Lethal Injection - Not So Cruel

Zion National Park - photo by JoAnn-Sturman

Scott Sturman
fliesinyoureyes.com

Several years ago while driving to work I listened to an NPR reporter’s witnessed account of an execution by lethal injection at San Quentin Prison. After administration of sodium pentothal to the criminal she described his chest as “heaving violently as if in pain.” This observation struck me as inaccurate and disingenuous. It was inconsistent with a twenty-five year experience as an anesthesiologist and incorrectly portrayed a person's physiologic response to intravenous sodium pentothal.

When sodium pentothal is injected into a vein, the patient is rendered unconscious within a few seconds. Unlike the sedative propofol used in general anesthesia, there typically is no pain with a sodium pentothal injection, and it is common for the patient to take one large, final breath when falling rapidly into a profound drug induced coma. This respiratory reflex is so usual that in anesthesiology training programs it is referred to as an “agonal” breath. The dose of sodium pentothal used for lethal injection is ten times the normal clinical dose. This is a lethal dose in its own right; it is virtually impossible for the condemned to be aware of the execution process.

There are two minor technical problems which complicate lethal injection and may lead to a failed execution. The first is the lack of skilled technicians who are experienced with starting intravenous lines. Difficulty or the inability to secure an intravenous line has been described in the sensational press and by death penalty opponents as “cruel and unusual punishment.” The second is to give the muscle paralyzing drug before the sodium pentothal has cleared the IV line. In this case the drugs will form a solid precipitate and at times render the IV useless. This week the state of Ohio announced it will use a single intramuscular injection technique to obviate the problems with intravenous access.

On November 13, 2009 the Death Penalty Clinic at the University of California Berkeley School of Law issued this following statement in response to the state of Ohio's one drug execution mandate:

“Ohio has become the first death penalty state to abandon the practice of paralyzing inmates before executing them. ...they will no longer use a paralyzing drug or the excruciatingly painful potassium chloride to execute inmates. Instead, executions will involve an overdose of one drug ...”

“This is a significant step forward,” added Ty Alper, Associate Director of the Death Penalty Clinic. “Paralyzing inmates before executing them – so we can't tell whether they are suffering – is a barbaric practice...”

The advocates at the Death Penalty Clinic conveniently ignore the order and timing in which drugs given to an inmate during an execution. Given alone or in a different order the described symptoms can occur, but given the established protocols their claims are preposterous. The technique of lethal injection provides a merciful and painless method of execution – the prisoner drifts into sleep just as millions of surgical patients do each year. The procedure begins with a huge dose of sodium pentothal- ten times the normal anesthetic dose. Following unconsciousness which occurs in seconds and lasts for many minutes, ten times the normal dose of a skeletal muscle paralyzing agent is administered. Again this effect occurs in seconds, and there is no awareness on the part of the criminal. With no muscular function no breathing occurs. Finally, potassium chloride is injected which fibrillates the heart. This injection would be painful to an awake patient, but in this case the inmate is in the state of profound coma. All three medications given at these doses insure death, but they are administered intentionally in a logical order – sleep, paralysis, cardiac arrest.

Opponents of capital punishment realize authorities have developed a humane method of putting criminals to death. False statements and exaggeration are used to undermine the process, for if lethal injection is held unconstitutional, then no method of execution can satisfy the inordinately strict interpretation of cruel and unusual punishment.