A typical witnesses view of gassing is as follows "At first there is evidence of extreme horror, pain, and strangling. The eyes pop, the skin turns purple and the victim begins to drool".So that was still a bit too much for the executioners. That brings us to lethal injection. Justin E. H. Smith explains this latest form of state sanctioned murder and the questions that are arising about it.
In medical terms, victims of cyanide gas die from hypoxia, which means the cut-off of oxygen to the brain. The initial result of this is spasms, as in an epileptic seizure. Because of the straps, however, involuntary body movements are restrained. Seconds after the prisoner first inhales, he/she will feel himself unable to breathe, but will not lose consciousness immediately. "The person is unquestionably experiencing pain and extreme anxiety," according to Dr. Richard Traystman of John Hopkins University. "The pain begins immediately and is felt in the arms, shoulders, back, and chest. The sensation is similar to the pain felt by a person during a heart attack, where essentially the heart is being deprived of oxygen." Traystman adds: "We would not use asphyxiation, by cyanide gas or by any other substance, in our laboratory to kill animals that have been used in experiments."
The first drug administered in this procedure is the barbiturate sodium thiopental. As Liptak reports, "properly administered... it is sufficient to render an inmate unconscious for many hours, if not to kill him." (Sodium thiopental, it is interesting to note, is the sole drug administered in the routine euthanization of pets and farm animals.)Smith reports that a number of judges are now insisting that the drugs be administered by medical personnel. There is of course a problem with this.
The second drug is pancuronium bromide which, if administered by itself, would bring about paralysis without unconsciousness. If the prisoner suffers after this drug is injected, his anguish can generally not be detected by external observers since he is unable to move and thus unable to register pain. The bromide thus serves to obscure from view the effect of the third and final drug, potassium chloride, which causes the heart to stop beating but also causes unimaginable pain while travelling through the veins.
If the first drug is administered correctly, it is sufficient to render the prisoner fully unconscious and to cancel out the painful effects of the two drugs to follow. But poorly trained prison staff often choose the wrong spot on the prisoner's body to inject the barbiturate, resulting in inadequate distribution throughout his system.
Why not, then, include well-trained medical personnel in the procedure? The American Medical Association's ethics code explicitly forbids physicians to prescribe the drugs to be used in execution, to select intravenous sites, to administer the drugs, and to pronounce death. As Liptak reports, the code is not legally binding, and anonymous participation by doctors is not uncommon. Collusion by doctors in earlier stage of the process is also a well-known fact, from the various experts who spoke in favor of the guillotine in the 1790s to the Oklahoma state medical examiner's oversight of the recipe for lethal injection in the 1970s.So what choice do the states have?
It is not clear whether Judge Howard was aware of the AMA's code of ethics when he ordered that the execution of Willie Brown Jr. could not proceed without the guarantee of supervision by personnel capable of "providing appropriate medical care" should Mr. Brown wake up. The judge did not say that the personnel had to be licensed physicians, but clearly the only other possibility would be to invite unlicensed individuals purporting to be medical experts. This would be to condone medical fraud, a felony in all 50 states.
The state has only two options: either to stop feigning humanism, or to stop executing people. Judge Howard's refusal to permit a lethal injection to proceed without medical participation, and his simultaneous inability to arrange for this participation, reveals the worsening paralysis of a system that tries to play both options at once.Of course there is a third option and as it turns out the Chinese may have the right idea. They simply force the person to be executed to his knees and put a bullet in the back of his head. It may be messy but it's probably "humane". You can't suffer too long with your brains plastered all over the pavement in front of you.
And the worse, the better. Capital punishment in America will eventually collapse under the weight of such paradoxes-- unless of course those people have their way who openly see execution as a fitting occasion to inflict harm and thereby to exact revenge. This is the principle of capital punishment under Shariah law, and under the absolute monarchies of early modern Europe, where men were flayed in public squares, or torn to pieces by horses made to run in opposite directions. An awesome spectacle, to be sure, but one that does not fit well with our constitutional opposition to cruel and unusual punishment.