In the wake of numer­ous law­suits chal­leng­ing cur­rent lethal injec­tion pro­ce­dures and a recent U.S. Supreme Court rul­ing that makes it eas­i­er for those on death row to file such claims, med­ical experts have iden­ti­fied alter­na­tive pro­to­cols that would be less risky to the pris­on­er but more dif­fi­cult for wit­ness­es to observe. ​“There’s an innu­mer­ably long list of med­ica­tions that can be giv­en to cause some­one to die,” said Dr. Mark Dershwitz, a pro­fes­sor of anes­the­si­ol­o­gy at the University of Massachusetts. He added that while alter­na­tives exist, the empha­sis on ensur­ing a speedy death may pre­vent state law­mak­ers from con­sid­er­ing all of the options. ​“Policy mak­ers have his­tor­i­cal­ly con­sid­ered the needs of wit­ness­es in devis­ing pro­to­cols (for exe­cu­tion),” Dershwitz stated.

Dr. Jay Chapman, a foren­sic pathol­o­gist who devised the nation’s first lethal injec­tion pro­to­col, no longer rec­om­mends the com­mon­ly used three-drug con­coc­tion that he devel­oped in 1977. He said that his orig­i­nal intent was to have the lethal drugs admin­is­tered by med­ical per­son­nel, but that pro­fes­sion­al groups like the American Medical Association have since declared it uneth­i­cal for mem­bers to par­tic­i­pate. This leaves exe­cu­tions in the hands of para­medics, tech­ni­cians or oth­er prison employ­ees who do not have spe­cial train­ing in anesthesia.

Chapman’s method, which is used by almost all death penal­ty juris­dic­tions, calls for an ini­tial dose of the bar­bi­tu­rate sodi­um thiopen­tal to cause uncon­scious­ness. This drug is then fol­lowed by pan­curo­ni­um bro­mide (Pavulon) to cause paral­y­sis and halt breath­ing, as well as potas­si­um chlo­ride to stop the heart. Challenges to the method state that the sec­ond and third drugs may cause extreme pain for those exe­cut­ed. Chapman not­ed that if he were to redesign the pro­to­col, he would rec­om­mend an over­dose of one drug, a bar­bi­tu­rate, to pain­less­ly cause pris­on­ers to lose con­scious­ness, stop breath­ing, and die. This method, how­ev­er, would take sig­nif­i­cant­ly longer than the three-drug exe­cu­tion pro­to­col cur­rent­ly in use and could be more dif­fi­cult for wit­ness­es to observe. The cur­rent approx­i­mate time until death is 2 – 10 min­utes. Using a sin­gle dose of a bar­bi­tu­rate would take an aver­age of 30 – 45 min­utes until death. Alternative meth­ods of exe­cu­tion may also result in jerk­ing move­ments that the pris­on­er would not feel, but would be unpleas­ant for oth­ers to watch.

Dr. Dershwitz said oth­er alter­na­tives exist. A sin­gle dose of bar­bi­tu­rates could be inject­ed into mus­cle instead of veins, which would also extend the time it would take for pris­on­ers to die, or an inmate could take an oral over­dose of bar­bi­tu­rates. No state has yet adopt­ed an alter­na­tive lethal injection protocol.

(New York Times, June 23, 2006). See Methods of Execution.

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