Lethal Injection

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Kiichiro Sato / AP

Public-information director Larry Greene demonstrates how a curtain is pulled between the death chamber and witness room at Southern Ohio Corrections Facility in Lucasville, Ohio

The state of Virginia has executed John Allen Muhammad via lethal injection on Nov. 10. Muhammad, known as the D.C. sniper, was sentenced to death for the murder of Dean Harold Meyers, one of 10 victims gunned down during a three-week rampage around the capital in 2002. Muhammad is the highest-profile inmate to die by lethal injection since the U.S. Supreme Court ruled in April 2008 that the state of Kentucky was not violating a statute prohibiting "cruel and unusual punishment" by executing prisoners using the controversial method. The ruling effectively allowed executions by lethal injection to recommence after an unofficial seven-month moratorium.

The first proposal for using injected drugs as a form of capital punishment came in the late 19th century, when a New York commission on capital punishment included the suggestion that the method might prove more humane than hanging. According to Robert M. Bohm, a professor at the University of Central Florida who has written extensively on capital punishment, the proposal was rejected over concerns it would lead the public to associate the hypodermic needle — only recently introduced as an important medical tool — with death. During World War II, lethal injection was part of the Nazis' chilling arsenal of methods for disposing of sick, weak and disabled prisoners, along with the gas chamber and firing squad. After the war, death by lethal injection again faded from view; it was proposed in the U.K. in the 1950s, but was rejected by the Royal Commission on Capital Punishment because of objections from the medical community.

Then, in 1977, an Oklahoma medical examiner named Jay Chapman proposed that death-row inmates be executed using three drugs administered in a specific sequence: a barbiturate (to anesthetize inmates), pancuronium bromide (to paralyze inmates and stop their breathing) and lastly potassium chloride (which stops the heart). A simpler, barbiturate-only procedure was rejected on the grounds that the public would not support a killing method for humans modeled after that used for animals, according to Ty Alper, a lawyer who represents death-row inmates and is associate director of the Death Penalty Clinic at the University of California at Berkeley School of Law.

Despite the fact that Chapman had scant experience with pharmacology — his expertise was in forensic pathology — the proposal was well received. Lethal injection gave executioners another option besides electrocution, which could set inmates on fire and cause extreme pain; in addition, prisoners who were paralyzed would not writhe around or cry out as they died, which made watching executions easier for witnesses. Chapman's proposal was approved by the Oklahoma state legislature the same year and quickly adopted by other states. In 1982, Texas became the first to use the procedure, executing 40-year-old Charles Brooks for murdering Fort Worth mechanic David Gregory.

In the years since, lethal injection has become the standard method in the U.S., although other types of executions can still be carried out in some states. Prisoners in some jurisdictions can choose their method of execution, and the vast majority opt for lethal injection. In all, 936 out of the 1,107 U.S. prisoners executed since 1977 have died by the method, according to the Death Penalty Information Center. Just five U.S. inmates have been executed any other way since 2000 — all by the electric chair — although other options are still on the books in some states, including the firing squad in Utah, hanging in Washington and the gas chamber in Arizona. All told, two U.S. prisoners have died by firing squad since 1977, three by hanging, and 11 by the gas chamber.

The basic method for killing someone by lethal injection in the U.S. is fairly consistent. The inmate is strapped to a gurney and covered with a sheet, and intravenous lines are connected to both arms. After last rites and an opportunity for any final words, the drugs are typically administered by a prison employee or medical professional either in another room or behind a curtain. (The ethical implications for medical professionals participating in executions are a matter of much debate: most of the country's leading medical organizations, including the American Medical Association, the American Nurses Association and the American Society of Anesthesiologists oppose their members' involvement.) After a cardiac monitor indicates that the inmate's heart has definitively stopped, the inmate is declared dead.

Outside the U.S., according to Amnesty International, lethal-injection executions have been carried out in China, Thailand, Guatemala and the Philippines, although the last two of these countries recently outlawed capital punishment. (Taiwan technically permits lethal-injection executions but has never killed anyone with the method.) China, which executes more people than any other nation by far, is phasing out death by gunshot in favor of lethal injection; the government provides mobile execution vans, which travel to smaller cities and towns that don't have permanent death chambers. While that morbid procession wouldn't fly in Virginia, the state clearly considers lethal injection the most humane option. When prisoners — like Muhammad — decline to specify whether they want to be executed by electrocution or lethal injection, Virginia gives them the latter by default.