Drugs Used in Executions May Cause Paralysis, Pain for Conscious Inmates

The researchers examined what is known about the drugs' ability to achieve those results, based on clinical and laboratory studies in humans and animals. They then examined how the drugs are used based on records from 33 executions in North Carolina and eight in California between 1984 and 2006, such as medical examiners' reports on the inmates' weights. The researchers said their work was hindered by the secrecy surrounding executions in most states.

Nevertheless, in a paper being published online in the April issue of the journal PLoS Medicine, the researchers concluded that the dosages of thiopental and potassium chloride were insufficient. In addition, the dosages of thiopental may not be enough to render inmates unconscious at the outset or to keep them from waking during the process.

As a result, they wrote, some inmates may be fully aware as the paralyzing agent cuts off their ability to breathe. Moreover, pancuronium is known to cause severe pain, but the inmate would be unable to express that.

"It causes all the pain fibers in the body to fire," Koniaris said, noting that the protocol has been banned for use in animals. "It would be akin to feeling like your whole body is on fire. It's extremely painful."

Koniaris noted that even though the inmates are paralyzed, they are still able to cry, and tears have been reported in some executions.

"They are awake, but they would not be able to move their mouth or give any outward signs of being awake except tears," he said.

Jay Chapman, who developed the lethal-injection protocol when he was the state medical examiner in Oklahoma in 1977, disputed the findings, saying the method works if done properly.

"If the protocol is set up and carried out properly, death will result," he said. "It has to be done competently."

In an editorial accompanying the paper, the editors of the journal said they were not publishing the study in the hopes of prompting improvements to the protocol. Instead, they are hoping it will fuel a campaign to abolish executions.

"As a moral society, the U.S. should take a leading role in the abandonment of executions worldwide," they wrote.