Cruel and usual punishment

New scientific evidence suggests that supposedly humane executions by lethal injection are medically and morally suspect because some prisoners remain conscious, and experience intense pain, through all or part of the procedure.

In particular, the three components of lethal injections may not work together as intended to cause prisoners to lose consciousness before dying of paralysis and cardiac arrest. Some unknown percentage of prisoners may appear to be in a comatose state when in fact they remain or become conscious (a phenomenon known as "anaesthesia awareness") as their lungs stop functioning and they slowly die of "chemical asphixiation."

All this from a study reported in PLoS (Public Library of Science) that found:

Most US executions are beset by procedural problems that could lead to insufficient anesthesia in executions. This hypothesis has been supported by findings of low postmortem blood thiopental levels and eyewitness accounts of problematic executions. Herein we report evidence that the design of the drug scheme itself is flawed.

The study concluded that:

Execution outcomes from North Carolina and California together with interspecies dosage scaling of thiopental effects suggest that in the current practice of lethal injection, thiopental might not be fatal and might be insufficient to induce surgical anesthesia for the duration of the execution. Furthermore, evidence from North Carolina, California, and Virginia indicates that potassium chloride in lethal injection does not reliably induce cardiac arrest.

And:

We were able to analyze only a limited number of executions. However, 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 asphyxiation. Thus the conventional view of lethal injection leading to an invariably peaceful and painless death is questionable.

...potentially aware inmates could die through asphyxiation induced by the muscle paralysis caused by pancuronium.

...even if lethal injection is administered without technical error, those executed may experience suffocation, and therefore... “the conventional view of lethal injection as an invariably peaceful and painless death is questionable.”

Lethal injection is currently authorized for use by 37 states, the federal government and the military. Its use has recently been suspended in 11 states due to questions about its efficacy and possible violations of the Eighth Amendment's ban on "cruel and unusual punishment."

Only one of 53 executions in the U.S. during 2006 utilized a method other than lethal injection. The PLoS report makes it clear that lethal injection became the most widely used method of execution in the U.S. despite the lack of peer-reviewed scientific evaluations on the effects of the three chemicals. In fact, the methods used on animals have received far more attention, resulting in strict guidelines:

In the United States and Europe, techniques of animal euthanasia for clinical, laboratory, and agricultural applications are rigorously evaluated and governed by professional, institutional, and regulatory oversight. In university and laboratory settings, local oversight bodies known as Animal Care and Use Committees typically follow the American Veterinary Medical Association's guidelines on euthanasia, which consider all aspects of euthanasia methods, including drugs, tools, and expertise of personnel in order to minimize pain and distress to the animal. Under those guidelines, lethal injections of companion or laboratory animals are limited to injection by qualified personnel of certain clinically tested, Food and Drug Administration–approved anesthetics or euthanasics, while monitoring for awareness.

In stark contrast to animal euthanasia, lethal injection for judicial execution was designed and implemented with no clinical or basic research whatsoever [my emphasis]. To our knowledge, no ethical or oversight groups have ever evaluated the protocols and outcomes in lethal injection. Furthermore, there are no published clinical or experimental data regarding the safety and efficacy of the three-drug lethal injection protocol. Until the unprecedented and controversial use of bispectral index monitoring in the last two North Carolina lethal injections, no monitoring for anesthesia was performed.

The biologist who led the study commented: "You wouldn't be able to use this protocol to kill a pig at the University of Miami" without more proof that it worked as intended. The researchers also found that doses were not adjusted to reflect a prisoner's weight or other variables. In cases where the dosage was wrong:

"The person would feel either asphyxiation or the burning sensation associated with the potassium," said Dr. Leonidas Koniaris, a surgeon and co-author at the University of Miami. "The potassium would cause extreme discomfort, something like being put on fire."

The study was limited in scope to just four states and about 40 prisoners due to "the secrecy surrounding lethal injections" in the U.S. The authors propose "that the secrecy surrounding protocol design and implementation should be broken. The available data or lack of data should be made public and deliberations should be open and transparent."

A prosecutor in Indiana described a response that many people, faced with this evidence, would probably share: "It doesn't matter a whole lot to me that someone may have felt some pain before they were administered poison as a method of execution." I always thought that the intentional infliction of significant pain on someone is a form of cruelty. Apparently this prosecutor's Con Law class bypassed the last half of the Bill of Rights.

Others have protested that the evidence supporting the study is a bit thin, reflecting a Catch-22 paradox: the execution protocols have never been seriously evaluated by scientists in the first place, and much of the limited data has been kept secret, so there's precious little evidence available for study.

Capital punishment is a travesty in itself no matter how it is implemented. But this latest study suggests that its basic moral infirmity is compounded by a reckless and inexcusable failure to make sure that executions do not result in prolonged agony for unknown numbers of prisoners.

PHOTO: A gurney used for executions by lethal injection in Florida.