Lethal Injections Ill-Conceived, With Painful Results
Even people who support capital punishment are uncomfortable thinking too much about the actual mechanics of putting someone to death. Lethal injection seemed to be the perfect solution. Compared to electrocution, gas or hanging, execution by lethal injection looks as humane as putting a horse to sleep, as Ronald Reagan once suggested.
But appearances are deceiving. Mounting evidence suggests some prisoners may have suffered horribly and needlessly before they died because executioners use a bizarre three-drug protocol hastily concocted 30 years ago and never revised. The Supreme Court has agreed to consider whether executions with these drugs pose an unnecessary and unconstitutionally cruel risk of pain and suffering. This case was brought against Kentucky, but the result will affect all 38 states that use lethal injections, so all have imposed moratoria on executions until the court rules on the legality of this method.
The idea of a "humane execution" is a contradiction in terms; all executions are inherently cruel. But if states are going to have the death penalty, it is not enough to believe that death by poisoning is inherently more humane than the electric chair. Public officials have a human rights obligation to choose the specific drugs and methods of administration that carry the least risk of pain and suffering for the condemned. To date, they have not done so.
Dr. Jay Chapman, a medical examiner in Oklahoma with no pharmacology experience, came up with the three-drug protocol in 1977 used in U.S. executions. When Human Rights Watch interviewed him, Chapman told us that, "despite having no experience with this sort of thing," he had done no research before deciding on the drugs that should be used in lethal injections. In fact, when we asked why he chose the three drugs he did, he replied, "Why not?"
Texas, the nation's most prolific executioner by far, copied his formula and 37 states followed suit. No one consulted with toxicologists, anesthesiologists or other experts to assess the risks inherent in Chapman's choice of drugs or to determine if there were lethal injection options that would pose less risk of pain and suffering.
The first of the three drugs used in lethal injections is an anesthetic (sodium thiopental) to render the prisoner unconscious. Next is pancuronium bromide, a drug that paralyzes voluntary muscles, including the lungs and diaphragm, but does not affect consciousness or the experience of pain. The final drug is potassium chloride, which causes cardiac arrest.
If the prisoner does not receive a sufficient quantity of anesthesia he will feel himself suffocating from the pancuronium bromide. If he is still conscious when given the potassium chloride, he will feel his veins burning as the poison courses to his heart. Indeed, potassium chloride is so painful that U.S. veterinarian guidelines prohibit its use on domestic animals unless a vet first ensures they are deeply unconscious.
Incorrect dosage, faulty catheter insertion, kinking IV tubes - many problems can prevent anesthesia from working. No surgery would ever be conducted without assessing and continually monitoring the patient's level of consciousness. But during lethal injections, no one makes sure the prisoner is deeply unconscious before and during the injection of the second and third drugs.
States have fought hard to keep their execution records secret. But lawyers in some cases have succeeded in prying loose evidence that prisoners may have been conscious as they were killed. For example, logs from six executions in California reveal that prisoners' chests were still moving regularly up and down long after the anesthetic should have stopped their breathing -- suggesting they were awake and suffering. Toxicology reports from executions in North Carolina also suggest some prisoners had been inadequately anesthetized.
It is not surprising that lethal injections are not what the public hoped. The protocol was not sound when originally developed and advances in pharmacology and anesthesia administration have rendered it archaic at best, torturous at worst. Medical experts agree that there are other drug protocols that could be used in lethal injections that do not carry the same risks of excruciating pain.
For example, eliminating the pancuronium bromide would eliminate the risk that a paralyzed prisoner is insufficiently anesthetized but unable to move or say anything to alert witnesses or executioners. The only purpose of that drug is to keep the prisoner still, saving execution observers from having to witness the convulsions or other body movements that might otherwise occur from the potassium chloride. And saving corrections officials from the public relations consequences of such a troubling sight.
A federal judge in California has suggested replacing the three-drug protocol with a single injection of a massive dose of a barbiturate. Although it would guarantee a painless death for the prisoner, California officials rejected that option because it could take 30 to 45 minutes for the prisoner's heart to stop beating.
Corrections officials argue they are not constitutionally required to choose the execution methods that pose the least risk of pain. The Supreme Court will judge the merits of their legal argument. But we must judge the morality of their conduct.
Jamie Fellner is Senior Counsel in the US program at Human Rights Watch and co-author of "So Long as They Die: Lethal Injections in the United States."
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Critics of the Lancet article say it does not account for postmortem redistribution of the anesthetic - thiopental. The redistribution, the critics say, accounts for the lower levels of thiopental on which Dr. Koniaris based his Lancet article conclusions that the levels of anesthetic were inadequate. The Ross autopsy results document this redistribution, bolstering the critics' assertions.
Dr. H. Wayne Carver II, Connecticut's chief medical examiner, was aware of the controversial Lancet article before performing the Ross autopsy. As a result, he took the additional step of drawing a sample of Ross's blood 20 minutes after he was pronounced dead at 2:25 a.m. May 13. Carver took a subsequent sample during the autopsy, which began about 7 hours later, at 9:40 a.m.
The 1st sample showed a concentration of 29.6 milligrams per liter of thiopental; the second sample showed a concentration of 9.4 milligrams per liter. The 1st sample was drawn from Ross' right femoral artery, and the second from his heart, which can account for some of the discrepancy. But Dr. Mark Heath, a New York anesthesiologist and one of the numerous doctors who have signed letters to The Lancet challenging the Koniaris article, said it clearly substantiates the postmortem redistribution of the thiopental.
Dr. Jonathan Groner, a pediatric surgeon from Ohio said he interviewed a number of forensic toxicologists before adopting the view that thiopental in a corpse leaves the blood and is absorbed by the fat, causing blood samples taken hours after death to be an unreliable marker of the levels of thiopental in the body at the time of death.
Groner described the Ross autopsy results as "a powerful refutation" of the Lancet-Koniaris study.
Further, lethal injection is not a medical procedure, but the culmination of a judicial sentence carried out by criminal justice professionals, the result of which is intended as death, the outcome of every case.
The follow up research/article is "Lethal Injection for Execution: Chemical Asphyxiati
The question mark from the title says it all.
From the Conclusion:
" . . . our findings suggest that current lethal injection protocols "may" not reliably effect death through the mechanisms intended, indicating a failure of design and implementation. "If" thiopental and potassium chloride fail to cause anesthesia and cardiac arrest, potentially aware inmates "could" die through pancuronium-induced asphyxiati
In other words, the authors tell us they cannot prove this has ever happened. They are speculating.
Skip the speculation: Some Reality
From Hartford Courant, "Ross Autopsy Stirs Execution Debate----Results Cited To Counter Talk Of Pre-Death Pain", August 11, 2005
The below is a paraphrase of parts of that article, including some exact quotes.
Results of the autopsy done on serial killer Michael Ross are being cited by several prominent doctors to refute a highly publicized article that appeared in The Lancet, the British medical journal, in April, 2005.
contd
I'm not an opponent nor a proponenet for Capitol Punishment.
Some States use it too liberally, others should use it more.
Regardless of the methods- you are putting some one to death- It ain't gonna be pretty. I work with animals and have assisted in Euthanasia via injections- most are 'peaceful, but some are not.When an animal is suffering it is the kindest thing we can do. When an animal is 'feral' it is the only thing we can do.
I have gotten to the point where I see animal Breeding being conducted with a lot more thought and care than any human places on themselves. We create these mal adjusted/ feral humans by the very structure of our imposed 'societal' structures
I think, that should a person ever find themselves taking the Long Walk, they should have a choice, the bullet, or the needle.
If they choose the needle, just feed em morphine until they cross over to the Other Side. No pain, no suffering, just goodbye.
On the other hand, the bullet is 100% certain,
yet probably painful. But, not as painful as
asphyxiating and being paralyzed and basically
'dying' for 10 minutes or however that all
happened. I think if they're going to put
someone to death, then don't screw around.
Or, forget it.
How about crying for a little girl, raped, beaten and buried ALIVE?
How about crying for 5 little children struggling for their lives while their MOTHER systematically drowns them?
How about crying for two little tiny boys strapped into the back seat of the car while their MOTHER drives it into a lake and leaves them to die in the water?
You people make me sick. You care so much more for the Ted Bundy's, the John Wayne Gacey's, the Jeffery Dahmer's of the world than the innocent victims they so methodically stalked and slaughtered. So instead of lethal injection, how about putting them into a vacuum chamber like the animals? Better yet, let the "punishment fit the crime". Drown Andrea Yates and the mother of the two little boys in the car. Bury the scum alive who bragged about burying the little girl then yelled at her father that she liked what he did to her in the court room. Instead of crying for these SCUM, fight for the DNA evidence of innocence to be used to get the innocent out and shut up about the worst of the worst. They deserve worse than lethal injection. They deserve to die the same way their victims did. Pain and all.
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