Lethal injection

“ Bucklew cites evidence that executing him by lethal injection will cause the tumors that grow in his throat to rupture during his execution, causing him to sputter, choke, and suffocate on his own blood for up to several minutes before he dies. That evidence establishes at this stage of the proceedings that executing Bucklew by lethal injection risks subjecting him to constitutionally impermissible suffering. The majority holds that the State may execute him anyway. In my view, that holding violates the clear command of the Eighth Amendment. ”

“ Seven years ago, in Baze v. Rees, 553 U. S. 35 (2008) , the Court addressed the application of this mandate to Kentucky’s lethal injec­ tion protocol. At that time, Kentucky, like at least 29 of the 35 other States with the death penalty, utilized a series of three drugs to perform executions: (1) sodium thiopental, a “fast-acting barbiturate sedative that induces a deep, comalike unconsciousness when given in the amounts used for lethal injection”; (2) pancuronium bro­ mide, “a paralytic agent that inhibits all muscular-skeletal movements and . . . stops respiration” ”

“ Petitioners in this case—each convicted of double homicide—acknowledge that the lethal injection procedure, if applied as intended, will result in a humane death. They nevertheless contend that the lethal injection protocol is unconstitutional under the Eighth Amendment's ban on "cruel and unusual punishments," because of the risk that the protocol's terms might not be properly followed, resulting in significant pain. They propose an alternative protocol, one that they concede has not been adopted by any State and has never been tried. ”

“ Has been used to carry out over 100 executions, without incident. Has been repeatedly invoked by prisoners as a less painful and risky alternative to the lethal injection protocols of other jurisdictions. ”

“ The Kentucky statute does not specify the drugs or categories of drugs to be used during an execution, instead mandating that "every death sentence shall be executed by continuous intravenous injection of a substance or combination of substances sufficient to cause death." Ky. Rev. Stat. Ann. §431.220 (1) (a) (West 2006) . Prisoners sentenced before 1998 have the option of electing either electrocution or lethal injection, but lethal injection is the default if—as is the case with petitioners—the prisoner refuses to make a choice at least 20 days before the scheduled execution. ”

“ We too agree that petitioners have not carried their burden of showing that the risk of pain from maladministration of a concededly humane lethal injection protocol, and the failure to adopt untried and untested alternatives, constitute cruel and unusual punishment. ”

“ He must show that the risk is substantial when compared to the known and available alternatives. A State with a lethal injection protocol substantially similar to the protocol we uphold today would not create a risk that meets this standard.
* * Reasonable people of good faith disagree on the morality and efficacy of capital punishment, and for many who oppose it, no method of execution would ever be acceptable. ”

“ The plaintiffs committed their crimes decades ago and have long exhausted all avenues for direct and collateral review. The first of their executions was scheduled to take place this afternoon, with others to follow this week and next month.To carry out these sentences, the Federal Government plans to use a single drug—pentobarbital sodium—that "is widely conceded to be able to render a person fully insensate" and "does not carry the risks" of pain that some have associated with other lethal injection protocols. ”

“ So, also, it is unnecessary to aver that the poison was taken into the stomach of the deceased. The crime would be complete if the poison was by hypodermic injection, or otherwise, introduced into the body of the deceased, and, affecting the heart or other organ, caused the death. The indictment need not specify in detail the mode in which the poison affected the body, or the particular organ upon which its operation was had. It is enough to charge that poison was administered, and that such poison, so administered, caused the death. ”

“ If every ordinary bullet-wound which did not call for immediate operation because of injury to some essential or vital part—such as a large blood-vessel or nerve-trunk, or some of the viscera—were antiseptically and hermetically sealed at the very outset, there would be a much smaller percentage of death from gunshot wounds, either in civil or military practice, than now obtains. ”

“ Medicine and surgery have made rapid strides since the days, not a century agone, when in the naval cockpit, and on the open battlefield, the hatchet was the ready implement for amputation, the rough cautery that of a red hot iron applied to the fizzing flesh; and when the doctor cried, “Spit, man, spit” to the suffering soldier with a gunshot wound in his chest, and when the sputum came tinged with blood, simply plugged up the bullet-hole and left the poor fellow to his fate, while he passed on to cases less hopeless. ”

“ Doctor examines body--finds no evidence of violence, except slight discoloured mark on one side of neck--opinion of inspector that something, chain probably, has been wrenched off by assassin--is also of opinion that death could not have been thus caused. Doctor says death is caused by blood-poisoning--evidence being, swollen condition of body, protruding tongue, discolouration of skin--thinks it must be poison--makes minute examination--finds on neck slight scratch just on jugular vein, greatly inflamed--is of opinion that assassin has wounded victim in neck with poisoned dagger or knife. ”

“ If a weapon be found near to the body, its position should be noted, and if in the hand, the firmness of the grasp—cadaveric spasm—should be recorded. All clothing should be carefully examined, and the relation of cuts and body wounds noted. All blood-stains on the clothing should be examined and described.
Multiple bullet wounds denote homicide, but suicides have been known to inflict more than one wound. It is strong evidence of suicide if the gun or pistol has burst by the explosion, as suicides have a predilection for overloading the weapon employed. ”

“ A portion of clothing may be carried into the wound and lead to death from hemorrhage, or death may occur from many secondary causes, such as tetanus or sepsis. Accidents so frequently occur from weapons discharged in sport, not loaded with ball or shot, that it is worth while to bear this in mind. It has been observed, for instance, that persons attempting [618] to commit suicide have forgotten to put a bullet in the pistol, nevertheless the discharge of the weapon into the mouth has sufficed, from the wadding alone, to produce a considerable laceration and hemorrhage (Taylor) . ”

“ Should the question come up as to whether a gunshot wound had been inflicted before or after death, we may remember the principal characteristics of a wound inflicted during life, which are more or less eversion, more or less hemorrhage with diffusion of blood into the tissues, and the presence of clots. In a wound made after death little or no blood is effused, unless it come from some vessel very near the surface, in which case it will be venous in character and will not coagulate as does that which is poured out of a wound in the living. ”

“ In suicide or accidental discharges of a shot-gun the muzzle is so near the body that the charge of shot acts very much as would a single bullet of the size of the bore of the gun, and near wounds thus inflicted, while necessarily large, have about them a minimum laceration and disturbance of tissue, so that perhaps only by their size could one say, viewing the wound alone, that the weapon used had been a shot-gun. ”

“ Due to the close proximity of arteries and veins in the areas most commonly used for intravenous injection, extreme care should be exercised to avoid peri vascular extravasation or inadvertent intra-arterial injection. Reports compatible with inadvertent intra-arterial injection of Phenergan Injection, usually in conjunction with other drugs intended for intravenous use, suggest that pain, severe chemical irritation, severe spasm of distal vessels, and resultant gangrene requiring amputation are likely under such circumstances. ”

“ Death from Surgical Operations Necessitated by Gunshot Wound.—The modern treatment of serious or so-called penetrating gunshot wounds where the cranium, thoracic viscera, or the abdominal viscera, especially the intestines, have been perforated one or more times, calls for surgical procedures which are of severity and danger in proportion to the gravity of the wound which necessitates them, and which, while they often save life, must necessarily often fail. Indeed, such operations may prove fatal upon the operating-table, i.e., patients may die before the conclusion of the operation. ”

“ If death has been caused by a bullet which has not passed through the body, but lodged, it should by all means be obtained, since evidence of the greatest value may inhere in it. Moreover, in first noting the position of the body, the direction of the wound, or the location of a blood-clot upon the floor or clothing or elsewhere, may indicate to the surgeon or other astute person the point at which the bullet may be found concealed or buried in some soft or hard object. ”

“ If blood is not found on a weapon, hair and other substances which can be identified may be. This is especially the case with blunt weapons, on which, as we have seen, blood usually fails. A fragment of the weapon may break off in the wound, as in stab-wounds, and may be identified as belonging to one in the murderer’s possession.
The signs of a struggle furnish important evidence, as they are not likely to be found in the case of suicide. ”

“ A charge of small shot is much more destructive to blood vessels, tendons, and ligaments than a single bullet, which in many cases pushes such structures aside without dividing them. In the abdomen and chest, also, the damage done by a full charge of shot is much more extensive than that inflicted by a single bullet, the deflection of the pellets leading to a greater number of perforations of the intestine and more widespread laceration of solid viscera. ”

“ In wounds of the thoracic cavity it should now be held that so long as air has entered through a bullet-wound there are cases where free incision, even with removal of ribs, can scarcely increase the dangers, while permitting opportunity for much more accurate exploration and determination of life-saving methods. The experiments of numerous investigators, the writer included, have shown that bullet-wounds of the heart need not be always and invariably fatal, and have afforded an element of hope from the possible surgery of even this organ. ”

“ It is not often that there is more than one wound—a charging boar rarely returns to the attack once his impetus [86] has carried him clear of his enemies—and the consequences of this depend largely upon its location. If a thigh is cut deeply enough the wounded man will bleed to death; and if the slash is across the abdomen, though he may linger, it is rarely indeed that blood-poisoning fails ultimately to claim him for a victim. ”

“ My curiosity was somewhat aroused, and I questioned him, whereupon he told me that the drug, being tasteless, was given in food or drink, and that the victim was seized with a terrible and immeasurable sadness and depth of despair, in which life appeared too horrible to endure, and which the unfortunate always ended by seizing a weapon of some sort and killing himself; and the chief, being of an inquiring mind, had caused the poison to be administered to a man who was carefully guarded and allowed no weapon. ”

“ The literature also casts a shadow of uncertainty upon the ready availability of some of the alternatives to lethal execution methods. Petitioners argued to the trial court, for example, that Kentucky should eliminate the use of a paralytic agent, such as pancuronium bromide, which could, by preventing any outcry, mask suffering an inmate might be experiencing because of inadequate administration of the anesthetic. ”

“ Prevent the poison from traveling toward the heart and brain by putting on at once a tourniquet between the wound and the heart.
2. Suck the wound and be sure to spit out the poison and rinse the mouth afterward. It is safe, if you have no cuts or sores on the lips or in the mouth.
3. Enlarge the wound with a knife (in the direction of the bone, not across) to make it bleed more freely, and again suck the wound.
4. Apply to the wound any strong acid or caustic, such as carbolic acid, lime, wood ashes or tincture of iodine, or burn it with a hot iron. Telegraph wire will do. ”

“ The operation by injection has, I know, many advocates, both in this country and in Europe; and, when well executed, is generally unattended with risk, if not always successful. The fact, however, that it may be followed by serious mischief, with occasional loss of life, should be sufficient to deter the practitioner from resorting to it, more especially when we reflect that we are in possession of another remedy, not only entirely devoid of danger, but always, so far as my observation extends, most effective. ”

“ One circumstance which always strongly points to suicide is the finding of the weapon firmly grasped in the hand of the cadaver. The hand of a dead person cannot be made to grasp or retain a weapon as does the hand which has grasped it at the last moments of life. The amount of blood on the weapon should be noted, but it must be remembered that a knife may have produced a fatal stab wound and still no blood be found on it. ”