NCR reports the approval of pentobarbital as part of a drug cocktail for executing prisoners in Florida. The state joins OK, AL, AZ, MS, OH, TX, SC and GA in permitting the use of pentobarbital, which has been used in 22 executions so far.
As a (licensed, but non-practicing) veterinarian, I’ve long been puzzled by the controversy over drug cocktails for this purpose. Put simply, humane euthanasia is not rocket science. All that is required is to reliably render the patient (in the veterinary context) deeply unconscious before the principal drug or another drug or technique results in death. High-dose barbiturates do this, and most veterinary euthanasia drugs are pentobarbital-based, sometimes combined with phenytoin, which, like pentobarbital, is also used in cases of severe seizure activity.
No ethical veterinarian would use a drug combination where there was any risk of causing the animal pain in the process. I cannot imagine any well-trained veterinarian using on animals the 3-drug cocktail that has been used until recently in executions. That cocktail contained an anesthetic (sodium thiopental or pentobarbital) followed by a muscle relaxant, (pancuronium bromide) that paralyzes skeletal muscle, including the diaphragm, followed by potassium chloride to stop the heart. The drugs were administered in sequence–the barbiturate followed by the paralytic followed by the potassium, and, at least in the movies, without stopping in between to assess the patient’s state of consciousness or the patency of the catheters through which the drugs were given. Conceivably, a prisoner could receive an insufficient dose of the barbiturate to produce a deep plane of anesthesia, perhaps because one of two catheters became clotted or kinked, or perhaps the drug is not given enough time to reach its maximum effect before the paralytic takes hold. If the muscle relaxant is given without deep enough anesthesia, the patient is unable to move or to struggle or to breathe, despite being at least partially conscious. Worse still, if for some reason the potassium solution is given to a conscious patient, it causes the heart to stop in a conscious patient, which can be excruciating. The second two drugs were given to ensure a “smooth” execution, in part because the prisoner would be incapable of objecting.
Sometimes when barbiturates are used for euthanasia or anesthesia, a patient goes through “excitement phase,” and might move or vocalize as the barbiturate takes effect. I was taught that people recovering from barbiturate anesthesia in which they’d moved or vocalized during induction did not remember any discomfort. Assuming I was taught correctly, that means that the second two drugs–the problematic chemicals from the standpoint of humaneness–are given merely to make the process easier on those watching. Excitement phase is, in my experience, rare in veterinary euthanasia using pentobarbital or pentobarbital/phenytoin combinations. I warned clients about it, but cannot remember a single serious instance. If it were common, vets would not use that drug because it would be too hard on the owners.
Barbiturate alone would do the executioner’s job reliably and humanely. Various states seem to be figuring this out, and it is hard to imagine a barbiturate execution being considered cruel, since similar drugs are used for anesthesia as well as animal euthanasia.
The task of those of us opposed to capital punishment has to stop focusing on the drugs–to do so was, perhaps, a useful tactic to slow the states, but won’t be a convincing argument for death penalty abolition. We need to start a real conversation about matters like racial and economic injustice, errors and sometimes corruption in the legal system, and whether the concept of the dignity of human life applies even to those who have committed horrific acts. Beyond that, we need to ask ourselves a basic virtue question. Are we, individually and as a society, made better by killing evildoers? Are we gentler, kinder, more reverent of human life? Do we care more deeply about the injustices in our justice system, or do we just move on after each inmate is killed? Do we simply cheer that someone who did something awful–or at least was convicted of doing something awful–got theirs? Shouldn’t we, as Christians, be trying to do better? Shouldn’t we, as Americans, be trying to do better?