除前,圣昆廷的致命注射设施被展示。加州州长加文·纽瑟姆宣布暂停该州的死刑。

由于获得死刑药物的途径越来越窄,一些州转而采取秘密手段,在公众视线之外进行交易。

例如,2014年,时任密苏里州惩教署署长的乔治·隆巴迪,作证在一次监督听证会上,该州派遣一名部门员工越过边境进入邻近的俄克拉荷马州,在一笔全现金交易中购买镇静剂戊巴比妥。

BuzzFeed新闻已报告就在2018年,德州还在从一家混合药房采购致命注射药物,该药房的执照已经处于试用期,此前曾因违反安全规定而被传讯。

各州手中药品的完整性不可靠是一个问题,但Zivot表示,各州应披露“它们是否过期或质量低下”。

迄今为止,唯一对公开信做出回应的州是怀俄明州,该州规定了死刑,但自1992年以来从未处决过囚犯。2014年,该州唯一一名死囚的判决被推翻。齐沃特说,怀俄明州告诉他,该州没有任何相关的药物。

可能会要求真诚遵守Zivot要求的国家披露它们是否参与了不良的药物采购行为。在许多州,这些信息被法律视为机密,以保护秘密供应链。此外,一旦各州将死刑药物从库存中移除,他们可能会面临补充供应的巨大障碍。

“公众期望这个问题永远不会是供应问题,供应将永远存在,”齐沃特解释了医疗保健行业应对COVID-19疫情的能力。“让我们不受阻碍地完成我们的工作。因为不幸的是,由于这一问题的严重性,已经出现了阻碍。”

HEALTH CARE WORKERS ASK STATES TO HAND OVER DEATH PENALTY DRUGS NEEDED TO FIGHT COVID-19 PANDEMIC

According to research by Dr. Joel Zivot and his fellow signatories, the amount of death penalty drugs currently stockpiled in states that disclose this information could be used to treat around 137 COVID-19 patients.

A group of doctors, pharmacists and front-line medical workers have published an open letter to state prison systems, calling on administrators to hand over drugs used for capital punishment that are also critical in the fight against COVID-19.

Many of the pain relievers, sedatives and paralytics that are used in lethal injection protocols are the same drugs needed to calm patients in order to attach them to a ventilator, which requires intubation.

"These medicines were never made or developed to cause death – to the contrary, many were formulated to connect patients to life‐saving ventilators and lessen the discomfort of intubation," the letter states.

The availability of midazolam, a commonly used sedative that is also part of some death penalty protocols, is currently facing several shortages, according to the American Society of Hospital Pharmacists (ASHP), an industry association that regularly communicates with manufacturers. Supplies of the drug from the firms Akorn and Fresenius Kabi are facing shortages "due to increased demand." The pharmaceutical giant Pfizer is experiencing manufacturing delays.

Fentanyl citrate, an opioid that the Justice Department had reportedly considered when resurrecting the federal death penalty and one that is used in Nebraska's cocktail, is also facing shortages, according to the Food and Drug Administration.

These drugs are among several medications that may be in the hands of state correctional programs—notorious for shrouding their lethal injection protocols in secrecy—that health care workers are finding it increasingly difficult to procure on the front lines of the COVID-19 outbreak.

"The patient volume is unprecedented. We are trying to do the best we can for as many people as we can," Dr. Joel Zivot, an associate professor of anesthesiology who signed on to the letter in his personal capacity, told Newsweek. "All of the supplies that would normally be in place are being stretched thin. I think all of us are trying very hard to make do with what we've got, to use what we have in the best possible way. But everything is needed."

According to research by Zivot and his fellow signatories, nine in total, the volume of drugs currently stockpiled in at least three states that disclose this information could be used to treat around 137 patients.

But the health care professionals believe that, when combined with inventory from other states that may have comparable supplies, "potentially hundreds" of patients suffering from COVID-19 could stand to benefit.

Zivot does not believe that medicine should "be used as an arm of state punishment." However, he says his aim in drafting the letter is not to impair the readiness of the death penalty but to merely help as many patients as possible.

Reports in recent years of botched executions and mounting public pressure to abolish the death penalty have sent states scrambling to procure the necessary drugs or to retool their lethal injection protocols.

Many manufacturers have sworn against supplying states with any drugs that will be used for capital punishment.

According to the Death Penalty Information Center, 28 states allow for capital punishment, however governors in three of these states—California, Oregon and Pennsylvania—have imposed moratoria on the practice.

In July 2019, the Justice Department announced it would move to re-establish the death penalty in federal cases for the first time in nearly two decades.

In this handout photo, San Quentin's lethal injection facility is shown before being dismantled at San Quentin State Prison on March 13, 2019, in San Quentin, California. California Governor Gavin Newsom announced a moratorium on the state's death penalty.

Because of the narrowing pathways for obtaining death penalty drugs, some states have turned to underhanded practices to conduct transactions out of the public eye.

For example, in 2014, George Lombardi, then the director of Missouri's Department of Corrections, testified at an oversight hearing that the state sends a department employee over the border into neighboring Oklahoma to procure pentobarbital, a sedative, in an all-cash deal.

BuzzFeed News has reported that as recently as 2018, Texas has been procuring its supply of lethal injection drugs from a compounding pharmacy whose license had been on probation and that was previously cited for safety violations.

That the integrity of drugs in states' hands would be unreliable is a concern, but Zivot says that states should disclose "if what they have is expired or of low quality."

So far, the only state to have responded to the open letter is Wyoming, which provides for capital punishment but has not executed an inmate since 1992. In 2014, the state's lone death row inmate had his sentence overturned. Zivot says that Wyoming told him it did not have any of the relevant drugs in its possession.

States seeking to comply in good faith with Zivot's request may be asked to disclose whether they have engaged in unsavory drug-procurement practices. In many states, this information is deemed confidential by law, so as to protect secret supply chains. Furthermore, once states remove death penalty drugs from their inventory, they may face enormous hurdles restocking their supply.

"The public has an expectation that the issue will never be one of supply, that supply will always be there," Zivot explained about the health care industry's ability to respond to the COVID-19 outbreak. "Let us do our job in an unencumbered way. Because there are already encumbrances that have occurred, tragically, as a result of the enormity of this problem."

 

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