No Right Way To Do A Wrong Thing

The state of Oklahoma tried and failed to kill death row inmate Clayton Lockett last night, and then he died anyway.  Ten minutes into the lethal injection, when Lockett was supposedly unconscious, he began writhing and struggling and gasping and gagging.  The executioners decided to stop the infusion ten minutes later, when it was fairly clear that Lockett wasn’t dead. What happened next isn’t completely clear.  On MSNBC last night, Rachel Maddow reported that, in what can only be described as an irony of Shakespearean proportions, Lockett was being transported to a hospital when he died of a heart attack about 43 minutes after the first drug had been administered.  According to today’s reports, Lockett died in the execution chamber.  Whether anyone tried to resuscitate him or offer other medical attention between the time the infusion was halted and he ultimately perished has not been revealed.  What has been reported is that the cause of the execution procedure failure was a blown vein at the injection site.

As a guy who’s started tens of thousands of IV’s over forty years of practice, I can tell you that this happens all the time, and that’s in cooperative patients who have no objection to being stuck in the first place, a situation that’s unlikely in the case of a condemned prisoner.  It’s why it was always protocol in my department for a tech to watch the injection site for the first twenty or thirty seconds during power injections for CT scans, and for her to immediately hit the “abort” button if , IV infiltrated. It’s hardly surprising that the same thing happens not infrequently in the case of condemned prisoners.

It’s getting harder and harder for states to kill prisoners in the US, and make no mistake about it, that’s what they are doing…they are killing prisoners.  In the past, this has been done in all kinds of supposedley quick and relatively painless ways (unless you happen to be the one being killed, in which case that whole “relatively” modifier carries some real weight).  They’ve used hanging, which works nearly instantaneously if the hangman’s noose successfully breaks the cervical spine, causing a so-called “hangman’s fracture”, but can take several minutes if the fracture fails to occur and the victim dies by slow strangulation.  Firing squads have been rarely employed, but are reasonably effective, just so long as no one misses, although the results are somewhat messier than in other methods.  Early in the twentieth century, someone came up with the bright idea of taking Edison’s invention to the next level and using electrocution as a means of execution, perhaps believing that this method would be less barbaric than hanging.  Anyone who’s ever inadvertently touched a hot wire while attempting an electrical repair can testify that electrocution is anything but painless.

So in the latter half of the twentieth century, in an effort to comply with the constitutional ban on “cruel and unusual punishment”, many states switched to death by lethal injection.  A sequential three-drug cocktail is typically used, first a drug to induce unconsciousness, then a drug to paralyze the muscles including the breathing muscles, and then potassium chloride to stop the heart.  For years, the first drug administered was sodium thiopental, a barbiturate routinely used to induce general anesthesia, and which, if used in sufficient dosage, inhibits the respiratory center of the brain to the point where the patient ceases breathing and simply dies.  But the European manufacturers of the drug began to refuse to supply it to American officials on the moral grounds of objecting to its use as a state-sanctioned murder weapon.  American executioners have had to scramble for a new sedative, and in Lockett’s case, they were trying Versed.  Versed is the same medication that those of you in my demographic have received while lying on your left side with gastroenterologist holding a four-foot black snake standing behind you.  It’s used for conscious sedation, which basically means that in controlled doses, the patient is sedated, but still awake.  In larger doses it causes complete unconsciousness and even death from respiratory arrest…just so long as it actually goes in the vein.

The point of all this is the whole oxymoronic concept of kind and painless execution.  There is simply no way to put lipstick on this pig.  Execution is by its very nature a cruel and unusual and painful process, whether it’s by drawing and quartering, burning at the stake, or the controlled infusion of deadly drugs.  If Americans want to continue in their biblical adherence to “an eye for an eye” and the glorification of revenge as a social remedy, they ought to stop pretending that execution is something that it is not.  Go back to the days of public hangings and laugh with your children as the victim twitches and expels his bowels at the end of a rope.  Or do the civilized thing and stop this nonsense altogether.  American prisons already hold a population larger than some European countries.  Keeping a few hundred more bodies in there for life will hardly make a dent.

BW