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.