A recent news article talked about a doctor who was having trouble finding a vein for the injection. So, is it always intravenous? Why? Why not just a couple of shots: One to knock 'em out, and another to stop the heart. If the person is unconscious (so that there’s no pain), a guillotine would certainly clinch the deal.
Because IM or subcutaneous injection is not a practical way to knock someone out, nor would it be effective at painlessly causing death.
When injections are given in the vein, they quickly circulate throughout the body, getting where they need to go in adequate doses very, very quickly.
When they are given by other routes, the drug is absorbed at various rates, sometimes minutes, sometimes hours, sometimes days for some meds. So the onset of action is variably delayed, depending on many factors, and the degree of the desired response is far more unpredictable.
So you may just make someone groggy when you’re trying to make them unconscious, then you’ve got to shoot them up again. Or if trying to kill them, you might first give them agonizing pain as the deadly drug erodes the tisse it’s in, then just drop their blood pressure and turn them into brain-dead living bodies. Messy, messy. Cruel and unusual, too.
In the modern era, execution technology has almost always gone forward with the goal of delivering swift, painless death. IM or SQ injections of accepted drugs would not facilitate that approach.
Actually, there are anesthetics that can be given IM, like ketamine. You just need to give more and it takes longer to take effect. Also, they use potassium chloride to kill during lethal injection. While getting a big shot of potassium chloride does hurt, it doesn’t erode your tissues, it stops your heart from beating by preventing it from depolarizing and generating action potentials.
I dunno, ketamine is a dissociative drug, it doesn’t induce unconciousness, nor is it particularly dangerous. I would expect that a big shot of ketamine followed by a big shot of potassium would be an unpleasant experience for the witnesses. If I was in that position, I’d request a Brevital enema. Seriously.
I’ve always wondered why they didn’t just use a massive morphine overdose-no way they can say it’s cruel (and I understand a potassium chloride kill shot probably hurts).
I guess they just don’t want their last moments being easy. And well, being killers, maybe they don’t deserve an easy death, but the whole death penalty thing still worries the heck out of me for many reasons.
Why not inject into the carotid artery?
Possibly because of difficulties of obtaining it for the purposes of execution - morphine is a schedule II narcotic and subject to heavy controls, but all of the three drugs currently used are either schedule III drugs (which are still proving difficult to obtain) or are uncontrolled and thus easier for non-doctors to obtain from other non-doctors for the purpose of administering lethal injection.
That’s a tough target to hit, it would take a licensed medical professional trained to do it, and such licensed professional is forbidden ethically, and in many cases legally from using said skills to do harm to the patient.
Injecting something into an artery is very, very different from injecting something into a vein.
How so?
Trained I can see. The licensing and ethics really don’t come into it. Are you forced to get a license and take the oath before you go through the training?
Or is it a case that you need a lot of hands on training on live people?
At any rate, the idea that state sponsored lethal injections can’t get the drugs required(or at least those that are less likely to not work correctly) strikes my morbid funny bone. Thats some dedicated adherence to bureaucracy right there.
Arteries are the high pressure fluid pipelines of the body; muscular, buried deep, generally surrounded by other things line veins and nerves and muscles and tendons. Getting into one with a catheter is technically more difficult than starting a peripheral IV into a vein just under the skin.
Veins on the other hand are the lazy rivers with many, many branches off of the main one, all flowing in the same general direction.
Thanks, Qadgop!
The vast majority of people qualified to place stuff in a human carotid artery are licensed; Physicians, Nurse Anesthetists, etc. These folks hold licenses prohibit using such skills to kill someone intentionally.
I’ll add to the ‘stay away from the neck’s arteries’ (and veins, imho) due to, say, if a person messed up the carotid insertion (for whatever reason, ain’t guarantee to work first time), there can be near-fatal consequences from bleeding that are hard to stop. Putting firm pressure on a neck/throat can be problematic for longish periods of time (to prevent aneurysms, pseudo or otherwise, as one example) ;). It can be pretty ugly visually, as well, afterwords - not good for ‘public relations’.
I’ve assisted with numerous (emergency) jugular vein ‘sticks’ upon X-ray/CT-tables, and even those had issues more often than you’d think. Pretty much a last resort (ie life-saving situation, more or less). Doing jugulars also takes fairly skilled training and knowing of neck/throat anatomy as messing up there is quite different than messing up on an elbow/foot, etc.
A person without some type of ‘licensing’ that carries ethics as part is very unlikely to ever have had any kind of hands-on training (to impart skill at doing it) with IV-in-neck stuff. You just can’t get close to a person needing such a thing as a neck-IV without already being licensed (for the most part, maybe there are easy-enough methods/locations of training such skills?)
Your post is spot-on, save that I’ve had a few lab techs that I was comfortable having them do blood draws from external jugular veins.
We’d slip the patient in reverse trendelenberg, have them stick their thumb in their mouth and blow, and voila, the EJ would usually pop up beautifully.
Of course, it’s quite a superficial vein, removed fairly well from the more complex anatomy a few centimeters away.
Damn, there’s a lot of stuff that’s packed into the neck!
I suspect there would be an issue of finding sufficient doctors or nurses that have done something sufficiently bad in the past, but if you can find them what about hiring doctors or nurses who have had their licenses revoked for one reason or another?
It’d sure end their hopes of ever getting their license restored, if they decided to use their skills for state-sponsored execution.
And I’d wager that most former health professionals who’d been stripped of their license would hesitate to kill someone for money.
Besides, there’s easier ways to kill folks than carotid artery catheterization. A single rapid IV Infusion of a large dose of a potent barbituate or opiate would do it nicely. The bureaucracy and regulation surrounding the death penalty process has kept that method from being used. Instead we use chemical combos which can fail to do the job. This despite plenty of evidence that single dose regimens work very well on large mammals.
Angels of Death … they are trained, and lost their licensing, and already living in the prison … win win situation 
I’m pretty much against the death penalty. But there are so many possibilities for killing somebody - so why can’t the convicted choose what’s best for them? They still don’t have to commit suicide, which may be against their beliefs/religion, but it may help to keep their dignity.
Typically, what kind of medical instruction (if any) have the prison employees that perform lethal injection executions undergone? Or is it all on the job training?