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Lethal Injection 101Why states still use three drugs to kill when one will do.

By Daniel Engber
Posted Monday, Jan. 7, 2008, at 2:32 PM ET

The Supreme Court heard oral arguments today in Baze v. Rees, a case that challenges the current means of lethal injection for death-row inmates in Kentucky. Many—including lawyers in the Baze case—have argued that a single barbiturate, like those used in animal euthanasia, is less likely to cause excruciating pain for the inmate than the three-drug cocktail used around the country. In an "Explainer" column published in 2006 and reproduced below, Daniel Engber describes why they use three drugs for lethal injections.

"It don't work," complained Ohio death-row inmate Joseph Lewis Clark as prison officials struggled to execute him by lethal injection Tuesday. Last week, the Supreme Court heard from lawyers who say the standard three-drug lethal injection protocol creates the risk of "wanton and gratuitous pain." Why do they use three drugs for lethal injections?

Because that's what they've always done. Oklahoma passed the first lethal-injection statute in May of 1977 in an effort to come up with a more humane way to execute prisoners. (The national ban on execution had just been lifted, and Gary Gilmore had been put to death by firing squad that January.) The Oklahoma lawmakers declared that "the punishment of death must be inflicted by continuous, intravenous administration of a lethal quantity of an ultra-short-acting barbiturate" combined with a chemical paralytic agent. The first drug (in practice, almost always sodium thiopental) would cause anesthesia, and the second (usually pancuronium bromide) would relax the muscles in the body. Texas passed its own lethal-injection law the following day but used more generic language.

The Oklahoma Department of Corrections added the third drug in the cocktail—potassium chloride, which stops the heart—to its lethal-injection protocol the same year. The combination of poisons was supposed to increase the certainty of death. Texas used all three drugs when it conducted the first execution by lethal injection in 1982.

Other states copied their procedures from Oklahoma and Texas. Today, 34 others use the same lethal-injection cocktail. (Only one state, Nebraska, insists on electrocution for its death-row inmates.) When asked in court how they developed their injection protocols, corrections officials have said they learned directly from agencies in other states.

If the three-drug cocktail may cause unnecessary suffering, why don't death-row inmates get the same drugs doctors prescribe for assisted suicide? Terminally ill patients in Oregon can take a large dose by mouth of a barbiturate that puts them in a coma within about five minutes, with an apparently painless death coming around half an hour later. (In some rare cases, an assisted suicide by barbiturates can take as long as two days.) For one thing, corrections officials haven't changed the three-drug protocol because there hasn't been significant pressure to do so until recently. They also may prefer the standard cocktail because it works much faster than straight barbiturates when administered properly. (The lethal-injection cocktail typically kills within 10 minutes.) They also have to deal with involuntary subjects, and it's easier to inject someone who's strapped to a table than it is to force oral medication down his throat.

Explainer thanks Deborah Denno of Fordham University.

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Daniel Engber is an associate editor at Slate. He can be reached at .
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