The major issue, as I see it in all these arguments, and I believe is the crux of the matter, is "how much pain is too much pain?. Many death sentences state in the wording that the defendant "suffer the pains of death", so that he / she recognizes that murder is painful.
Since no one came back from the dead to complain about the experience, and Willie Francis is the only one to describe the pain of electrocution, all statements about pain has to be subjective -- an interpretation of what the witnesses saw or heard.
Lethal injection is touted to be "painless". That ignores the fact that the very act of puncturing a vein van be quite painful (I know all about that), and the thiopental is not an anesthetic but a hypnotic in the concentrations employed.
We wrongfully look to doctors to determine if the inmate feels pain. I believe that as done -- electrocardiogram(EKG) and electroencephalogram (EEC) -- the procedure looks "medical" but in my opinion the EKG and EEC cannot be used except to watch how the heart and brain react in the dying process. Maybe the only indicator that the inmate feels pain is by production of tears. I do not know if an anesthesiologist has any other way to judge if a paralyzed patient is hurting.
Heart rate and brain activity can be associated with anxiety; Q waves do not appear for a few hours, so they are not helpful. With the potassium chloride, the heart stops in systole ("stone heart") with unconsciousness in seconds. Clinical death within six minutes after that.
If the experience is painful, the inmate cannot voice it due to the pancuronium, which paralyzes all striated muscles at the myo-neural space.
If the inmate is not anesthetized -- and remember thiopental is not -- repeat not -- an anesthetic, there is a strong possibility that the inmate feels the pain associated with the caustic pancuronium and the potassium chloride
Even if a perfect venipuncture is performed, and the drugs remain in the veins, the probability of pain being felt is strong; there are rarely perfect injections, to intensify the pain. Now pain is a subjective phenomenon, and although people feel pain, their reaction to it is different.
What might be perceived as minimal pain by me might be perceived as intense pain by you. This is another imponderable. Our founding fathers knew almost nothing about how pain works, and treated all pain as one. This makes "too much "pain" impossible to know.. We cannot quantify "too much pain" so we try to average it qualitatively. Simply put, is all pain to much pain?
I would say "YES", and declare the use of the three drug cocktail unconstitutional. This message does not even include the technical botching by the hooded executioner.
The states have gotten themselves into a Catch 22, and the best way to untangle it is to abolish the death penalty,
More will follow....
G M Larkin MD
Charlotte NC USA