A botched execution in Oklahoma on Tuesday night left a death row inmate writhing, clenching his teeth, and calling out in apparent pain. Clayton Lockett ended up dying of a massive heart attack more than 40 minutes after he received what was supposed to be a lethal injection of drugs to kill him quickly and painlessly. It’s not yet clear exactly what went wrong, but there’s some evidence that the needle was inserted incorrectly.
How is that possible? Because it probably wasn’t done by a medical professional familiar with doing injections.
According to Oklahoma state law, a physician must be present at executions to examine the condemned inmate and officially pronounce them dead. But they don’t do the injections themselves. The American Medical Association, the American Public Health Association, the American Board of Anesthesiology, and the American Nurses Association all prohibit their members from assisting in executions, saying that practice violates their medical code of ethics. So the IV is usually administered by another state official who’s not necessarily an expert in anesthesiology, often an EMT.
It’s not entirely clear how this played out in Oklahoma last night. Although the New York Times reported that the doctor in the room administered the drugs to Clayton Lockett, an Associated Press reporter who witnessed the execution later confirmed the state appeared to be following protocol and using a different individual to insert the IV.
As the New Republic’s Ben Crair points out, there’s often little oversight in selecting the people responsible for carrying out executions. Although states are definitely worried about the type of drugs they’re using for lethal injections — and the media attention has largely focused on the fact that states are increasingly relying on untested cocktails — less attention is paid to whether qualified people are administering them.
However, without a medical expert participating, things can easily go awry. If the person inserting the IV initially misses the inmate’s vein, the anesthetic doesn’t take effect. Inmates can end up dying slow and painful deaths that essentially feel like suffocating.
This isn’t a problem specific to Oklahoma or to Clayton Lockett. For years, there’s been mounting evidence that lethal injections are being bungled in the hands of non-experts, leading an increasing number of medical professionals to condemn this method of execution as inhumane. At least 13 executions have been botched since 2000 specifically because state officials struggled to locate inmates’ veins. One study examining executions from 1890 to 2010 found that lethal injections had the highest error rate of any method of killing a condemned person. In 2005, several doctors published an op-ed in the medical journal The Lancet calling for an end to lethal injections altogether, pointing to studies that found that 43 percent of executed inmates in four states were probably conscious when they died.
Some doctors advocate for returning to alternate methods of execution that are more gruesome upon first glance, but ultimately harder to mess up. Dr. Jay Chapman, the doctor who initially developed the three-drug cocktail that most states use in their lethal injections, recently acknowledged that his method of execution needs to be revisited and suggested a return to the guillotine.