Cold facts of execution lead to scary conclusion

John R. Agnew
Cold facts of execution lead to scary conclusion

The News-Press has other writers to do the serious stuff, but I ask your indulgence for this piece because I'm so mad I could spit. If you had ever seen me spit, you would not want to watch it again.

The subject is lethal injection, a sub-heading of capital punishment. The latter has a long and tortuous history, here and worldwide.

The British produced a protocol for hanging based on length of the "drop" and weight of the subject. This was necessary because too long a drop ripped the head off, grossing out the spectators, and too short a drop resulted in slow strangulation, grossing out the spectators. The British wished to avoid grossed-out spectators.

Hanging replaced decapitation, which replaced disemboweling, and I suppose the spectators were pretty grossed-out at these affairs, as well. Burning at the stake produced a lot of screaming, but when done in cold weather was generally acceptable in medieval times, when keeping warm was a concern.

The falling blade used in France and Germany was recommended — but not invented — by Dr. Guillotin, as a more "humane" method of execution. ("Humane" appears to mean "lower animals wouldn't do this.") He claimed the subject would feel "only a slight coolness on the neck." The subject might remain conscious for three or four seconds after his head hit the basket, although not everyone believes this.

Florida joined many other states in converting to lethal injection, but only after later electrocutions resulted in two heads being set on fire and one impressive nosebleed. Again, the main problem is grossing out the spectators/witnesses. Also, it looks bad on the death certificate: "Cause of Death, head set on fire by State of Florida." Let's face it, you just can't sugar-coat this information.

Governor Bush declared a moratorium on executions pending further investigation of the last one. This was successful, after a fashion, and Mr. Diaz died after 34 minutes, a long time for something that should take 10. He didn't appear to be unconscious or paralyzed until shortly before death. This is a problem because the first drug given is Pentothal, which rapidly induces coma, and the second is Tubocurarine, which causes paralysis of everything but the heart. The latter drug, one supposes, is to shield spectators from the possibility that the subject will wake up, because paralysis mimics coma to the observer (although not to the person being executed).

The third injection is a chemical, potassium chloride, given last because it would cause excruciating pain if given to a conscious subject. Potassium stops the heart.

A spokeswoman explained that the process took longer because Diaz had liver disease (which, at autopsy, he did not), and this caused slow metabolism of the drugs. Nice try, lady, but nonsense. Slower metabolism of the drugs would mean a quicker death, but metabolism of massive doses of drugs has no effect on the outcome in this situation—there is insufficient time to make any practical difference.

At autopsy, it was found that the needles were not in the veins (they put one in each arm). The technicians were unaware that the fluids were going into the surrounding tissues. Having started perhaps a thousand IVs, I know everybody misses a vein occasionally, but you don't administer a drug (for any purpose) until you verify a freely-running IV, which takes no more than a minute.

Sometimes it's difficult to enter a vein, no doubt about that, and experience is a big help. Some might recommend more executions, for the experience; I am not one of them.

I would point out here that the people involved in this execution did not know what they were doing and did not know what they were talking about. Zero for two is not good, even for government work. This was simply pathetic.

Then a front page Associated Press story tried to make sense of all this, but gave misinformation about one of the drugs. In my fashion, I am offering better information along with a dollop of opinion.

Everything you read about the medical science of lethal injection is colored by the writer's view of capital punishment. This is inescapable. You can easily tell that I have a bias, but how can anyone be totally objective about such a subject? It's not as impersonal as rules for solving an algebra problem.

Courts have difficulty deciding what constitutes "cruel and inhuman punishment." The justice system may have difficulty deciding who is guilty and who is merely available and poor. The system may have difficulty providing the accused with a competent lawyer. Juries may be prejudiced for or against the accused for racial or economic reasons. Eyewitnesses are notoriously unreliable, yet their testimony is given great weight. It gets very complicated.

The State of Florida has been severely challenged by electrical and pharmacological technology, so maybe the pragmatic conclusion is to return to low-tech burning at the stake, especially in cold weather.

— John R. Agnew is a retired Fort Myers physician. He can be reached through mstephens@news-press.com. Please write Agnew in the subject line.