In an ongoing battle to spare the life of death row inmate Brian Dorsey, his lawyers have filed an appeal claiming that Missouri's execution protocol allows for an invasive "surgery without anesthesia" if the initial process of finding a suitable vein for injection fails. Scheduled for execution on Tuesday, Dorsey was convicted of the 2006 murders of his cousin and her husband in central Missouri.

According to Dorsey's attorneys, Missouri's written protocol provides no specific guidance on how far the execution team can go in searching for a suitable vein, leaving room for potentially invasive measures, such as a "cutdown procedure." This procedure involves making a deep incision and tearing tissue away from a vein to create an injection point. The defense argues that this amounts to surgical intervention without the administration of anesthesia, causing extreme pain and violating constitutional rights against cruel and unusual punishment.

The appeal outlines Dorsey's increased risk of needing a cutdown procedure due to his obesity and compromised veins resulting from diabetes and past intravenous drug use. His attorneys argue that the use of such an invasive procedure without proper pain relief would be especially agonizing.

In response, the state maintains that cutdown procedures are rarely used in Missouri's executions, and that in the event it becomes necessary, medical personnel have access to pain-relieving medications. However, Dorsey's legal team contends that medication alone would be inadequate, and if a cutdown procedure is performed, he should receive a local anesthetic.

Furthermore, Dorsey's lawyers argue that the use of the cutdown procedure would impede his right to religious freedom, as it would prevent meaningful interaction with his spiritual adviser, including the administration of last rites.

Missouri's execution process has come under scrutiny due to its secretive nature. The lack of independent observers during the insertion of the IV line raises questions about the frequency of cutdown procedures in the state's executions. Witnesses are kept in dark rooms until moments before the lethal drug is injected, and the spiritual adviser is only allowed in the room once the preparation is complete.

The defense team for Dorsey references the case of Amber McLaughlin, an openly transgender individual who was executed in January 2023 in Missouri. McLaughlin reportedly experienced pain during the execution, but the cause of the distress remained unknown. This has raised concerns about the potential use of the cutdown procedure during that execution.

The issue of problematic IV insertions has been seen in other states as well. In Oklahoma in 2014, inmate Clayton Lockett experienced an excruciatingly long and painful execution due to repeated failures to insert an IV line correctly. Similar issues arose in Alabama in 2022, where difficulties establishing an IV line caused a significant delay in the execution of Joe Nathan James Jr.

As Dorsey's legal battle continues, his attorneys argue that the potential use of a cutdown procedure without proper pain relief violates his constitutional rights and religious freedoms, urging for a reconsideration of his scheduled execution.

The outcome of Dorsey's appeals and the fate of Missouri's execution protocol remain uncertain as the case unfolds.