What and How Lethal Injection Works?

Many governments have punished people convicted of certain crimes by putting them to death, using various means to accomplish this. The death penalty is considered by many to be the ultimate form of punishment for those who have committed society's most heinous crimes, including rape and murder. As times have changed, so have the methods of execution.
The idea of someone being put to death is not a pleasant one. About 74 of the world's countries and 38 American states have a death penalty (although the vast majority of executions in 2004 took place in China, Iran, Vietnam and the United States).

The form by which prisoners are executed is changing. In America and a growing number of other countries, lethal injection is becoming the most commonly used form of capital punishment.


Prior to Execution

More than 3,315 men and women were serving death sentences in American prisons as of December 2004, according to the U.S. Department of Justice. Many of these people have been on death row for decades, waiting as their cases work their way through the appeals process. Some will die before ever having to face the execution chamber. Still, the number of executions taking place in the United States continues to grow.

Photo courtesy California Department of Corrections
Condemned-inmate housing Adjustment Center at San Quentin State Prison

Final 24 Hours

In the final 24 hours before the execution, a prisoner can be visited by several people, including family, friends, attorneys and spiritual advisors. These visits take place in the death watch area or a special visitation room, and are halted sometime during that last day.

• Last meal is provided - Prisons try to provide whatever meal is requested by the condemned prisoner.
• Warden and chaplain visit - The warden and the state-appointed chaplain visit with the inmate and stay until the end of the execution.
• Witnesses arrive - There is no contact allowed between witnesses and the condemned prisoner. Witnesses are typically restricted to the witness room adjacent to the execution chamber, and are instructed to remain silent.
• Inmate makes final preparations - In some states, male inmates are given a fresh pair of pants and a shirt, female inmates a dress, and the prisoner is allowed to shower before getting dressed. In other states, the inmate must remove all outer clothing.
• Heart monitor is connected - The inmate is connected to an electrocardiogram (EKG) machine, which will be monitored for flat line to determine when the heart stops and death has occurred.

Once the inmate is dressed, he or she waits in the death-watch cell with a spiritual advisor until the warden gives the signal to bring the prisoner to the execution chamber. The prisoner is brought to the chamber just a few minutes before the scheduled execution.

The Chamber

Few people know when there are only a few minutes left in their lives. Those sitting on death row are fully aware of when they are going to die, sometimes to the exact minute. Most state laws regarding capital punishment include a timeline of the events that must take place in the hours leading up to execution, including when the prisoner is to be taken to the execution chamber.

Once properly dressed, the inmate is taken to the execution chamber. They either walk on their own or are restrained to and rolled in on a gurney. Inmates who walk to the execution chamber are then restrained on a gurney or table either inside the chamber or in an adjacent preparation room.

The inmate is secured to the gurney or table with lined ankle and wrist restraints. A sheet may be placed over the prisoner.

The Injections

Unless a call is received from state officials to stay the execution, the execution proceeds as planned. While a lethal-injection machine exists, and was once used by several states, most states now opt to perform the injections manually due to the fear of mechanical failure. Usually an execution team comprises prison employees. Some states use the same personnel for every execution, while others rotate the duty among several employees.

The drugs are administered, in this order:

• Anesthetic - Sodium thiopental, which has the trademark name Pentothal, puts the inmate into a deep sleep. This drug is a barbiturate that induces general anesthesia when administered intravenously. It can reach effective clinical concentrations in the brain within 30 seconds, according to an Amnesty International report. For surgical operations, patients are given a dose of 100 to 150 milligrams over a period of 10 to 15 seconds. For executions, as many as 5 grams (5,000 mg) of Pentothal may be administered. This in itself is a lethal dose. It's believed by some that after this anesthetic is delivered, the inmate doesn't feel anything.

• Saline solution flushes the intravenous line.

• Paralyzing agent - Pancuronium bromide, also known as Pavulon, is a muscle relaxant that is given in a dose that stops breathing by paralyzing the diaphragm and lungs. Conventionally, this drug takes effect in one to three minutes after being injected. In many states, this drug is given in doses of up to 100 milligrams, a much higher dose than is used in surgical operations -- usually 40 to 100 micrograms per one kilogram of body weight. Other chemicals that can be used as a paralyzing agent include tubocurarine chloride and succinylcholine chloride.

• Saline solution flushes the intravenous line.

• Toxic agent (not used by all states) - Potassium chloride is given at a lethal dose in order to interrupt the electrical signaling essential to heart functions. This induces cardiac arrest.

Within a minute or two after the last drug is administered, a physician or medical technician declares the inmate dead. The amount of time between when the prisoner leaves the holding cell and when he or she is declared dead may be just 30 minutes. Death usually occurs anywhere from five to 18 minutes after the execution order is given. After the execution, the body is placed in a body bag and taken to medical examiner, who may perform an autopsy. It is then either claimed by the inmate's family or interred by the state.

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