Ever since the time of the guillotine, doctors have been at the centre of the death penalty. Joseph Guillotin, the physician who suggested the device be used in 18th-century France, was actually against the death penalty – he hoped that a more humane method of decapitation would be a prelude to ending capital punishment.
It was nearly 200 years later, in 1977, that the end came for the guillotine. That same year, anaesthetist Stanley Deutsch proposed the so-called triple cocktail for lethal injection, consisting of a fast-acting anaesthetic (sodium thiopental), a muscle-paralysing agent (pancuronium) and a cardiotoxin (potassium chloride) to stop the heart for an execution in Oklahoma. There was a perception that this might be somehow more humane, despite reports of botched executions – deaths that took longer than they should, signs of skin burns and convulsions – and more than 1100 prisoners have been executed in this way.
But pressure by drug manufacturers and European export controls mean the supply of these drugs (and subsequent substitutions such as pentobarbital, a barbituate used for severe forms of epilepsy) is now limited, leading to executing states using different concoctions and combinations. The reported last words of Michael Lee Wilson in Oklahoma earlier this month, that he felt his “whole body burning” around 20 seconds into his execution, prompted some to suggest this may have played a part.
Much has been made about untested drugs being used in Ohio’s execution of Dennis McGuire, because the state opted to use a sedative called midazolam and a painkiller, hydromorphone, due to a shortage of pentobarbital.
In one sense being untested is true of all drugs used in executions, as no pharmaceutical company has ever developed a drug to be used to kill someone – this would be in complete breach of medical ethics. As a consequence, the executioners had to make a guess (and not necessarily an educated one) about what the lethal toxic dose is of the drug concerned.
The biggest change to how lethal injections are used came in 2011, when the European Union (which is fundamentally opposed to the death penalty) introduced export controls to prevent drugs being used for executions.
The ban on exports of sodium thiopental for executions led the US to switch to pentobarbital. Then following pressure from the medical profession and others, Lundbeck, the Danish manufacturer of pentobarbital (sold as Nembutal), introduced a controlled distribution mechanism to tighten up its supply chain, preventing use by US prisons.