A Straight Dope Classic from Cecil's Storehouse of Human Knowledge

Why does lethal injection go wrong so often?

November 11, 2016

Dear Cecil:

I recently had to put down our dog, a large Labrador. Despite my emotional turmoil, I couldn’t help but notice the complete lack of pain, trauma, and stress our dog experienced, and how quickly it was all over. Why do there seem to be ongoing issues whenever we execute people by lethal injection that we never see when dogs get put to sleep?

Cecil replies:

Every dog must someday romp off into the great beyond, and when its owner decides that the time has come, a licensed vet will be there to administer a lethal shot, typically of pentobarbital. Delivered in sufficient dosage, this barbiturate, most widely marketed in the U.S. as Nembutal, zips through the bloodstream to knock out brain and heart functions pretty much simultaneously. The end is instant and painless, the process so far from cruel and unusual that even the Humane Society grudgingly recommends it if euthanasia is unavoidable. With an even bigger hit of pentobarbital you can put down a horse — or end a human life with little muss or fuss.

Next time you’re looking for reasons to grumble that we Americans treat our pets better than our fellow human beings, contrast that frictionless procedure with the dysfunctional workings of death row. As of 2010, about seven percent of lethal injections conducted in the U.S. resulted in some shameful, often headline-snagging snafu. And that incompetence hasn’t abated in the years since — capital punishment has if anything become an even less professional undertaking, as reputation-protecting drug manufacturers and physicians edge away from the institution and states grow cagier about what happens in the death chamber.

The irony here is that the earliest advocates of chemical execution actually got the idea from animal euthanasia. “We kill animals more humanely than people,” pathologist Jay Chapman recalls thinking circa 1977, while Gary Gilmore was awaiting death by firing squad. It was in that year that Chapman, then Oklahoma’s chief medical examiner, whipped up the lethal-injection protocol that still bears his name. His three-drug cocktail — sodium thiopental as a sedative, pancuronium to still the lungs, and potassium chloride to stop the heart — was eventually adopted nationwide, as well as in some of those few other countries that still execute criminals.

The Illinois-based drug manufacturer Hospira slammed the brakes on the Chapman protocol in 2011 when it ceased production of sodium thiopental. Scrambling about for a substitute, death-penalty states turned to the drug that vets had been using for years: pentobarbital. But once word got out that Nembutal was now being used for capital-punishment purposes, public outcry in execution-averse Europe led to a pledge from its Danish manufacturer, Lundbeck, to stop selling it to states that practiced lethal injection. Undeterred, some corrections departments started buying compounded barbiturates from unregulated smaller pharmacies, while state lawmakers moved to shield the drugs’ provenance from journalists, defense lawyers, and even judges. When in 2014 a lethal-injection recipient in Oklahoma protested, “I feel my whole body burning,” there was no way for reporters to determine where the crucial dose of pentobarbital had come from.

Undependable drugs notwithstanding, the bigger problem may lie in … well, in the execution. Someone has to do the injecting, and it matters quite a bit who that someone is. Though lethal injection superficially resembles a medical procedure (as we discussed here back in 1991, the prisoner’s arm typically gets swabbed with alcohol first, as though infection were a concern), inducing death in the healthy is something many doctors and other licensed pros choose to steer clear of. The American Nurses Association is “strongly opposed” to its members taking part in an execution, and the American Medical Association's code of ethics states flat out that physicians shouldn’t get involved. In 2010 the American Board of Anesthesiology went further, reserving its right to revoke certification for lethal-injection participants.

With the pool of experienced injectors thus limited, it’s maybe unsurprising how often execution personnel can’t manage to find a vein. Stanley “Tookie” Williams got jabbed like a pincushion by California injection techs for almost 20 minutes in 2005; four years later in Ohio, executioners fumbled around so ineffectually that Romell Broom is still alive to appeal his sentence. And in the most notoriously botched injection of recent years, the IV line that was at length inserted into Oklahoma prisoner Clayton Lockett in 2014 pumped sedative into his flesh rather than the intended blood vessel; he was apparently at least semiconscious when the potassium chloride hit, and it took him nearly 45 torturous and bloody minutes to finally die. As Jay Chapman himself said in 2007, “It never occurred to me when we set this up that we’d have complete idiots administering the drugs.”

To be fair, not every instance of animal euthanasia goes off without a hitch either. In 2010, a Detroit man brought his apparently lifeless Rottweiler home from the vet believing she'd been put to sleep, planning to bury her the next day; come morning, she was up and about, the recipient of an insufficient barbiturate dosage. If plans go awry even when we dote on the creature we’re killing, small wonder that issues arise when injecting humans we've decided don't deserve to live.

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