The July 2007 issue of Scientific American mag­a­zine con­tains both an arti­cle dis­cussing the med­ical impli­ca­tions of lethal injec­tion and an edi­to­r­i­al dis­cussing the humane­ness of cap­i­tal pun­ish­ment gen­er­al­ly. The edi­to­r­i­al sug­gests that cap­i­tal pun­ish­ment ​“can nev­er be any­thing but inhu­mane,” and offers the opin­ion that it is ​“wrong” and an ​“out­rage.” But it fur­ther states that even those who believe the death penal­ty is accept­able, should agree that it not be car­ried out cru­el­ly. The edi­to­r­i­al calls for a renew­al of pub­lic dis­cus­sion of the death penal­ty in all ​“its dis­taste­ful details.” The edi­to­r­i­al in full fol­lows:

In rev­o­lu­tion­ary France in the ear­ly 1790s, physi­cian Joseph-Ignace Guillotin pro­posed that a sure­fire exe­cu­tion mech­a­nism be used to car­ry out the death penal­ty for the state. Historians believe that Guillotin sug­gest­ed the use of the instan­ta­neous decap­i­ta­tion device that would lat­er bear his name as a humane form of cap­i­tal pun­ish­ment. The guil­lo­tine was thought to bring quick mor­tal­i­ty more reli­ably than the stan­dard meth­ods of pre­rev­o­lu­tion­ary France — behead­ing by sword or ax, which some­times involved repeat­ed blows, or hang­ing by a noose, which could take sev­er­al min­utes or even longer.

In the U.S. in the late 1970s, Oklahoma state med­ical exam­in­er Jay Chapman devel­oped a fail-safe exe­cu­tion method that many states soon adopt­ed as their main form of cap­i­tal pun­ish­ment. Lethal injec­tion, in which three poi­so­nous chem­i­cals are admin­is­tered to the con­demned, large­ly replaced exe­cu­tion by hang­ing, fir­ing squad, gas cham­ber and elec­tric chair, each of which had at some point been judged to be inhu­mane or excessively violent.

Yet this method is far from fool­proof. According to reports, unskilled exe­cu­tion­ers have caused pro­longed suf­fer­ing in the con­demned by mis­han­dling the dead­ly drug jabs — instances in which they missed veins, used blocked IVs or mis­cal­cu­lat­ed dos­es, lead­ing to failed anes­the­sia and chem­i­cal burns. Meanwhile eth­i­cal pro­hi­bi­tions to the par­tic­i­pa­tion of trained med­ical per­son­nel (“Do no harm…”) have most­ly kept the ama­teurs and their ad hoc meth­ods on the job. In recent months, how­ev­er, news of numer­ous botched lethal injec­tions has led courts and state gov­ern­ments to place mora­to­ri­ums on the prac­tice in a third of the 38 U.S. states that have the death penalty. 

In the mean­time, some researchers have chal­lenged the assumed air­tight effi­ca­cy of the drug pro­to­cols used in most American lethal injec­tions. The authors of two papers pub­lished in Lancet and PLoS Medicine in recent years have ques­tioned whether the rec­om­mend­ed pro­to­cols, even if car­ried out as pre­scribed, would pro­duce death with­out unnec­es­sary or gra­tu­itous pain — the ​“cru­el and unusu­al pun­ish­ment” for­bid­den by the Eighth Amend­ment to the U.S. Constitution. Although some crit­ics argue that the stud­ies are flawed, the dearth of research on lethal injec­tion mere­ly high­lights our lim­it­ed knowl­edge of the procedure. 

The gen­er­al­ly accept­ed approach relies on intro­duc­ing into the sen­tenced criminal’s blood­stream a chem­i­cal cock­tail con­sist­ing of a bar­bi­tu­rate to bring on seda­tion and sup­press res­pi­ra­tion, a neu­ro­mus­cu­lar par­a­lyt­ic to halt breath­ing and body con­vul­sions, and a potas­si­um elec­trolyte to stop the heart. The intent of the mix­ture is to pro­vide tox­ic redun­dan­cy so that each drug alone would bring on death. Dosages remain the same whether the con­demned weighs 150 pounds or twice that. Scientists have found that, as a result, there have been instances in which breath­ing has con­tin­ued, the heart beat on, or nerves remained undead­ened despite the injections. 

In vet­eri­nary med­i­cine, the fed­er­al gov­ern­ment and pro­fes­sion­al asso­ci­a­tions keep data on ani­mal euthana­sia and have devel­oped guide­lines and pro­ce­dures in accord with the research. Obviously, the same can­not be done for human exe­cu­tion tech­niques. It would help, how­ev­er, if states released their data on lethal injec­tions: only two have done so, leav­ing sci­en­tists able to ana­lyze only 41 of the 904 lethal injec­tions that have been con­duct­ed in the U.S. (at press time). More com­plete infor­ma­tion would sure­ly help soci­ety sur­mount the lin­ger­ing uncer­tain­ties regard­ing the dead­ly pro­to­col and its application. 

For those of us who already believe cap­i­tal pun­ish­ment is wrong, this sit­u­a­tion is just one more out­rage. But even those who dis­agree would have to acknowl­edge that the Constitution holds that the state must not exe­cute peo­ple cru­el­ly. Perhaps cap­i­tal pun­ish­ment can nev­er be any­thing but inhu­mane, but until soci­ety is will­ing to accept that prin­ci­ple, it is oblig­ed to exe­cute as humane­ly as it can. Certainly some ways of killing are less cru­el than oth­ers. So what can and must gov­ern­ment do to be more humane? Clearly, the time has come for renewed pub­lic dis­cus­sion and con­sid­er­a­tion of the death penal­ty, includ­ing all its dis­taste­ful details.

(Scientific American, July 2007, at p.36 Perspectives; see also D. Biello, ​“Reasonable Doubt,” at p.20). See Editorials and Lethal Injection.

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