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Concerns About Pain Put Lethal Injection on Trial

April 24, 2006|Maura Dolan and Henry Weinstein | Times Staff Writers

A flurry of litigation challenging the constitutionality of lethal injection has placed a spotlight on growing evidence that condemned inmates may not be properly anesthetized and therefore experience excruciating pain during executions.

Although it has become the predominant method of execution around the country, lethal injection was initially adopted three decades ago without scientific or medical studies, on the recommendation of an Oklahoma state legislator who wanted a more humane procedure.

Since then, objections have arisen in many of the 37 other states that adapted Oklahoma's procedures, including California, where a federal judge has scheduled a two-day hearing next week on altering or even eliminating the state's lethal injection methods.

So far this year, executions have been delayed in California, Florida, Maryland and Missouri -- and in three federal cases -- because of litigation challenging the use of lethal injections. Cases from Kentucky, Louisiana and Tennessee are pending, and unsuccessful challenges have been waged in Indiana, North Carolina, Ohio, Oklahoma and Texas.

Although it offends some death penalty proponents that the state is obliged to limit inmates' suffering during execution, the Supreme Court in its 1976 decision reinstating the death penalty cautioned that officials must avoid "the unnecessary and wanton infliction of pain." The problem with the three-stage lethal injection drug procedure is that it may mask rather than prevent pain, critics contend.

The first drug administered, the sedative sodium thiopental, is meant to deaden pain, the second, a paralytic, to immobilize the prisoner and the third, potassium chloride, to stop the heart.

However, sedative dosages, especially as administered by untrained prison personnel, have been found inadequate to anesthetize inmates, according to testimony in some of the cases. And the paralytic prevents them from expressing the intense pain of the heart-stopping chemical, physicians say.

In a study to be released today, Human Rights Watch reported on more than a dozen executions in which inmates appeared to suffer.

For example, in North Carolina in 2003, a prisoner started to convulse, sat up and gagged during his execution. He appeared to be choking and his arms seemed to struggle under the sheet, the report said.

In a 2001 execution, again in North Carolina, an inmate appeared to lose consciousness and then began convulsing and opened his eyes, the report said. A witness said the inmate tried to catch his breath as his chest heaved.

Earlier this year, lawyers for a condemned inmate in California presented evidence from six recent California executions in which the inmates were still breathing minutes after receiving massive doses of anesthetic, a possible sign that the drug was not working as intended.

The legal assault on lethal injection has been building for several years. A Human Rights Watch report, entitled "So Long as They Die," highlights admissions from prison officials in several states that no medical professionals were involved in developing their lethal injection procedures and that prison personnel are simply not versed in administering drugs.

For example, when asked in a 2003 court hearing about what considerations went into the development of Louisiana's lethal injection protocol, Annette Viator, former chief counsel for the state penitentiary, said, "The only thing that mattered was that the guy ended up dead." Asked how the state chose the chemicals it used, Donald Courts, the pharmacy director at the prison, said, "it wasn't a medical decision. It was based on the other states that had all used a similar dose."

Similarly, a judge in Kentucky noted last year that officials there "did not conduct any independent scientific or medical studies or consult any medical professionals concerning the drugs and dosage amounts to be injected into the condemned. Kentucky appears to be no different from any other state."

Dr. Jay Chapman, the former Oklahoma medical examiner who played a key role in developing the original lethal injection procedure, told a Human Rights Watch researcher, "I never knew we would have complete idiots injecting these drugs. Which we seem to have."

Critics say the only way to ensure the sedative dosage is adequate is to have trained medical personnel on hand to administer the drug and monitor its levels. That, however, would violate the canons of medical ethics forbidding doctors, nurses and other medical professionals from participating in a killing.

"There are smarter drug cocktails to use where you have less concern [about suffering], but the problem is compounded by people who have no idea what they are doing," said Dr. Leonidas Koniaris, a University of Miami physician who has done research on lethal injections.

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