The Cons of the Current Drugs Used for Lethal Injection

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This essay examines the cons of the current drugs used for lethal injection as well as other negative aspects of the practice of lethal injection itself. Lethal injection describes practice injecting of fatal drugs with the aim of causing death that is mainly applied in capital punishment. The method was adopted in late twentieth century replacing other execution methods including hanging, electrocution, gas chamber and beheading. The argument for lethal injection was that it was less painful, humane and cost effective as compared to other execution method. Currently, lethal injection is the most popular form of execution. However, the practice is faced with opposition from several quarters.

The current protocol applied in lethal injection, uses thiopental, potassium chloride, and pancuronium bromide. Thiopental is an ultrashort-acting of the barbiturate. Pancuronium bromide is a neuromuscular blocker while potassium chloride is an electrolyte endowed with lethal effects². When combined these drugs are expected to induce anesthesia effects followed by death due to cardiac arrest and respiratory reduced activity. The use of three-drug practice for lethal injection is faced with challenges.

According to the available literature, thiopental when administered by its self may not have any lethal effects. Small dosages that are permitted in individual states have no ability to kill. The dosage of thiopental in some states ranges from 10 to about 45 mg/Kg while others use doses ranging from 17 to 75 mg/Kg as well as 6.6 to 30mg/Kg. A dose of 3 to 6.6 mg/Kg of thiopental is recommended for clinical anesthesia. As such, inmates who receive the minimal doses will only experience anesthesia effects without any lethal consequences. Even in an ill population of persons due for euthanasia, the Netherlands Euthenics Task Force states that it is impossible to administer a lot of thiopental to induce lethal effects. There are documented accounts of persons who continued to breathe for approximately nine minutes even after the administration of thiopental. Effects of thiopental also vary with age, health status as well as history of substance abuse among individuals.

Analysis of the effects of potassium chloride shows that the electrolyte does not hasten death as intended in lethal injection. As such one can assert that potassium is not the lethal agent when used in lethal injection. In the laboratory injection of large animal species, a dose of 1 to 2 mmol/Kg of potassium chloride induces death. It is therefore expected that a dose of 1.11 to 2.35 mmol/Kg administered to humans should have fatal effects, which is not the case. Main causal of death following administration of potassium chloride is cardiotoxicity. Evaluation of ECG results for persons who underwent lethal injection by the use of potassium chloride and thiopental alone indicated that the ECG did not flatten as quickly as it was expected.

Given that both thiopental and potassium chloride may not have lethal effects as assumed, in lethal injection pancuronium bromide is the responsible for the lethal impact. Pancuronium bromide causes death by inhibiting respiratory activity. A review of the administration of pancuronium bromide in a case concerning a Florida inmate named Diaz shows that his eyes were open for 24 minutes and was only pronounced dead in 34 minutes. The case required the administration of extra doses of the drug so as to achieve desired effects. As such the argument that lethal injection is more humane is lost since death seems to take longer in certain cases than it should. It is right to conclude that the existing protocol regarded as the standard protocol for the practice of lethal injection, failed to kill.

Opposition to the practice of lethal injection is based on the fact that the choice of drugs was chosen through the improvisation of an Oklahoma anesthesiologist and not medical research. The examiner has since indicated that the selection of the preferred drugs such as thiopental, potassium chloride and pancuronium bromide, was not based on any scientific data. The execution of the existing protocol occurs in an ad hoc manner. The safety of the three-drug combination is not documented. There is no authority that exercises oversight in the application of the existing lethal injection protocol.

Executioners who apply the lethal injection have no anesthesia training. Hence the administration of the three drugs, occurs without paying attention or monitoring the anesthesia effects of the drugs used. Thus, there is no documentation of data on the anesthesia effects of the drugs during lethal injection. The administration of lethal injection without anesthesia training can lead to some physical challenges. Persons with collapsed veins or non-visible veins, present a challenge to the administration of drugs for lethal injection.

Opposition to lethal injection also arises from the fact that wrong dosages results in severe muscular pain instead of causing death. The existing statutes for lethal injection clearly state that the process should be fast and cause no pain to the individual. Some drug as used in plan B for lethal injection is prohibited even by some veterinary associations. When drugs such as thiopental are used after being proven to be ineffective, the administration of second and third drugs compounds to achieve lethal effects amounts to torture. The mechanism of death through the use of the three-drug protocol is not clear. Many jurisdictions only specify mass quantities that should be applied in lethal injections as opposed to applying the standard pharmacological practice. In pharmacological practice, drug dosage is based on the body weight so as to determine the effects of the drugs accurately in the context of the particular individual’s physiological mechanism.

There have been shortages of lethal injection drugs in some states leading to the importation of the required drugs. Some of the existing drug-protocols do not permit the use of foreign drugs and as such creating opposition to lethal injection. It is argued that the use of foreign drugs will result in some level of risks contravening the argument that lethal injection is more humane as compared to other methods of execution. Reliance on imported drugs is also opposed as some countries have banned exports on ascertaining that the compounds are to be used for lethal injection. Given such a possibility, the use of lethal injection as the only mode of execution can be affected by artificial shortages. The time taken to transport products in times of shortages leads to questions on the safety of compounds. Individual manufacturers have also blocked the use of their drugs for lethal injection citing that the practice would have adverse effects on their brands, ultimately leading to negative effects on their sales.

The growing concerns surrounding lethal injection require that more research should be carried out in the practice. The issues related to lethal injection arise due to drug factors as well as the legality of the practice. Some of the states that used to practice lethal injection have suspended it as well as other method of capital punishment to allow for further evaluation of the issues raised. Transparency is paramount especially concerning the lack of enough data to support the practice of lethal injection.

Bibliography

Denno, D., ‘Lethal injection secrecy post-baze’, The Georgetown Law Journal vol. 102, no. 5, 2013, pp. 1331-1382

Garland, D., Peculiar Institution: America’s death penalty in an age of abolition, Harvard University Press, Cambridge, 2012

Katari, S., Mehra, L. & Badiye, A., ‘A study of pharmacokinetics of sodium thiopental in rats by histological examinations of kidney and heart’, Research Journal of Pharmaceutical, vol.1, no. 2, 2012, pp. 1-6

Mowen, T. J. & Schroeder, R., ‘Not In My Name: An Investigation of Victims’ Family Clemency Movements and Court Appointed Closure’, Western Criminology Review, vol. 12, no. 1, 2011. pp. 65-81

Romanelli, F., ‘Lethal Injection as a Component of a Therapeutics Toxicology Module’, Am J Pharm Educ, vol. 75, no. 6, 2011, pp. 117

Ruble, J., ‘The “death” of lethal injection as we know it: The role of chemical execution in the American criminal justice system’, Journal of pain & palliative care pharmacotherapy. vol. 28, no. 3, 2014, pp. 276-281

Sabale, P.M., Prajapati, P., Kalal, G. & Nagar, D., ‘Azasteroids as Promising Neuromuscular Blockers: A review’ , J App Pharm Sci, vol. 2, no. 11, 2012, pp. 164-173

Sheehan, M.J., ‘The Death Penalty: A bad idea’, Origins, vol. 39, no. 40, 2010, pp. 658

Tabak, R., ‘Capital Punishment: The State of Criminal Justice,’ A.B.A. Crim. J. vol. 305, 2013, pp. 305-345

Vivian, J., ‘Lethal Injections, Drug Shortages, and Pharmacy Ethics’, US Pharm, vol. 38, no. 10, 2013, pp. 38-40

Vivian, J., Fink. L. & Whisman, R., ‘Use of legally marketed drugs for lethal injection’, US Pharm, vol. 33, no. 11, 2008, pp. 40-42

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The Cons of the Current Drugs Used for Lethal Injection

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