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Running head: A LITERATURE REVIEW OF LETHAL INJECTIONS, CHALLENGES AND
ANSWERS 1
A Literature Review Of Lethal Injections, Challenges and Answers
Jesus Chavez
The University of Texas at El Paso

A LITERATURE REVIEW OF LETHAL INJECTIONS, CHALLENGES, AND, ANSWERS
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Abstract.
The main topic of research is, the current status of lethal injections in America. The research
questions asked were, How Has the Lethal Injection been applied throughout history, and, how
did it compare to other execution methods? Have the lethal injection procedures affected the US
inmate population, if so, how? How do the methodologies used in OK, OH, AZ, and, other states
differ from other procedures, and are they compliant within the law in regards to the 8th
amendment? And, What steps should be taken to address the challenges presented to lethal
injections? The research methods used, include primary and secondary research sources. Primary
sources, such as, a survey; secondary, such as, magazines, newspapers, and, books.

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Literature Review Of Lethal Injections, Challenges and Answers
The history of lethal injections and, therefore, the death penalty is archaic. It has been
found to be part of the English common law; moreover, hence the United States started as an
English colony, the first laws were primarily focused on such code. The death penalty has since
evolved throughout, as this paper will explain, into more humane ways of administration. The
topic is also of concern now days, hence questions about, supply, and, application, regarding
lethal injections have been raised. The following research questions are aimed to add a depth of
understanding to the history, application, challenges, and, answers that lethal injections face:
• How Has the Lethal Injection been applied throughout history, and, how did it
compare to other execution methods?
• Have the lethal injection procedures affected the US inmate population, if so,
how?
• How do the methodologies used in OK, OH, AZ, and other states differ from
other procedures, and are they compliant within the law in regards to the 8th
amendment?
• What steps should be taken to address the challenges presented to lethal
injections?
Exploring such questions will provide an effective framework to address the current challenges,
and, answers, the lethal injection and its administration face.
How Has the Lethal Injection been applied throughout history, and, how did it
compare to other execution methods?
Capital Punishment in America was established since conception, since the first puritans
arrived to the country. Moreover, the drive to establish a capital punishment in the form of an

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execution was not an accidental phenomenon. There were many implications that influenced an
establishment of a capital punishment. For instance, since the first established colonies in North
America were from a puritan background, and, located in the Northeast, the push to establish
such penalty was mainly religious (Banner, 2002). On the other hand, the drives in the Southern
colonies differed extensively; inhabitants arrived to the South later on and the sub-continent was
different than that of their counterparts in the north. Their surroundings were very much similar
to England and the land was distributed in a county fashion as it was in England (Banner, 2002).
Such drives differ, and as Stuart Banner a professor from the UCLA law school explains
(2002), the inhabitants of the southern colonies preferred to use the English law instead of
fermenting local customs as the puritans did, because many of the puritans had to run away due
to religious reasons rather than a signing servitude contract. Mr. Banner (2002) also emphasizes
that a contrast emerges when the Southern and Northern colonies are compared was the
distribution of wealth. In the North property was better distributed and there was also some
industry (2002). In the South, land was sold to who could buy it and many had none; the majority
were those who could not buy property, mainly, white immigrants in indentured servitude or
slaves (Galenson , 2009). The Southern elites had to look for a framework to regulate in such
unequal society and the English common law was sought. The reason for this, as Banner (2002)
writes, is because the English common law had a set of penalties regarding property theft and
most of them implied the Death penalty.
The means of administrating the Death Penalty have changed alongside the reasons. The
first methods of execution were not thought out to be humane, but to serve as an example; more
brute methods were used such as hanging people and shooting (Banner, 2002). In 1853 public
hangings were attacked and private hanging legislation was passed (Regio, n.d.). In the 20th

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century though, more humane ways of administrating the Death Penalty were sought. In the
seventies, the Furman v Georgia case put a hold on executions due to constitutional
considerations on the current methods and procedures; although some judges clarified that such
considerations were on regards to its due process and, not in regards to the death penalty it self
(Sorensen, Pilgrim, 2006).
The case prompted a search for a legal means of execution. The gas chamber was tried to
as a means of a more humane execution. It took 8 minutes for a prisoner to die hence he hit his
head 11 times, and visitors were asked to leave (“when the state kills”, 1989). Next, in New York
a commission was formed to analyze execution methods a pick a more humane method for the
execution of William Kemmler (Moran, 2010). While the electric chair was still on the books,
the lethal injection was proposed as a more humane option as well. In 1977 it was officially as a
method by the state of Oklahoma and since then it became the standard of execution as 936
inmates out of 1107 have been executed this way (Picket, 2009).
In 2014, it was reported that hospira, the only company making such serum, had to
renounce any intentions of chemical production due to pressure within the west. Such shortage
prompted local governments to experiment to look for alternative serums (Sewer, 2014). As
Hospira was closed down, in Oklahoma, in April of 2014, the state executed Clayton Lockett but
the inmate regained life after a few minutes; finally, remained conscious until death arrived
(Koppel, 2014). After that incident other botched executions have taken place in other states,
such as, Ohio and Arizona (Regio, nd).
Have the lethal injection procedures affected the US inmate population, if so, how?
Although many experts assert the humanity of the lethal injection, in some instances the
injection may have been flawed. For instance, Amnesty International reported that it took James

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Autry 10 minutes to die while he was moving, and, complaining (“When The State Kills, 1989).
Next, Lancet reported that technicians anesthetized many inmates, and, the anesthetic portion of
the serum was not properly applied (Henningfeld, 2006). But, on the other hand, Kyle Janeck,
anesthesiologist and Texas senator asserts that a serum composed of sodium penthotal (see fig
1.0), pancuronium bromide and potassium chloride, when administered correctly, such agents
have no painful effect on the inmate. He explains:
Sodium penthotal is a barbiturate that until about 10 years ago was the most widely used
medication for general anesthesia (It since has been displaced by newer drugs that cause
fewer side effects upon awakening. For obvious reasons, that isn’t a concern for death
penalty cases). It is important to understand that sodium penthotal is given to the inmate
first to render him completely unconscious and insensible to pain. A normal surgical dose
for a man weighing 220 pounds would be about 300 milligrams, yet for lethal injection,
the inmate receives 3 grams –or 10 times the normal amount based on body weight. I can
attest with all medical certainty that anyone receiving that massive dose will be under
anesthesia (Henningfeld, 2006, pp 206).
Ever since Hospira closed down, access to such serum has been limited, and states have
been moved to look for alternative means of injection (The Associated Press, 2014); for instance,
In Oklahoma, an untested serum composed of, midazolam, vecuronium bromide, and, potassium
chlorideuses, is used as lethal injection (sewer, 2014). The preparation referred before was
administered to Clayton Lockett through an iv, and the state investigation found out that such iv
was not placed correctly( see fig 1.0) by the technician (Sewer, 2014). According to the
Washington post (2014) post it took Mr. Locket 11 minutes to die. The following was said in
regards to the IV:

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An independent autopsy found that the execution team failed to properly place the IV,
despite the “excellent integrity” of Lockett’s veins at the time of his death. While
Department of Corrections employees said they believed that Lockett had dehydrated
himself on purpose, the independent autopsy and the state-ordered autopsy found that
there were no indications that Lockett was dehydrated (Berman, 2014).
In Arizona, midazolam was used as well, it was reported that the inmate had to take 15 times the
recommended dose and that it took an hour for the inmate to die (Sewer, 2014). In Ohio, an
inmate was talking though out the execution, he apparently “complained that he was "burning"
after receiving a lethal mix of drugs including pentobarbital” according to visitors (US news,
2014).
Figure 1. Inmate’s description. This figure is a concept map showing how the iv was placed
incorrectly. (Feldenkirchen, 2014).
How do the methodologies used in OK, OH, and AZ differ from other procedures, and are
they compliant within the law in regards to the 8th amendment?

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The legal opinion of authorities is not fixed, and, does change from time to time;
moreover, the history of lethal injections is accompanied by several opinions. Such opinions
have been either detractors or promoters of the death penalty but at the same time, some judges
have also implied why their decision is not a mere moral judgment but the meaningful call of
duty. For instance, current Federal judge Scalia wrote in his essay that such considerations were
not to be answered by the judiciary rather by the legislative wing of government; Scalia wrote :
The constitution I interpret and apply is not living but dead –or, as I prefer to put it,
enduring. It means today not what current society thinks it ought to mean, but what it
meant when it was adopted. For me, therefore, the constitutionality of the death penalty is
not a difficult soul-wrenching question” and then he proceeds to write “Of course, those
who deny the authority of a government to exert vengeance are not entirely logical
(Henningfeld, 2006, p# 18)”.
On the other side, the legality of the death penalty was decided upon a different Supreme
Court than that of Scalia’s. In 1977 the Supreme Court debated the Furman v Georgia case. The
NAACP legal defense team fought such case by “raising every possible constitutional claim in
every inmates case in an effort to clog the system”(Sorensen, Pilgrim, 2006, pp 2). In the case,
justice Stewart “compared receiving the dead penalty with being struck with lightening”
(Conrad, 1998, pp 215); while, justice Brennan, another justice, debated that the death penalty
was being arbitrarily imposed (Conrad, 1998). This case is considered a landmark, in the since
that it set a pathway for the next 10 years in American judicial history, going from abolition to
reinstatement in following cases (Regio, nd). According to Conrad (1998):
Two justices (William J. Brennan, and Thurgood Marshal) the death penalty is cruel and
unusual per se, and, could never be unconstitutional under any circumstances. Three

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justices (Byron R. White, Potter Stewart, William O. Douglas) agreed that then current
punishment procedures were unconstitutional but were willing to commit as to weather
future schemes could be developed which would comply with constitutional
requirements. (p. 213-214)
As the case was finished, the proponents of capital punishment pushed for methods of
administration that were more suitable to meet the Supreme Court’s expectations, such as the
lethal injection; for instance, former Texas representative Close commented on the lethal
injection, “it’s a very scary thing to see. Blood squirts out of the nose. The eyeballs pop out. The
body almost catches fire. I voted for a more humane treatment because death is pretty final”
(Sorensen & Pilgrim, 2006, p. #). Texas, alongside other states passed legislation to reestablish
to capital punishment years later (Regio, nd). In the Texas legislation, as well as in other states,
specific demands of the Supreme Court were met, such as “the person murders a police officer or
fire fighter”, and, “the person murders an individual under six years of age” (Sorensen, Pilgrim,
2006, p. 4-5).
After the death penalty was reestablished and administered through lethal injection,
newer issues regarding the procedure are based on the opinion that such procedure might be in
conflict with the third amendment; moreover, Andrew Fulkerson from the South East Missouri
State University, and, Michael Stuttmoeler from Michigan State University write on the Criminal
Justice Studies journal (2008) that on the present, most cases against lethal injection and the
death penalty are focused on the Eighth Amendment of the constitution. They (2008) then
explain, how, on the Supreme Court case Baze v Rees, A Kentucky inmate challenged the
current methodologies on the grounds of the secondary effects of lethal injections; the inmate
based his claim on the potential ocurrences caused by the failure in the administration sodium

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pentothal. Kyle Janeck writes in his essay “Lethal injection should be maintained”, the
ingredients of such injection are, sodium pentothal, pancuronium bromide, potassium chloride,
(Henningfield, 2006, p# 205). The Supreme Court delimited, that such claims did not constitute
any violation to the amendment, because multiple doses of the anesthetic may be applied
(Fullkerson, Stutmoeller, 2008).
As the preparations of lethal injections became limited, and, states pursued newer
methods, legal challenges to the administration of the injection surfaced again. In the resent
Oklahoma case, the focus was to challenge the secrecy involving the ingredients the state sought
after traditional ingredients became inexistent. After the case was heard, the Oklahoma Supreme
Court ordered that such ingredients could not be stored in secrecy. The state informed the
inmates that a 5-ingredient serum that had never been tested before was going to be applied.
After the executions were carried out, the governor ordered an internal review on the matter. The
review found, as previously shown, a defect on the application of the iv (“Oklahoma unveils new
execution protocols”, 2014). Oklahoma proceeded to change the protocol (Sanburn, 2014). Such
protocol updated the contingency plan and the training the health crew has to go through;
moreover the new protocol allowed an administration of midazolam, the same chemical used in
the previous execution, five times greater than the previous (“Oklahoma unveils new execution
protocols”, 2014).
What steps should be taken to address the challenges presented to lethal injections?
As the lethal injection faces legal challenges, and, the supply of the serum becomes
limited, institutions and U.S. Representatives have sought newer methods to administer the death
penalty. While states like Oklahoma were mandated to change their procedures, but some did not
follow their lead. For instance, the guardian reports (2014) that State representatives have

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introduced legislation involving new and updated procedures in several states; they report
“Wyoming lawmaker this month offered a bill allowing the firing squad (2014, p#1)”.
Moreover, According to the guardian, other states have also introduced legislation such as gas
chambers and electrical chairs. Next, another representative, Mike Christian, also questioned
current lethal injection procedures and proposed Nitrogen Asphyxiation, Markus Feldenkirchen
(2014) writes in the newspaper der Spiegel. According to Mike Christian “Nitrogen and noble
gases such as helium are seen by proponents of assisted suicide as offering a reliable, quick and
painless way to die ( Feldenkirchen , 2014)”.
On the other hand, Amnesty international suggests that the only solution to the current
challenges is to abolish the death penalty. As heather in one of their press releases, they wrote
“USA: Another ‘botched’ execution, abolition the only solution” (2014). For the ONG, recent
failed executions represent a “wake up call for authorities (“USA: Another ‘botched’ execution,
abolition the only solution”, 2014)”; and, also, one of the researchers working for the group was
quoted saying “However the state chooses to kill the prisoner – and whether the execution goes
according to plan or not – does not change the fact that this is a punishment incompatible with
fundamental human rights principles (“USA: Another ‘botched’ execution, abolition the only
solution”, 2014)”. The group also goes on to describe capital punishment in America as unruly;
they reported, “The death penalty in the USA is riddled with arbitrariness, discrimination and
error (“USA: Another ‘botched’ execution, abolition the only solution”, 2014)”.
The subject has been researched through surveys and, the majority in most has been on
the side of lethal injection; at the same time, research also suggests that, when the hypothetical
case of painful injections is raised, most tend to not agree with the lethal injection. For instance,
a poll on Texas residents found that the support given to the lethal injection was inversely

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proportional to the amount of information the agent hade while conducting the survey (Sorensen,
Pilgrim, 2006). Another survey conducted on young adults found that while most prefer the
death penalty by injection, but most also agree that such procedure should not be performed if it
inflicts pain to the inmate. The survey conducted also found that, most pollsters tended to skip
the section to provide an alternative to lethal injections (see fig 1.2 & fig 1.3).
Figure 1.2. Survey on young adults. This figure is shows the distribution of answers regarding
the death penalty methods.

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Figure 1.3. Second question conducted on survey. Shows distribution of answers regarding the
secondary effects of lethal injections.
Finally, this research looked at the history, challenges, and, the answers given to such.
The work reviewed was scientific. For instance, the Texas senator, and, doctor, argued on a
scientific basis, the neutrality of the ingredients used in the lethal injection. The review also takes
a look at the newer ingredients and shortages of reliable, traditional approaches. Then, it
proceeds to review the legality of such. The results that the research point at is, many are indeed

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looking for alternatives. Also, it gives a chance for abolitionists, quoting amnesty international,
for instance. At the end it was found that many don’t know of such ingredients. It also found
through primary and secondary research that, the consensus is to look for an effective
administration of the lethal injection if it’s going to be applied; on the other hand, the majority
also rejects an application of a flawed injection.

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References
Banner, S. (2002). The death penalty: An American history. Cambridge, Mass.: Harvard
University Press.
Conrad, C. (1998). Jury nullification: The evolution of a doctrine. Durham, N.C.: Carolina
Academic Press.
Fulkerson, A., & Stuttmoeller, M. (2008). Current Issues Involving Lethal Injections. Criminal
Justice Studies: A Critical Journal of Crime, Law and Society, 21(4). Retrieved
November 6, 2014, from Ebsco.
Galenson, D. (2009). He Rise and Fall of Indentured Servitude in the Americas: An Economic
Analysis. The Journal of Economic History, 44(01), 1-26. Retrieved October 15, 2014,
from
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=4142924&fi
leId=S002205070003134X
Henningfeld, D. (2006). The death penalty: Opposing viewpoints. Farmington Hills, MI:
Greenhaven Press.
Regio, M. (n.d.). A History Of The Death Penalty. Retrieved November 16, 2014, from
http://www.pbs.org/wgbh/pages/frontline/shows/execution/readings/history.html
Sanburn, J. (2014). Oklahoma Changes Lethal Injection Protocol, But Keeps Controversial Drug.
Time.Com, 1.
Sanburn, J. (2014). Oklahoma is Changing The Way it Carries Out Lethal Injections. Time.Com,
47.
Will botched execution kill the death penalty?. US News. Retrieved November 5, 2014, from
The return of the firing squad? US states reconsider execution methods. (2014, January 28). The
Guardian. Retrieved November 3, 2014, from
http://www.theguardian.com/world/2014/jan/28/return-firing-squad-us-states-execution-methods

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USA: Another ‘botched’ execution, abolition the only solution. (2014, july 24). Retrieved
November 18, 2014, from http://www.amnestyusa.org/news/news-item/usa-another-
%E2%80%98botched-execution-abolition-the-only-solution
Picket, K. (2009, November 10). A Brief History of Lethal Injection. Time.
Moran, R. (2010, June 23). Shock Treatment. Time.
Koppel, N. (2011, January 1). Drug Halt Hinders Executions in the U.S. The Wall Streat Journal.
Retrieved October 12, 2014, from
http://online.wsj.com/articles/SB10001424052748704754304576095980790129692
Denno, D. (2013, January 11). Gas chamber. Retrieved October 14, 2014, from
http://www.britannica.com/EBchecked/topic/226365/ The Death Penalty In Practice.
(1989). In When the state kills--: The death penalty, a human rights issue. New York,
NY: Amnesty International USA. gas-chamber
The Associated press (2014, July 24). How Arizona, Ohio, Oklahoma, executions went awry.
The Associated press. Retrieved November 5, 2014, from
http://bigstory.ap.org/article/how-arizona-ohio-oklahoma-executions-went-awry
Sewer, A. (2014, August 2). Lethal drugs injected 15 times in botched Arizona execution.
Retrieved November 5, 2015, from http://www.msnbc.com/msnbc/lethal-drugs-injected-
15-times-botched-arizona-execution
http://www.usnews.com/news/articles/2014/08/07/can-the-death-penalty-survive-lethal-injection
Berman, M. (2014, September 5). Oklahoma Investigation into Botched Execution Finds
Problems with IV Insertion, Training of Execution Team. The Washington Post.
Retrieved November 17, 2014, from http://www.highbeam.com/doc/1P2-37152300.html?

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Feldenkirchen, M. (2014, September 15). Proposal from Oklahoma: Could Nitrogen
Asphyxiation Replace Lethal Injection? Der Spiegel.
Feldenkirchen, M. (2014, September 18). Otched Execution: The Death that Could Kill Lethal
Injection. Der Spiegel. Retrieved November 15, 2014, from
http://www.spiegel.de/international/world/execution-of-clayton-lockett-and-the-flaws-of-lethal-
injection-a-992359.html

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