In the December 2020 episode of Discussions with DPIC, anesthesiologist Dr. Joel Zivot from Emory University Hospital speaks with Death Penalty Information Center Executive Director Robert Dunham about his discoveries from the autopsies of more than 200 executed prisoners. Those autopsies revealed the gruesome effects of execution by lethal injection and shattered the popular myth that lethal injection is a humane and painless execution process. Zivot and Dunham also discuss the ethical questions raised by physician participation in executions.

In 2016, Zivot was approached by lawyers representing capital defendants, who asked him to examine autopsy reports to determine whether there was enough anesthetic in the prisoners’ bloodstreams to render them fully unconscious during their executions. Zivot was surprised to discover that “the weight of the lungs was about twice normal of what I would expect to have happened if death was instantaneous.” He has since testified about his findings in multiple states, and the results of his research were featured in a September 2020 National Public Radio report, “Gasping for Air.”

Zivot contrasts the “bloodless” appearance of lethal-injection executions with the reality of what he found in the autopsies. The discovery that prisoners’ lungs were filling with fluid and causing a sensation of drowning or suffocating “confirmed my worst fears about what was actually happening here.” These effects were found both in three-drug executions, and in one-drug executions, leading Zivot to believe it was the first drug that caused the lung tissue to break down and allow fluid to fill the lungs. The effect of the drugs was previously unknown because executions use them in quantities that are unprecedented in a medical setting.

In discussing the ethics of lethal injection, Zivot states, “lethal injection is in no way a medical act,” and says he believes states use the appearance of medicine to reassure the public about the process. “Physicians, or any other healthcare workers have no role here whatsoever in making execution different or even ‘better’ than it could possibly be. That’s not the job of the doctor. That’s the job of the state,” Zivot said. He offered his assessment of lethal injection, saying, “I feel confident that my work has shown that execution by lethal injection is clearly and unambiguously cruel. If the state wishes to execute individuals, that’s the state’s prerogative. But I would ask them to stay away from everything that is mine, everything that is medicine, that capital punishment does not require lethal injection.”


Discussions with DPIC pod­cast, Anesthesiologist Dr. Joel Zivot on What Prisoner Autopsies Tell Us About Lethal Injection, Death Penalty Information Center, December 92020.