The death penalty has been practiced as a fundamental tool in criminal and judicial systems for thousands of years and has played an integral role, both socially and punitively, in many ancient and modern societies. The practice of capital punishment in the United States began in the colony of Jamestown with the first reported execution occurring in 1608 [1]. This practice has withstood the test of time, remaining a possible sentence in twenty four states [2]. Many states, most recently, Virginia, which outlawed the practice of the death penalty in 2021, have stopped carrying out executions altogether as a form of criminal punishment. Currently in the states where the death penalty is still practiced, the most common and widely used method of execution is lethal injection, in which various medications are administered through intravenous injections resulting in the death of the prisoner. This method of execution is regarded, generally, as the most humane and is not meant to cause any pain to the person being executed [3].
In striving for this aversion to pain in the practice of lethal injection, legislators and advocates aim to parallel the philosophies of the medical field. In medicine, practitioners attempt to reduce the pain of patients undergoing procedures through anesthesia and control for pain in post-op recovery with pain medications as strong as morphine or fentanyl. When all goes well, lethal injection is similar to any other medical procedure where pain is managed or even completely absent for the patient. However, this is not always reality. Lethal injection has the highest rate of failure among other contemporary methods of execution sitting at 7.12%, while other methods such as electric chair or firing squad have failure rates of 1.92% and 0% respectively [4].
These so-called botched executions subject the person being executed to visible extreme pain, discomfort, and distress. One such execution made national news when an Oklahoma man was seen convulsing and throwing up during his execution [5]. In multiple cases, executions have failed due to prisoners who have compromised veins as a result of drug use that make it harder to insert an IV through which to inject the drugs. In these circumstances, a decision must be made to continue with the execution by finding other ways to insert IVs, such as in hands, necks, and other places on the body, causing extreme discomfort for the prisoner involved [4]. In these cases, physicians often aid technicians in establishing an IV through which to administer the drugs. And in this way, physicians play a central role in the medical killing of another human being. If the consistency of lethal injection as a mode of capital punishment requires physicians to play a role in carrying out this work, physicians must face various ethical dilemmas in weighing the benefits of both “justice” and medical ethics, similar to the ethical dilemmas of euthanasia or assisted suicide.
Lethal injection, the most “humane” method of execution, comes with complications not seen with other methods of executions that put into question the efficacy of lethal injection. The use of firing squads has dwindled over the years due to the sheer carnage it endows the body of the prisoner with, and execution by electric chair has similarly dwindled due to concerns over pain and suffering during the procedure [6]. So now, we have been left with lethal injection. If the most “humane” method of execution is still having unforeseen consequences for the prisoners who are being executed, perhaps capital punishment as a whole needs to be reevaluated as a practice.
References
“History of the Death Penalty.” Death Penalty Information Center. https://deathpenaltyinfo.org/facts-and-research/history-of-the-death-penalty/early-history-of-the-death-penalty.
“State by State,” Death Penalty Information Center. https://deathpenaltyinfo.org/state-and-federal-info/state-by-state.
“So Long as They Die: Lethal Injection in the United States,” Human Rights Watch. https://www.hrw.org/report/2006/04/23/so-long-they-die/lethal-injections-united-states#:~:text=Compared%20to%20electrocution%2C%20lethal%20gas,it%20mimics%20a%20medical%20procedure.
“Botched Executions,” Death Penalty Information Center. https://deathpenaltyinfo.org/executions/botched-executions.
“Oklahoma executes inmate who dies vomiting and convulsing,” AP, October 28, 2021. https://apnews.com/article/us-supreme-court-prisons-executions-oklahoma-oklahoma-attorney-generals-office-6e5eedd1956a38f83db96187651f145c.
“South Carolina judge halts the use of firing squad, electric chair,” Washington Post, September 7, 2022. https://www.washingtonpost.com/nation/2022/09/07/south-carolina-firing-squad-electric-chair/.