|
Lethal injection in the USA. |
Lethal injection is the virtually the universal method of execution in
the United States, with all executions carried out during 2022 being by this method.
Of the 1,557 executions in the USA to the end of 2022, 1,377 have been by
lethal injection, including those of 12 women.
A state by state analysis is below – this is kept up to date.
|
State |
First used |
Executions |
State |
First used |
Executions |
||
|
|
mm/dd/yyyy |
1982-1999 |
2000-2024 |
|
mm/dd/yyyy |
1982-1999 |
2000-2024 |
|
|
|
0 |
51 |
|
|
0 |
19 |
|
|
|
17 |
21 |
|
|
2 |
1 |
|
|
|
20 |
10 |
|
08/14/2018 |
0 |
1 |
|
|
|
5 |
6 |
|
|
7 |
4 |
|
|
|
1 |
0 |
|
11/06/2001 |
0 |
1 |
|
|
|
0 |
1 |
|
|
13 |
28 |
|
|
|
9 |
6 |
|
|
1 |
55 |
|
Federal* |
|
0 |
15 |
|
|
19 |
106 |
|
|
|
0 |
63 |
|
|
2 |
0 |
|
|
|
0 |
54 |
|
|
3 |
0 |
|
|
|
1 |
2 |
|
|
19 |
19 |
|
|
|
12 |
0 |
|
07/11/2007 |
0 |
5 |
|
|
|
4 |
13 |
|
04/19/2000 |
0 |
7 |
|
|
|
1 |
1 |
|
|
199 |
392 |
|
|
|
5 |
3 |
|
|
4 |
1 |
|
|
|
3 |
2 |
|
|
48 |
34 |
|
|
|
41 |
59 |
|
|
1 |
2 |
|
|
|
|
|
|
|
1 |
0 |
|
* Carried out at |
|
Total
at |
11/01/2024 |
1417 |
|
||
Lethal injection was first considered as a means of execution in the
With the resumption of the death penalty in 1977, Oklahoma was looking
for an execution method to replace the state’s electric chair which was
derelict. A three drug lethal injection protocol was proposed for use in
Oklahoma by Chief Medical Examiner, A. Jay Chapman in 1977. This was approved by Dr. Stanley Deutsch, who
at the time chaired the Anaesthesiology Department of Oklahoma University
Medical School and passed into law in 1977. Deutsch described a way to administer
drugs through an intravenous drip so as to cause death rapidly and without
pain. "Having been anaesthetised on several occasions with ultra
short-acting barbiturates and having administered these drugs for approximately
20 years, I can assure you that this is a rapid, pleasant way of producing
unconsciousness," he wrote in February 1977.
Although Oklahoma became the first to legislate for it, Texas introduced
similar legislation later in the same year to replace their electric chair and
carried out the first execution by lethal injection on December 7th, 1982. This
was of Charles Brooks who was put to death at Huntsville for the murder of
second-hand car salesman, David Gregory, in 1976. Brook's girlfriend, Vanessa
Sapp, witnessed the procedure which began at 12.07 a.m. He was certified dead
at 12.16 a.m. There was no apparent problem and Brooks seemed to die easily. At
first he raised his head, clenched his fist and seemed to yawn or gasp before
passing into unconsciousness. A further 463 inmates were executed by this means
in Texas up to the end of 2010.
As of January 1, 2020, 29 American states have lethal injection
protocols either as their sole method or as an option to one of the traditional
methods. These being Alabama, Arizona, Arkansas, California, Colorado,
Connecticut, Delaware, Florida, Idaho, Indiana, Kansas, Kentucky, Louisiana,
Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico,
New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina,
South Dakota, Tennessee, Texas, Utah, Virginia, Washington and Wyoming. Only 32
states have actually carried out executions up to the end of 2010. Although
US Federal and military executions.
The American Federal Bureau of Prisons has a $300,000 lethal injection
facility at the federal prison in Terre Haute, Indiana. The death house is
located inside a non-descript brick building outside the main penitentiary
compound and consists of five viewing rooms surrounding the execution chamber.
The chamber is a stark, hospital-like room lined with green tiles and bare
except for the large gurney equipped with five Velcro restraints and a sink in
one corner. (see picture)
The intravenous tubes pass through a small opening in the wall and into the
executioner's room nearby. All but one room, the executioner's, are equipped
with large two-way windows with curtains. The executioner's room is fitted with
one-way glass. During an execution, prison officials will maintain an open
telephone line to the Justice Department in Washington. The President has sole
authority to grant a last minute clemency. Overhead, a camera linked to a
monitor inside the executioner's room will watch the process to note whether
the prisoner suffers any pain during the procedure.
On the 11th of June 2001, Timothy McVeigh, (see picture) the
Federal executions resumed in July of 2020 when three men were executed in a
week at the federal prison in Terre Haute, Indiana, by lethal injection with
pentobarbital sodium. They were Daniel
Lewis Lee on 7/14, Wesley Ira Purkey on 7/16 and Dustin Lee Honken on
7/17. Between them they had nine
victims. All three executions seemed to
go without a hitch. A further five executions
have been carried out in August and September 2020.
The American military has also moved to lethal injection (from hanging)
and now has a facility in the basement of the military prison at
Typical US execution procedure.
Lethal injection protocols vary from state to state.
Typically, the prisoner is strapped to a gurney (which is a wheeled hospital
style trolley bed) or a fixed execution table, rather like an operating room
table by leather or webbing straps over the body and legs. Click here for picture
of the
Their bare arms are strapped to boards projecting from the sides of the gurney.
Trained technicians then insert a 14 gauge (2.0mm diameter) catheter, the
largest commercially available needle into a vein in each arm, a process that
sounds much simpler than it often is. Once the catheters are in place, they are
flushed with 10cc of a Heperin solution, to prevent clots forming inside the
catheter, then a 1,000cc bag of saline solution is connected to the catheter
ends and the inmate is either wheeled into the execution chamber or the
curtains surrounding it are drawn back to allow the witnesses to see the
procedure. Once the condemned has made any final statement, the prison warden
gives the signal for the execution to begin and the technician(s) begins to
manually inject the three chemicals comprising typically of 2-3 grams of sodium
thiopental (C11H17N2NaO2S) in 80cc
of aqueous solution, 50 -100mg of Pavulon (the trade name for Pancuronium
bromide, formula C35H60N2O4)
and
of 100 milliequivalents (MEQ) potassium chloride (formula KCl) in 50cc of
aqueous solution. There is a short interval between each chemical during which
the saline solution continues to flow in the IV line to prevent any chemical
reaction which could block it. Typically, the actual injections will take from
3 to 5 minutes to complete. The amount
of sodium thiopental used is between eight and ten times the amount used for
medical anaesthesia.
Texas used the three drugs in the following quantities : 120cc of
solution containing three grams of sodium thiopental; 50cc of solution
containing 100 milligrams of pancuronium bromide, and 70cc of solution
containing 140 milliequivalents of potassium chloride. The drugs are
administered in this order, sequentially, with intervening saline flushes over
a period of approximately five minutes.
All the chemicals used in the USA are standard medical drugs. Sodium
thiopental is an ultra short acting barbiturate which was used widely as an
anaesthetic and causes unconsciousness very quickly if injected into a vein.
Pancuronium bromide (Pavulon) is a muscle relaxant that paralyses the diaphragm
and thus arrests breathing whilst potassium chloride finishes the job by
causing cardiac arrest. It is used in cardiac surgery to stop the heart.
In most cases, the inmate is unconscious in less than half a minute after the
sodium thiopental is administered, it’s effects also wear off rapidly which is
why in surgery, once the patient is unconscious, gaseous anaesthetic is used to
maintain them in that state. A British
medical journal, The Lancet, published an article critical of lethal injection
(Volume 365, 4/16/05) which claimed to have identified 21 cases of execution
where the level of post mortem sodium thiopental was below that used in
surgery, thus concluding that consciousness during the administration of the
other two drugs may have been possible.
However, sodium thiopental is rapidly absorbed by the body fat so any
testing should be done as soon as possible after death. This was done in the case in the execution of
Michael Ross in Connecticut in May 2005.
A blood sample was taken 25 minutes after death and showed 29.6
milligrams per litre of thiopental. A
second sample taken some five hours later showed a concentration of 9.4
milligrams per litre. There is no conclusive evidence that an inmate has still
been conscious while the second and third drugs were administered. After death, the inmate’s face may show a
bluish tinge that is a typical consequence of respiratory failure as oxygen
levels fall in the blood stream.
In the state of Kentucky, condemned inmate Ralph Baze appealed against
the use of lethal injection on the grounds that it was a “cruel and unusual
punishment” which is therefore unconstitutional under the 8th Amendment. His case was heard by the Supreme Court on
January 7, 2008. On Wednesday, April 15,
2008, the Supreme Court ruled by a majority of 7-2 that lethal injection does
not violate the US Constitution by inflicting cruel and unusual punishment,
which cleared the way for executions to resume in 2008. As a result of the earlier ruling, there were
no executions in the
In some states, a fully automated lethal injection machine has been used
that runs off a 12-volt battery. It injects the chemicals in the right order
and amount once the catheters are in place. The machine has six syringes
activated by mechanical plungers. Three syringes hold the lethal drugs, the
other three contain harmless saline solution. Two buttons control the machine,
one for the lethal syringes and one for the identical looking harmless ones.
The two executioners each press a button, and the syringes release the drugs
into the IV line.
Multiple
executions.
In
Click here to
read the first hand account of witnessing a lethal injection execution written
by the inmate’s spiritual advisor and published here at his request.
In the wake of the failed execution of Rommel Broom on September 15, 2009, Ohio
Corrections Department drew up plans to use a single injection of 5 grams of
sodium thiopental for future executions.
This amounts to a massive overdose of anaesthetic – 2 ½ times the amount
previously used. As the other two
controversial chemicals are not used, there is no possibility of the inmate
being caused physical pain as they drift into coma and death. Sodium thiopental depresses the heart rate
and respiration and at the quantity used, does so sufficiently to cause death.
This is the same procedure used in animal euthanasia. However, in view of the problems with the
Broom execution there will be a back up method, where suitable veins cannot be
located in the pre-execution assessment.
This will use the intra-muscular injection of two drugs, 10mg of
Midazolam and 40mg hydromorphone which will be injected in to the shoulder,
thigh or buttock muscles. After five
minutes, the prisoner will be examined by a doctor and if necessary, the
process will be repeated. Midazolam is
an ultra short-acting benzodiazepine derivative with powerful anaesthetic
properties. It is used for local
anaesthetic, e.g., in dentistry. Hydromorphone is a derivative of morphine and
is a strong pain killer. The first
execution using the single dose of sodium thiopental was successfully carried
out on Tuesday, December 8, 2009, when Kenneth Biros was executed at the
Southern Ohio Correctional Facility in Lucasville, Ohio. Biros was pronounced dead 43 minutes after
the commencement of the process. It took
10 minutes for the single drug to cause death, some 2-3 minutes longer than is
typical for the three drug process.
Reportedly Biros' chest heaved up and down several times, and he moved
his head a couple of times over about two minutes before his body became still.
Ten executions using this new protocol have been performed without problem up
to the end of 2010.
On January 16, 2014 Ohio executed 53 year old Denis McGuire using two
never before tried drugs, midazolam, a sedative (see below), and hydromorphone,
a painkiller, due to unavailability of thiopental and pentobarbital sodium. It took 25 minutes for McGuire to die, the
longest time ever recorded in
The sodium thiopental shortage.
Illinois based
Hospira Inc. was the sole US supplier of and suspended production in late 2009
due to problems in obtaining raw materials.
Initially it planned to continue production at its plants in
Pentobarbital sodium replaces
sodium thiopental.
Pentobarbital sodium has been used by
Pentobarbital (formula C11H17N2NaO3)
(trade name Nembutal, manufactured in the US by Lundbeck Inc. in Illinois) is a
fast acting barbiturate that causes a rapid slow down in the central and
peripheral nervous system activity and in large doses can mimic brain death.
This is the drug that vets use to euthanize animals and is also used for human
euthanasia. It was first synthesized in 1928
and is FDA approved.
On December 16, 2010
On Friday May 6,
On May 10, 2011,
On June 23, 2011
On the same day pentobarbital manufacturer, Lundbeck, announced a ban on
supplying the drugs to state Correctional facilities for use in executions.
Texas executed Humberto Leal Jr. on July 7th without any apparent
difficulty. He was pronounced dead ten
minutes after the injections began. Thomas West was executed in
The first execution of 2012 was carried out on Gary Roland Welch in
On October 15, 2013
The first chemical injected was 500mg of the sedative midazolam hydrochloride
which has never previously been used for an execution. The execution began at 6.02pm. Happ's
eyes opened and he blinked several times. He closed them and opened them again
two minutes later. He then yawned and his jaw dropped open.
At 6.08pm, a prison official stimulated Happ's eyelids and shook his
shoulder to check for a response. There was none. A minute later, Happ's head began moving back
and forth and shortly thereafter he stopped breathing. He was pronounced dead at
6.16pm. Happ appeared to remain
conscious longer and made more body movements after losing consciousness than
other people executed using thiopental or pentobarbital.
Midazolam is a short-acting
benzodiazepine central nervous system depressant, that is typically used by doctors for sedation and is a
water-soluble benzodiazepine. Midazolam
is a white to light yellow crystalline compound, insoluble in water. The
hydrochloride salt of midazolam, which is formed in situ, is soluble in aqueous
solutions. Chemically, midazolam HCl is
8-chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a][1,4]benzodiazepine
hydrochloride. Midazolam hydrochloride has the molecular formula C18H13CIFN3
HCl. Darius Kimbrough was
executed using the same combination of chemicals in
Oklahoma tries midazolam with
disastrous results.
On April 29,
2014, after weeks of legal wrangling,
Due to the
problems with obtaining and using midazolam,
Carey Dean Moore became the first person to be injected with fentanyl when he
was executed on August 14, 2018. The
The end of lethal injection in the
On July 1, 2011, Lundbeck Inc.’s parent company in
On March 27, 2012, a federal court in
Lethal injection in other
countries.
Lethal injection is used by
The
Guatemala also switched to lethal injection, after a botched firing squad
execution in 1996, and has carried out three executions since then. The first
occurred on February 10th, 1998, when 42 year Manuel Martinez was put to death
for killing four children, their parents and their aunt in 1995 in a dispute
over a small plot of land.
On June 29th, 2000, two members of a Guatemalan kidnapping ring were executed
in consecutive and televised executions. Amilcar Cetino Perez and Tomas Cerrate
Hernandez were members of a notorious kidnap gang believed to be responsible
for death threats against the family of President Alfonso Portillo. (Click here for photo of the execution of Cerrate)
An amendment to China’s Criminal Procedure Law in 1996 allowed for
executions by lethal injection.
During 2003, China introduced a fleet of mobile execution vehicles, converted
from large Iveco vans. The windowless execution chamber at the back contains a
metal bed on which the prisoner is strapped down. The executioner presses a
button that starts an automatic injection process which can be watched on a
video monitor next to the driver's seat and be recorded if required. Efficiency
and cost were apparently the main reasons for the introduction of these
vehicles, according to Yunnan officials. One was quoted as saying, "With
lethal injection, only four people are required to execute the death penalty:
one executioner, one forensic doctor, one member of the court and one other
official. A dozen guards are also required to keep watch around the
van". It is thought that
Is
lethal injection the humane alternative?
Execution by lethal
injection takes much longer from start to finish than any other method,
typically 20-30 minutes, depending on the execution protocol and ease or
otherwise of locating a vein. For the majority of this time, the inmate
receiving a lethal injection is fully aware of what is happening to them and
able to experience their execution. They know that they will be dead at the end
of it and the fear of dying (particularly in front of an audience) and of the
unknown, is strong in most of us. It is difficult to see, therefore, how it can
be considered more humane, as the prisoner is subjected to far more mental
anguish over a much longer period.
It is fair to say that injection is much less dramatic than the electric chair
or hanging and probably easier for the staff and witnesses as it looks more
like a surgical procedure than an execution. Looking at the Guatemala photo
above, it is not obvious that this is an execution, rather than a surgical
procedure. But does it cause the
prisoner less suffering overall?
When all goes well, the only physical pain is the insertion of the catheters.
If the person's veins are easy to find, this can be done in a minute or so. The
catheters are connected to the saline drip and the prisoner is either wheeled
into the execution chamber or the curtains drawn back so that they are in full
view of the witnesses and journalists. After they have made their final
statement, the injection of the lethal chemicals can begin and they may pass
almost instantly from full consciousness into unconsciousness or they may feel
themselves becoming drowsy and know that they are beginning to die. Rogelio Cannady was put to death by
lethal injection in Texas on May 19th, 2010.
Just before he became unconscious he told witnesses, “I am going to
sleep now. I can feel it - it’s affecting me.”
So he was able to feel something although he did not claim to be in any
pain.
Not everyone is of the opinion
that death by lethal injection is painless - Dr. Edward Brunner, chairman of
the Department of Anaesthesia at North-Western University Medical School,
submitted an affidavit on behalf of death row inmates in Illinois in which he
states that lethal injection, "create[s] the substantial risk that prisoners
will suffocate or suffer excruciating pain during the three chemical injections
but will be prevented by the paralytic agent from communicating their
distress."
The problems with injection.
The most common problem seems to be where the needle either misses the
vein or passes through it. Even for trained
medical staff, getting a needle into a vein is not always that easy. I have had it happen to me twice during
routine blood work (blood test), where a skilled nurse failed at the first
attempt. This could be easily checked,
however, by using a vacuum vial to ensure that blood flows freely after the
needle is inserted, as is done when taking a normal blood sample. Missing the vein appears to be what happened
in the case of Angel Nieves Diaz in Florida as described below.
Another problem with lethal injection is the aqueous pressure in the executee's
veins. Veins have an internal pressure (blood pressure) which has to be
overcome to allow injection into them. A doctor, when giving a normal
intravenous (IV) injection, has to equal and then slightly exceed this
pressure. If he produces a pressure that is too great, he will rupture the
vein. The doctor accomplishes this through his training, fingertip dexterity
and experience built up from giving repeated injections. He feels the pressure
in the vein against the top of the plunger of the syringe. In the case of a
lethal injection, the volume of the fluid required to fill the IV tubes running
between the executioner's cubicle and the prisoner, means that the syringes
must be of 50-60cc capacity. Syringes of this size are too big to give any real
feel to the person administering the injection. Thus, too much pressure can
easily be applied and a rupture of the vein may occur. This can happen in the
case of giving a non-lethal injection into good healthy veins in a normal
person.
It is not unusual for the inmate to be a former intravenous drug abuser, with
delicate, collapsed veins that can stand far less overpressure. This is also
true of people who are insulin injecting diabetics. When a person with normal
veins is frightened, their veins contract and become hard to find.
Before insertion of the catheters, a good vein must be located. It is not
unusual for a "cut-down operation" to have to be performed to find a
usable (not necessarily suitable) vein. This entails a minor surgical procedure
on the arm, leg or groin carried out under local anaesthetic, using a
subcutaneously injected dose of Xylocaine or similar local anaesthetic,
administered by a technician. The public are seldom made aware of this and the
witnesses would not typically see any evidence of it during the execution.
To produce a quick and painless death, it is vital that the chemicals
are injected into a vein, rather than an artery. Veins carry blood to the heart
and arteries away from the heart. The path of the chemicals (particularly the
potassium chloride) should be via the quickest route to the heart so as not to
prolong the execution. If an artery is used by mistake, instead of a vein, the
blood carrying the chemicals has to go the "long way round"
significantly increasing the time taken to stop the heart. The distinction
between a vein and an artery is not an easy one to make. Even a doctor can make
a mistake! It is clear from reading reports of executions that the time between
commencing the injection and certifying death varies a great deal.
Injections on film.
Sharon Stone's, "Last Dance," gives a good insight into what
goes on as well as examining many of the issues surrounding capital punishment
in a balanced and sensitive way.
