If It’s Good Enough For the Dogs……

Yesterday’s Supreme Court order to stay the execution of Ohio murderer, Kenneth Biros, has added energy to the battle that’s being fought—one lawsuit at a time—over the use of lethal injection in American executions.

Lethal injection was first instituted in 1977 as a supposedly pain-free alternative to the electric chair, a method that occasionally terrified onlookers by setting the condemned man or woman on fire.

Thirty-seven states, plus the Federal government and the US Military now use the injection alternative as the sole or preferred method of putting people to death. Up until a month or two ago, all of those 37 states pretty much used the same “cocktail” of drugs to do the job. First the inmate is given a massive dose of the barbiturate sodium pentothal to render him or her unconscious. Next comes pancuronium bromide to induce total paralysis and to stop respiration. Finally, potassium chloride stops the heart.

The problem comes when the first injection isn’t given properly, and the condemned is completely immobilized but not sedated. In the worst case this means that he or she is wide awake, can feel everything, but is unable to move. As a consequence, the prisoner experiences the sensation of being smothered, together with a full-body burning sensation as he or she dies a painful and often prolonged death —with no ability to express it.

The unsavory secret of these executions, however, has to do with the reasons behind the use of drug number two: pancuronium bromide, the paralyzing agent.

As it turns out, there is no medical necessity for administering the chemical paralysis—-except to stop the inmate from involuntarily writhing and groaning. In other words, the point of the pancuronium bromide is to make the death look less awful to observers. It’s about appearances, not practical function.

It was due to this preference for paralysis that injection executions were not originally flagged as a problem. Yet in the last few years, a few concerned doctors and anesthesiologists—and then a few more— began to look into the matter, and the suspicion arose that lethal injection executions often went horribly wrong. The physicians’ worries were validated by a 2005 report in the British medical journal, the Lancet. After viewing 49 inmates’ autopsies, the Lancet study’s authors found that 21 of the inmates whose cases were reviewed were fully, or very nearly fully, conscious when they died.

Part of the issue is the fact that the injections are neither given nor, in most cases, monitored by doctors or other medical personnel, most of whom feel their Hippocratic Oath prevents them from….well….killing people. The means the job usually falls to prison employees or paramedics who may or may not be up to dealing adequately with the complexities of anesthesia.

This past December, former Governor Jeb Bush was so troubled by the botched lethal injection death of a Florida inmate named Angel Diaz that he suspended all executions in his state until an appointed commission could come up with a better protocol. (Florida has recently rebooted its execution policy with a different drug cocktail.)

It’s interesting to note that the American Veterinary Medical Association and around 30 states now outlaw the use of neuromuscular blocking agents like pancuronium bromide when euthanizing animals—precisely to avoid such painful botches when putting down the family’s aging cat or dog.

The Lancet authors summed up the issue this way: “The absence of training and monitoring,” they wrote, “and the remote administration of drugs, coupled with eyewitness reports of muscle responses during execution, suggest that the current practice of lethal injection for execution fails to meet most veterinary standards.”