Oklahoma botched an execution. This is not news but I can help explain why it got botched. See Marcus Ranum (Long time reader and big time donor to A Million Gods) wrote this and I wished to expand on it. Clayton Lockett did a horrible thing. An inexcusable thing. He murdered another human. He raped another human. He invaded a home and raped one woman and shot and wounded another. He then buried her with is accomplice.
What ensued was cruel.
What ensued was unusual.
What ensued was a torturous death.
She was not alive. She was buried alive. He was captured, tried and found guilty and sentenced to death.
What ensued was cruel.
What ensued was unusual.
What ensued was a torturous death.
Lockett given an unknown and untried mixture of drugs was executed by lethal injection. Rather than the 5 minutes it normally takes it took 45 minutes for him to die. And he died in pain.
And we have a role in it. All of us who stood up and fought against the usage of medicine to murder.
Good job. No seriously. I am not sarcastic about this. This is our fault but it is a good thing.
See. These drugs have uses in medicine. Don’t fear them. The drugs I am going to discuss are very useful in medicine and surgery. Many of us will have used them. Many of these save lives.
But let us discuss how we caused this. We caused this because drug companies are looking at how their products are being used and refusing to make the medicines that are used to kill prisoners in the USA. It is a moral and ethical demand to use their products for the purpose designed. To alleviate suffering and improve life. Not to kill people who are murderers.
In the countries that these drugs are available, there are strict guidelines with regards to their administration and indeed many countries which produce the drugs for medical use explicitly restrict sales to the USA or will not do business with companies that sell to the USA.
This has forced places like Oklahoma to turn to novel drugs and new and unknown quantities of drugs to kill.
Before we think why and what went wrong? Let us look at the usual drugs. Marcus Ranum’s list is pretty good except for the first drug.
See the First Drug given is normally Thiopental Sodium.
It is not a mild hypnotic/dissociative. It is used as a short acting anaesthetic. It knocks people out. It however has a short action so it is used for minor procedures in small doses or for the induction of anaesthesia. Since the induction is rapid, the patient goes under in minutes and the procedure can start. By the time the General Anasthesia takes effect the sodium thiopental wears off.
You may know it from the various spy movies as the “Truth Serum”, it really isn’t. Patients blabber but one guy called me Shiva and as far as I am aware Shiva has way more hair than me.
This drug is given first. I am copy pastaing Marcus because “he’s done the hard work”.
(b) The Second Drug
The second drug is Vecuronium Bromide – basically, Curare. Curare causes rapid and severe paralysis of muscles. The subject remains conscious and the curare does not block pain; it renders the subject unable to move, blink, speak – or breathe. Someone on curare feels as if they are being held down by impossible force, and they begin to strangle as their diaphragm muscles stop functioning.
Your muscles don’t move under this but considering you are under sodium thiopentontal you don’t feel any of this and you asphyxiate.
Curare here is extremely useful as a muscle relaxant during any surgery using General Anasthesia. Our own Ed Brayton would have had this.
See anyone intubated is given a curare compound to paralyse the muscles of the throat to ease intubation and prevent choking. It is vital in emergency medicine. It however can kill you.
As a side note? Pancuronium in medical forensics has a special note for it’s use in Lethal Injection. In particular it is beloved of “Serial Killing Medical Staff”. Daisuke Mori, Richard Angelo, the Skin Hunters, Efren Saldivar and whoever the hell it is the USA hires to kill with the lethal injection.
It is also used in the voluntary lethal injection. In euthanasia in places like Holland.
This is a poison and a medicine. See a poison is determined by dose. You can save lives with this if you know how to use it. I do not. Maybe one day I will know to save lives with it but it is out of my skill set at the moment. To administer it is the role of the Critical Care specialist or Anaesthetist who are experts in its use. I just identify and know not to touch the stuff.
.(c) The Third Drug
The third drug is Potassium Chloride, which stops the heart.
Medically, it is used in the treatment of hypokalemia and associated conditions as an electrolyte replenisher.
Surgically? Open Heart Surgery. Things like bypasses. Know anyone who had a bypass? This drug was probably used to save their life. See you cannot operate on a beating heart anymore than you can replace a piston on a working engine. So the heart is stopped while a heart lung machine keeps the body alive. The drug used is KCl. Potassium Chloride. It is very handy.
So we know how these drugs work, now we must know why they do not work as a weapon. And they are weapons in the wrong hands. You can kill with a scalpel, you can kill with aspirin and you can kill with these. I see the difference between the voluntary Euthanasia of the Netherlands and Switzerland. This is murder for murder. Revenge. The only thing this achieves is blood on both our hands.
So the goal of this is to first anaesthetise, then paralyse and finally stop the heart. Should these drugs be administered the patient dies peacefully after having fallen asleep. The patient is “unaware” of anything after the anaesthetic works.
Now why doesn’t this always work?
The executioners are not medical professionals. I don’t think I know any medics who would do this. Even the euthanasia is via a suicide machine that the patient controls, doctors just set it up. No medic kills without the goal being the reduction of suffering (Think of it this way? Respiratory distress can be treated with Curare or Morphine but it will hasten death. If you are dying painfully, would you trade a few hours of life for a painless death?)
The Lancet’s paper on lethal injection shows that not only are the executioners untrained, but there is no actual controls on the compounding pharmacies that jury rig these specific concoctions.
The protocol information from Texas and Virginia showed that executioners had no training and the drugs were administered remotely with no monitoring for anasthaesia, data were not recorded and no peer-review was done. In short? They didn’t know if the patients were anaesthetised or not. They were just giving whatever in hopes that it would work. When serial killers do a better job than your staff, you may have to consider training.
Their analysis of toxicology reports from Arizona, Georgia, North Carolina, and South Carolina showed that post-mortem concentrations of thiopental in the blood were lower than that required for surgery in 43 of 49 executed inmates (88%); 21 (43%) inmates had concentrations consistent with awareness. Meaning that the majority of inmates had some self awareness, and above 40% were probably aware of what happened but could not move due to the second drug. Marcus Ranum’s description is florid but correct.
Taken together, we have a cocktail that is designed for maximum cruelty – the kind of thing Joseph Mengele might come up with – a subject is paralyzed but fully conscious without anything between them and their pain; they fully experience their death by suffocation and heart attack. A friend of mine has suffered a heart attack and says it is incredibly painful; someone paralyzed by curare would still feel every bit of it, if they hadn’t suffocated to death, first.
There are 11 states at the moment that use barbiturates. They are ideal because they are given to overdose so even an untrained executioner can kill with this as long as they can hit a vein. But even these will begin to not be sold and controlled to prevent their use. Already most manufacturers of Phenobarbitol ban it’s use for execution.
But I consider this cruel and unusual.
It is not unusual to find veins that are thready or hard to find. Many patients have a history of IV drug use and even a skilled nurse or doctor in ICU care would struggle to find a vein. Let alone some untrained executioner.
And Clayton Lockett’s death is not the first time the drugs failed. Angel Nieves Diaz suffered the same tortuous death. It took 35 minutes for him to die and two doses of drugs. The autopsy indicates the drug was given via IM rather than IV. Intra-muscularly rather than Intra-Venous. It meant he died in pain. The executioners made the diagnosis of liver disease, the doctors made the diagnosis of “liver is fine”. I have long said that autopsy is the final gift of medicine, it gives you the answer so that you can answer the questions that come around the next time. And this time the answer was “someone screwed up”. We should wait to see Lockett’s autopsy report. I have a feeling it was a similar administration error. To point out the difference? An IV venflon actually draws blood to indicate if it is in a vein or not. They didn’t even check.
This is not the first such case this year. Ohio had a botched execution this January. While not as long as this case, Dennis McGuire took 15 to 20 minutes to die and spent most of that gasping for air. This comes after the EU banned export of Sodium Thiopental to the USA on the basis of it is being used to murder. Murder murderers (sometimes… sometimes they are quite innocent) but it is still state sponsored murder.
In 2010 the UK banned Sodium Thiopental exports to the USA when it was proven that the only reason for it’s purchase by the USA was for use in executions. The EU banned all exports of the drugs used for executions in 2011 under our Human Rights Act as it was proven that all these drugs were being used for torture or capital punishment.
This here is the cause of this botched procedure. Global Opposition to execution, rather than try to deal with a world that was opposed to executing people as if this were the Kingdom of Saudi Arabia, the USA continued. The last Sodium Thiopental manufacturer in the USA shut down production in 2011. Since then? Lethal injections have had to be created by compounding pharmacies.
A simple expanation – It is a pharmacy dedicated to the creation of a particular pharmaceutical product to fit the unique need of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools. This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose needed of a particular active compound.
Compounding is most routine in the case of intravenous/parenteral medication, typically by hospital pharmacists, but is also offered by privately owned compounding pharmacies and certain retail pharmacies for various drugs.
Due to rising cost of compounding and shortage of drugs in recent times, many hospitals have shown a tendency to rely more upon large-scale compounding pharmacies to meet their regular requirement. This development raises concerns about safety and calls for proper regulatory control and monitoring.
We do not know what drug they used. Untried, untested and unknown drugs are being used with no idea as to their logical efficacy. It is only due to a media backlash that they are admitting it. Oklahoma has mentioned the drugs used though. The allegedly superior system of infection (ethically that is) is a state secret. It is rather puzzling as no one would defend the manufacturers of hemp, chemicals, electricity or bullets in this way. So far the new state secrecy laws have deflected all enquiry in Texas, Georgia, Missouri and Louisiana.
Oklahoma used, for the first time, midazolam in combination with vecuronium bromide and potassium chloride via IV. However I am aware that midazolam has a rather peculiar side effect. In some people it acts as a stimulant. It acts paradoxically when given via IV.
Midazolam was also used in the excution of Dennis McGuire.
These men were killed by incompetent, uneducated and unethical quacks who took it upon themselves to use a dangerous invention for the detriment of humanity. Yes these men were murderers.
But the difference is we are not. In killing them we became as bad as them. Sure we may not be as bad as Clayton because we are “taking out the trash” so to speak but in fighting monsters we become them ourselves.
The only difference is that these murderers were sanctioned by the state. No one will weep for the passing of these people. By all accounts Clayton Lockett was a horrible man who raped one woman and murdered another. The greatest punishment he can have is living. To live knowing what he has done and knowing that he will never have the chance to live a life that is productive because of what he did. But to do so people have had to hide their actions in the dark.
But what has happened? Is that a science experiment was used to kill people like Dennis McGuire and Clayton Lockett.
One thing I agree with was the UK’s spokesman. After being asked about whether the UK would allow for the shipping of the drugs that would enable the old “safer” three drug system (AKA Thiopental), the UK’s spokesman responded with this.
“The UK opposes the death penalty in all circumstances as a matter of principle, Its use undermines human dignity, there is no conclusive evidence of its deterrent value, and any miscarriage of justice leading to its imposition is irreversible and irreparable. We continue to call on all countries around the world that retain the death penalty to cease its use.”
100% behind you. The response to such a ban should be to examine your issue and wonder why the rest of the world thinks you cannot be trusted with medicine. Not do a science experiment to find out ways to kill people with other stuff.