Issues surrounding lethal injection as a means of capital punishment

Pharmacotherapy. 2008 Dec;28(12):1429-36. doi: 10.1592/phco.28.12.1429.

Abstract

Lethal injection as a method of state-sanctioned capital punishment was initially proposed in the United States in 1977 and used for the first time in 1982. Most lethal injection protocols use a sequential drug combination of sodium thiopental, pancuronium bromide, and potassium chloride. Lethal injection was originally introduced as a more humane form of execution compared with existing mechanical methods such as electrocution, toxic gassing, hanging, or firing squad. Lethal injection has not, however, been without controversy. Several states are considering whether lethal injection meets constitutional scrutiny forbidding cruel and unusual punishment. Recently in the case of Ralph Baze and Thomas C. Bowling, Petitioners, v John D. Rees, Commissioner, Kentucky Department of Corrections et al, the United States Supreme Court upheld the constitutionality of the lethal injection protocol as carried out in the Commonwealth of Kentucky. Most of the debate has surrounded the dosing and procedures used in lethal injection and whether the drug combinations and measures for administering the drugs truly produce a timely, pain-free, and fail-safe death. Many have also raised issues regarding the "medicalization" of execution and the ethics of health care professionals' participation in any part of the lethal injection process. As a result of all these issues, the future of lethal injection as a means of execution in the United States is under significant scrutiny. Outcomes of ongoing legislative and judicial reviews might result in cessation of lethal injection in totality or in alterations involving specific drug combinations or administration procedures.

Publication types

  • Review

MeSH terms

  • Bioethical Issues*
  • Capital Punishment / legislation & jurisprudence*
  • Capital Punishment / methods*
  • Drug Combinations
  • Humans
  • Injections, Intravenous / ethics
  • Injections, Intravenous / methods
  • Pancuronium / administration & dosage
  • Pancuronium / poisoning
  • Potassium Chloride / administration & dosage
  • Potassium Chloride / poisoning
  • Supreme Court Decisions
  • Thiopental / administration & dosage
  • Thiopental / poisoning
  • United States

Substances

  • Drug Combinations
  • Potassium Chloride
  • Pancuronium
  • Thiopental