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Court Halts Missouri Physician-Overseen Lethal Injection Execution; Blows Doctor’s Cover

A “secret” Missouri surgeon who has supervised 54 prisoner executions had his cover pulled and suffered immediate peer criticism, court restriction, and a media barrage. In tension were the Hippocratic Oath of doctors to sustain the life of their patients, doctor oversight of the dirty work of Missouri Department of Corrections’ (MDOC) executions, and prisoners’ rights to be free from cruel and unusual punishment. The doctor unavailingly attempted to distance himself by merely setting up the lethal injection execution mechanism, while employing a non-doctor assistant to start the flow of drugs. He defensively answered reporters’ questions, “Read my lips. I don’t do them.” But the details came to a head in U.S. District Court during a challenge to allegedly unconscionable pain during botched executions, wherein the court found the shaky process so troubling that it ordered them halted.

Dr. Alan R. Doerhoff, 62, has been a contract general surgeon with MDOC since 1969. But on the outside, his checkered career netted him at least 20 malpractice suits, and his failure to properly disclose these suits led to his loss of medical practice privileges at two Missouri hospitals. In 1989, when MDOC switched to lethal injection for its executions, Dr. Doerhoff became MDOC’s consultant. In 1995, as a permanent contractor with MDOC, he devised revised execution procedures when a bungled injection due to collapsed veins on drug-addict prisoner Emmitt Foster took 30 minutes.

The matter came to light during an appeal by condemned Missouri murder-rapist Michael Taylor, who challenged the execution procedure as cruel and unusual punishment. A review of execution logs revealed that Dr. Doerhoff’s anesthesia preparations were often only half the required strength. Dr. Doerhoff was called to testify, but did so from behind a screen to protect his identity. Missouri Attorney General Jay Nixon said Doerhoff’s identity had to be kept secret for the doctor’s safety. But this ploy fell apart when facts surrounding Doerhoff’s malpractice history, his official reprimands from the Missouri Board of Healing Arts and his loss of privileges at two Missouri hospitals events allegedly not truthfully reported to MDOC -- exposed his identity. Taylor’s lawyers challenged Dr. Doerhoff’s ethics by bringing up a 1995 lawsuit by a woman patient who claimed Doerhoff was having sex with her while she was under his care, whereupon he performed an operation to restore her virginity and gave her an abortion in a hotel room.

In January 2006, U.S. District Judge Fernando Gaitlan rejected Taylor’s appeal. But three months later, the U.S. Supreme Court agreed to hear such concerns in another case, landing Taylor back in Gaitlan’s court. There, the court became concerned over Dr. Doerhoff’s admitted dyslexia. Gaitlan ordered MDOC to use Board-certified anesthesiologists and to overhaul its execution procedures. In July 2006, MDOC told the court they had made the changes, but could not find a willing anesthesiologist to participate. The court found the revised procedures were “an improvement,” but said there were still “inadequacies with the personnel required to monitor and oversee” the death penalty.

Separately, California corrections officials have suffered a similar conundrum. When trying to execute condemned murder-rapist Michael Morales, the state was stopped by an order from U.S. District Judge Jeremy Fogel, who while announcing he was not ruling on cruelty of the death penalty per se, nonetheless put California on notice that it had to come up with procedures that passed constitutional muster of not causing unusual pain. In Judge Fogel’s court, state witnesses are having their identities strictly protected. The identity of just which member of California’s execution team actually starts the flow of lethal drugs is kept secret.

With pending U.S. Supreme Court and district court cases, California and Missouri are staying all executions. Florida has done so as well, following a recent highly publicized agonizing injection death. Of 38 states with death penalties on the books, only Nebraska does not offer lethal injection (it uses electrocution). While the other states grapple with the Hippocratic Oath / doctor-assisted lethal injection execution dilemma, critics suggest going back to hanging, firing squads, electrocution or poison gas.

As to Dr. Doerhoff’s future following the recent media blitz, he lamented, “nobody is going to hire me. It’s poisoned my career.” Sources: St. Louis Post-Dispatch, San Francisco Chronicle, Reuters.