It includes the following sentence, which really caught my attention:
My own research has shown that death by lethal injection involves choking on your own blood about 80 percent of the time.
This was the first time I’d heard of such a thing, so I googled around a bit. The only relevant page I found was this:
TL,DR: Bucklew, who had been sentenced to death by lethal injection, argued that he had a unique medical condition that could cause him to choke on his own blood during the procedure.
According to the Wikipedia page, there were no reported complications with the execution; he did not choke on his own blood.
So can anyone point to other cases that did result in the convict choking on their own blood, as claimed by the author of that article?
I think the article makes a false claim about Nitrogen hypoxia:
Inhalation of nitrogen gas rapidly empties the body of life, and a person would know they are dying – from the inside out.
As I understand it, the specific thing about safety hazards regarding the handling of nitrogen gas is that victims of nitrogen hypoxia don’t realise it’s happening. The human body evolved to sense suffocation by sensing the level of CO2 in the blood. if CO2 is still leaving your body (which it absolutely would if you are breathing pure nitrogen), you don’t feel like anything bad is happening, but you are not getting oxygen and you fall unconscious.
It was an opinion piece, so I guess we’re supposed to allow some latitude for emotive expression - but I’m not sure how to connect those claims back to physiology or cognition. What does it mean to “rapidly [empty] the body of life,” and how is that different from other methods of execution? And what does it mean for a person to know they are dying “from the inside out”, and how is that different from other methods? And above all, I’m still hoping someone can confirm or refute a connection between lethal injection and choking on one’s own blood.
In any event, having inhaled pure N2 and pure He on various occasions, I can confirm what you’ve said about being unable to detect a difference between those gases and ordinary atmospheric air. One lungful is fine, two gets you dizzy, and a third makes you liable to fall over (or down, if you’re standing up), all with no physical pain, odor, or other obvious sensation. I’m guessing four or more good deep breaths would result in outright unconsciousness. If you didn’t know you were inhaling something other than air, you’d have no idea.
Elevated CO2 concentrations in blood may cause shortness of breath in many folks, but inhaling high concentrations of CO2 causes immediate, intense respiratory tract pain - confirmed by a single personal experience I plan to never repeat.
Usual lethal injection drugs are midazolam (for sedation), pavulon (in high enough doses causes respiratory arrest) and potassium chloride (causes cardiac arrest). None of the mechanisms involve “choking on one’s own blood”. Pavulon (pancuronium bromide) sounds like the only drug that might conceivably cause pulmonary hemorrhage, but that isn’t one of its listed side effects (its non-lethal uses include relaxing skeletal muscles to allow intubation and during surgery).
It sounds like the article’s author is going for drama to prove an anti-death penalty point rather than reality.
Granted, TV is not known for scientific/medical accuracy, but every time someone dies from carbon monoxide poisoning it seems “peaceful” enough – like they went to sleep and never woke up. If this is accurate , why don’t they use CO for executions?
Well, no one has used CO or nitrogen yet, but I imagine the risk with CO is that it’s also just toxic. So, witnesses and monitors will be fine with some extra nitrogen in the air (not too much!), but extra CO would be bad.
If anything, I would suspect that breathing 100% CO would induce unconsciousness faster than breathing 100% N2 or He. Any hemoglobin passing through the ventilated parts of the lung would get its oxygen stripped off (if present) and replaced permanently with CO. Hemoglobin irreversibly bound to CO can’t scavenge O2 from anywhere else in the body and deliver it to the heart and brain. Not that there’s a significant reservoir of O2 stored anywhere in the body other than maybe residual dead space oxygen in the less-ventilated areas of the lung. But oxygen is dissolved in tissue fluids to a minor extent, so it could in theory get shuffled around a bit from low-oxidative-metabolism areas to higher-oxidative metabolism areas, given normal hemoglobin function. Carbon monoxide would prevent even that. As to whether that would mean unconsciousness and death one, ten, or twenty seconds earlier, I dunno, but picture it as holding your breath and waiting to pass out vs. having your heart stop completely and waiting to pass out.
Regarding the drowning in blood, I think the key is “My own research”, which is always a worrisome phrase when it comes to determining the validity of a claim.
Now Joel Zivot probably does have a bit more clout behind his research than the average “did my own research” conspiracy theorist on the interwebs, since Zivot is actually a well published research scientist anesthesiology. However, looking through his publications he has a lot of anti-death penalty publications, but none that I saw devoted to the side effects of lethal injections or (of those I could access) citing other papers about this. So whatever research he has done is probably informal and not peer-reviewed, and given his ideological bent is also probably heavily influenced by confirmation bias, if not outright twisting of the facts.
Dr. Antognini, testified that pentobarbital, too, would render Mr. Buck-
lew fully unconscious and incapable of experiencing pain
within 20 to 30 seconds. Id., at 299–301, 432–433. Dr.
Zivot disagreed; but when he was asked how long he
thought the twilight stage would last with pentobarbital,
his testimony was evasive. Eventually, he said his “num-
ber would be longer than” 20 to 30 seconds, but he de-
clined to say how much longer. Instead, he
referenced a 2015 study on euthanasia in horses.
…
In fact, there’s nothing in the record to suggest that Mr.
Bucklew will be capable of experiencing pain for signifi-
cantly more than 20 to 30 seconds after being injected
with pentobarbital. For one thing, Mr. Bucklew’s lawyer
now admits that Dr. Zivot “crossed up the numbers” from
the horse study. Tr. of Oral Arg. 7–8, 11–12. The study
actually reported that the horses displayed isoelectric
EEG between 2 and 52 seconds after infusion of pentobar-
bital was completed, with an average time of less than 24
seconds.
From the minority opinion
Dr. Joel Zivot, an anesthesiologist.
Dr. Zivot provided extensive testimony regarding the pain
that Bucklew would likely endure in an execution by
lethal injection:
Dr. Zivot testified that in light of “the degree to which
Mr. Bucklew’s airway is compromised by the hemangi-
omas” and “the particular psychological and physical
effects of lethal injection, it is highly likely that Mr.
4 BUCKLEW v. PRECYTHE
BREYER, J., dissenting
Bucklew would be unable to maintain the integrity of
his airway during the time after receiving the lethal
injection and before death.” App. 221.
Dr. Zivot explained that, as a result of “the highly fri-
able and fragile state of the tissue of Mr. Bucklew’s
mouth and airway,” Bucklew “will likely experience
hemorrhaging and/or the possible rupture of the tu-
mor” on his uvula during his execution. Id., at 222.
Dr. Zivot added that the “hemorrhaging will further
impede Mr. Bucklew’s airway by filling his mouth and
airway with blood, causing him to choke and cough on
his own blood.” Ibid.
Dr. Zivot concluded that “it is highly likely that Mr.
Bucklew, given his specific congenital medical condi-
tion, cannot undergo lethal injection without experi-
encing the excruciating pain and suffering” of “suffoca-
tion, convulsions, and visible hemorrhaging.” Id.,
at 223.
Dr. Zivot also testified about the duration of pain to
which an execution by lethal injection would subject Buck-
lew, describing it as “prolonged.” Id., at 234.
Dr. Zivot stated that the effects of a pentobarbital in-
jection “are highly unlikely to be instantaneous and
the period of time between receiving the injection and
death could range over a few minutes to many
minutes.” Id., at 222 (emphasis added).
Dr. Zivot “strongly disagree[d] with [the State’s ex-
pert’s] repeated claim that the pentobarbital injection
would result in ‘rapid unconsciousness.’ ” Id., at 233.
5Cite as: 587 U. S. ____ (2019)
BREYER, J., dissenting
Dr. Zivot explained that Bucklew “would likely experi-
ence unconsciousness that sets in progressively as the
chemical circulates through his system” and that it
was during this period that Bucklew was “likely to ex-
perience prolonged feelings of suffocation and excruci-
ating pain.” Id., at 233–234.
I figured it might be something like that, a unique risk factor (I was thinking of esophageal varices) so that if there was significant spasm or convulsion, and if there were a subsequent blood vessel rupture, and if the subject was still conscious it would be, perhaps, very unpleasant.
But most of the ‘physical effects’ of lethal injection are the same as the physical effects of induction of anesthesia for surgery, so I would have asked him what the procedure would have been for treating a pt with appendicitis and the same hemangiomas, and how often they choked on the own blood.
His statement that his own research shows 80% blah blah blah has a link in it to another opinion piece that doesn’t mention any such thing, and also fails to support its own conclusions, so I would consider those extraordinary claims, requiring extraordinary proof.
, why don’t they use CO for executions?