Many lethal-injection executions are bungled

May 06, 2001

TIMOTHY J. McVEIGH is sentenced to die by lethal injection at 7 a.m. May 16 in Terre Haute, Ind., for the role he played in the Oklahoma City federal building bombing. Edward Brunner, M.D., Ph.D., is the Eckenhoff professor and chairman emeritus of anesthesia at Northwestern University Medical School and at Northwestern Memorial Hospital. A death penalty opponent, he was a practicing anesthesiologist for four decades. The following is an edited interview done by Charles M. Madigan of the Chicago Tribune:

Q Is lethal injection a painless way to die?

A Not necessarily. It may be, but more often than not it is messed up. It is misused in its application because the people who use the drugs for lethal injection don't understand the mode of action or the time course over which the drugs act.

Q Describe what happens during a lethal injection.

A Three drugs are used. The first one is sodium thiopental, an ultrashort-acting drug. It acts within a minute to make the brain unconscious. From that point on it begins to wear off. Depending on the dosage, the individual may wake up within three or four minutes. The second drug is called succinylcholine. It acts at the point where the nerves enervate the muscles, and it causes an overstimulation of the muscle so you get muscle twitching all over the body. The muscles are then completely flaccid and unable to move. This drug will act for about 10 minutes, but if given in much larger doses it can act longer. The final drug that is used is called potassium chloride. We use that drug to stop the heart beating when we are doing heart surgery and in lethal injection it is used to stop the heart beating, never to start again.

Q What can go wrong in lethal injections?

A In misuse of the drugs, the thiopental will cause the patient to look like he is falling asleep. The second drug will paralyze him. If the drugs are not given properly, the sleep drug can wear off, allowing the patient to be aware but unable to move, even to breathe. He undergoes suffocation and asphyxiation in a horribly painful way, even though he looks completely calm as he is lying on the table. Then he experiences that deep burning sensation as the potassium courses through his veins on the way to his heart.

Q How often are mistakes made?

A We know that in about 40 percent of cases where lethal injection has been used, there has been misuse in one way or another, and it has taken as long as 45 minutes for the person to die. The problem is they tried to make this a very sterile kind of a procedure, but no matter how you dress it up, you are still killing someone.

Q What can go wrong technically?

A The chemistry of the drugs is such that thiopental and succinylcholine, when they react to each other, cause a precipitation of a white, flaky substance that will block up the needle from the IV. What has happened in a number of cases is that they give the thiopental and follow with the succinylcholine, then they get this precipitate which blocks the needle. The thiopental wears off. The patient is partly paralyzed and partly not, and begins to move around. In a number of circumstances, they have to close the curtains so that people can't see the struggling. Sometimes they have to start all over again. It is not a clean process because the people who are using the drugs aren't trained to use them.

Q Why can't doctors administer the drugs?

A Every medical society has looked at the problem, at this issue - the American Medical Association, the American College of Surgeons, the American College of Physicians and the American College of Pathologists. The whole spectrum of medical professional groups has condemned the participation of physicians in this process. Doctors are trained to heal, not to kill, and so it is unethical for doctors to participate.

Q So who administers the drugs?

A They turn to people who are untrained and who have no business using these drugs. Thiopental is a controlled substance. To use it you need a special license, which the executioner doesn't have and the warden doesn't have. So they are in violation of federal and state regulations when they use these things. More than that, the drugs have been tested for safety in therapeutic uses. They have never been tested for use in killing people. What they are really doing is experimenting on humans, much like the German doctors did in concentration camps. What they are doing is inhumane. The subjects end up with a strong possibility of being subjected to excruciating suffering.

Q Is there a humane way of killing anyone?

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