Tech + Health

02.06.14

The Death Penalty’s Gruesome Truth

Boiling, crucifying, drawing and quartering, burning at the stake, the chair, the firing squad, the 2-drug cocktail, the three—no matter the process, capital punishment will never be ethical.

The ethics of capital punishment, long at the forefront of centuries-old debate, have recently taken a back seat in recent years to practical matters. It’s not the why we weren’t concerned about, but the how.

First, a drug used for execution in the standard 3-drug “cocktail” devised in the 1970s, thiopental (also known as “truth serum”), is no longer available. Several years ago, the US manufacturer, Hospira, yielded to pressure from anti-death penalty activists and stopped making the drug while European companies stopped selling it to the United States.

Then, states that used lethal injection for execution turned to pentobarbital which, like thiopental, is a short-acting barbiturate. Like all barbiturates, it can overwhelm alertness to the point of stopping the urge to breathe. A report from execution observers in Texas, which executes more criminals than any other state, however reported that pentobarbital appeared to result in a slower death, thus raising ethical concerns.

Therefore in 2011, manufacturers of pentobarbital stopped selling the product to states, creating a second shortage.  States such as Missouri then turned to local small compounding companies to supply them. This however has not been a durable solution either; in the Missouri situation, protesters against capital punishment located the compounding company in Tulsa, Oklahoma (the state which executes more persons per capita than any other state), complicating any subsequent shipping.

So in the January 2014 execution carried out in Ohio, a convict was killed using a new two-drug regimen that included midazolam, a potent short acting sedative related to Valium™ and hydromorphone, a pain-killing opiate better known by its trade name, Dilaudid™. The prisoner, though, appeared to have a prolonged death—so long in fact that guards who witnessed the death accused him of “faking” his agony, a strange complaint indeed. According to reports, the death took 26 minutes from injection. That’s more than twice the length of the old three-drug cocktail.

What to do next?

The current turmoil is only the latest problem in our long pursuit of an efficient way to kill each other.

The old ways—boiling, crucifying, drawing and quartering, burning at the stake— proved to be either of unpredictable effectiveness or make quite a mess (emotional and physical). Over the last few centuries, since Dr Guillotin first showed the French National Assembly his device in 1789, proponents of the death penalty have sought a method that is certain, that is not unkind, equally crisp for all (Guillotin’s promise kept with the e’galite’! ethos of the moment: he assured that rich and poor would be executed in the same manner), and capable of muddying the true identity of the actual executioner among a group of the involved.

The main approaches to execution since the guillotine have been hanging, the firing squad, and the electric chair. Wikipedia, it’s no surprise, maintains an extremely thorough consideration of the topic, including state-by-state maps showing which methods are used in the 32 states that still allow capital punishment. 

“The old ways—boiling, crucifying, drawing and quartering, burning at the stake— proved to be either of unpredictable effectiveness or make quite a mess (emotional and physical).”

The first attempts to modernize the process were made by Thomas Edison and scientists working with American inventor. It was they who created the electric chair. Much debate centered on the necessary current and the current type (AC versus DC) to assure a rapid and painless death. The assumption was that an electric chair death would occur by jolting the heart into stopping.

The electric chair, though, had its problems. Some people, they soon realized, needed a second jolt—and there was an awful smell of burnt flesh. The other popular approach of the time was the firing squad. To obscure the exact executioner, some firing squad rifles had real bullets and others just blanks, according to a distribution unknown to the shooters. Plus hanging with a specific hangman never stopped and still is used in New Hampshire and Washington State.

These methods were mostly replaced in the 1970s by the 3-drug cocktail devised by Dr. Jay Chapman, then the chief medical examiner in Oklahoma.

His idea was to become modern, efficient and bloodless by using lethal injection. Plus, the exact person injecting the drugs was obscured by including syringes with no medication; many people were involved in pushing the medication into the vein but, similar to the deliberate confusion around the firing squad, no one person knew what they had done. 

The lethal injection consisted of three drugs: one (thiopental) to knock the person out; a second (pancuronium) to paralyze the muscles, specifically the breathing muscles; and a third (potassium chloride) which arrested the heart.

The hope was that death would occur quickly in an unconscious senseless person both by cardiac and respiratory arrest. Indeed the method appeared to be effective, at least as far as speed of death, but concerns about whether persons were truly unconscious surfaced, as did the corporate decision by drug makers to suspend production and/or shipping.

Which brings us to 2014, where we find experts busy with a reconsideration of whether firing squads and hangings need to pulled back until yet another approach can be found.

Please.

If the long sordid history of the tools of capital punishment has demonstrated anything, it is that there is hesitancy among people to kill—even among executioners.

If after all of the centuries we have not yet found the right way to kill each other, perhaps there is no right way.

Perhaps it’s the goal—capital punishment—that is morally wrong.