Lethal yes, painless no

IT IS EASY to understand why lethal injection has become the most frequently used method of execution in the United States. The procedure yields no gruesome spectacle of bodies bursting into flame in electric chairs, twitching at the end of gallows ropes, convulsing from lethal gas. Instead, lethal injection executions look reassuringly like a medical procedure: The prisoner is strapped to a gurney, injected with drugs and dies. A quiet, sanitized, efficient and ostensibly painless killing -- as seemingly benign as putting a horse to sleep, as Ronald Reagan suggested.

But appearances are deceiving. Mounting evidence suggests at least some prisoners may have suffered horribly before they died, awake and wracked by pain but unable to move to let anybody know.

Dr. Jay Chapman, an Oklahoma medical examiner with no pharmacology experience, came up with the lethal injection protocol in 1977 at the request of a state legislator. Without doing any research, he dictated a two-drug sequence, which he then expanded to the three-drug cocktail now used in California and 35 other states. (Nevada, which uses lethal injections, won't say what kind, and Nebraska executes by electrocution.)

First, a massive dose of the anesthetic sodium pentothal is injected, followed by pancuronium bromide -- a drug that paralyzes voluntary muscles, including the lungs and diaphragm, but leaves the prisoner conscious and able to experience pain. Then potassium chloride brings swift cardiac arrest. Why these three drugs? "Why not?" Chapman asked. The third drug is known to be so painful that veterinarian guidelines prohibit its use on dogs unless the vet first ensures they are deeply unconscious. But those precautions do not apply to prisoners. Their executioners stay behind a wall pushing drugs into IV tubes. No one makes sure the prisoner is unconscious; if he is not, he will be aware of suffocating from the pancuronium bromide and will feel the fiery pain of potassium chloride coursing through his veins to his heart.

Logs from six recent executions in California reveal that prisoners' chests were still moving regularly up and down long after the anesthetic should have stopped their breathing -- suggesting they were awake and suffering. Toxicology reports from executions in North Carolina also suggest some prisoners had been inadequately anesthetized.