There have been some cases where people have had to be dropped twice for the neck to break.

Death usually quick at hanging, experts say

New York Daily News
Dec. 29, 2006 08:24 PM NEW YORK - Saddam Hussein should feel no pain at his execution - unless the hangman is inexperienced, vengeful or both.

The former Iraqi dictator's trip to the gallows should produce near-instant death, say medical experts, though prolonged suffering is possible if Saddam doesn't fall far enough or with sufficient force.

Dr. Byron Bailey, associate professor of neurosurgery at the Medical University of South Carolina, expects Saddam to suffer a "hangman's fracture," a term used for the violent breaking of the C-2 vertebra just below the base of the skull.
"It should cause fracture and distraction of the spinal cord, in addition to compressing the arteries in the neck and crushing the windpipe. All those things happen at once," Bailey said.

Aside from the vertebra fracture, a properly placed rope will snap the trachea and compress the jugular veins and carotid artery, cutting off all oxygen and blood to the brain.

"A lot of people debate whether or not consciousness is lost immediately," said Dr. Lawrence Kobilinsky, a professor of forensic science at John Jay College of Criminal Justice. "I think consciousness is lost immediately, but nobody knows for sure. It's a philosophical question."

Anything less forceful may not instantly cut blood and oxygen flow - leaving Saddam to die over a few minutes by suffocation.

"Some people hang them from a shorter distance and simply strangulate them to death," Bailey said.

Two U.S. states - New Hampshire and Washington - permit hangings as capital punishment, usually as an alternative to lethal injection. The last hanging in the U.S. was in 1996 in Delaware.

Kobilinsky said hangings are believed to have originated almost 3,000 years ago in Persia, now known as Iran, which still carries them out.

Amnesty International, which supports a worldwide death penalty ban, says Egypt, Japan, Jordan, Pakistan and Singapore, among others, also currently hang prisoners.

Curt Goering, Amnesty International USA's deputy executive director, said grimly, "There have been some cases where people have had to be dropped twice for the neck to break."