The case, known as Baze v. Rees, is challenging the combination of drugs used in Kentucky and by most other states that perform lethal injection.,”

• Two Kentucky death row inmates suing Kentucky saying method of lethal injection inhumane.
• Three drugs injected to induce unconsciousness, paralysis, death may be problematic.
• Executioners not medically trained; unable to address problems in execution
• Calling for simpler, risk-free method

The Supreme Court is reviewing Kentucky's execution methods in a case that could change the way states perform lethal injections.

The case, Baze v. Rees, is challenging the combination of drugs used in Kentucky and by most other states that perform lethal injection. Richard Dieter, executive director of the Death Penalty Information Center, said nearly all these states use a three-drug "cocktail" in lethal injections.

The first drug is an anesthetic used to make the patient unconscious, the second paralyzes the patient and the third causes heart failure.

All three drugs alone can cause death, but Dieter said the reasons for using the combination are time and respect for witnesses and the patient. He said the second, paralytic drug serves a "cosmetic" purpose, preventing involuntary convulsing that can occur with heart failure to preserve the prisoner's dignity and make the execution easier for witnesses to watch.

David Barron, an attorney representing the two Kentucky death row inmates who are suing the state, said his clients are concerned with the three-drug method.

If the anesthetic fails, prisoners being executed would feel excruciating pain if their hearts stop, but they would also be paralyzed and incapable of communicating pain to those administering the injections.

Barron said the level of training for Kentucky executioners is insufficient for a complicated, multi-drug medical procedure. He said his clients are requesting a single barbiturate drug much like that used to euthanize pets, simplifying the procedure and eliminating the risk of pain.

According to Dieter, injections administered by non-medically trained prison guards are likely to result in error. He said someone with medical training, such as an emergency medical technician, inserts the needles into the prisoner. But because execution violates medical ethics the medically trained person will not witness the execution, push the plunger to inject the chemicals or monitor the patient during the procedure.

If a problem occurs, like missing a vein damaged by long-term drug abuse, the medical professional can attend to those problems, he said, but the professional is not typically present for the entire procedure.

Dieter said more qualified medical professionals are necessary.

"You're talking about a medical procedure," he said. "People who know how to enter a vein may not understand human physiology."

Execution technicians should be able, he said, to evaluate whether the procedure is working properly, adjusting dosages based on weight, size and medical history. Most importantly, he said, the technician should be able to determine whether the patient is properly anesthetized.

"To be adequately trained, they'd probably need doctor's training," he said.

The Rev. Pat Delahanty, assistant director of the Catholic Conference of Kentucky and chair of the Kentucky Coalition to Abolish the Death Penalty, said he worries a simple, pain-free method of execution could make people more comfortable about capital punishment.

"If the person laying on the gurney is innocent, it doesn't matter if there is a lot of pain, little pain, or no pain," he said.

Instead, Delahanty said the public should shift focus from the criminal's horrific actions to our own behavior in government and the penal system.

Marquette associate political science professor John McAdams said there is little medical evidence of excessive pain and that the Eighth Amendment, which names "cruel and unusual" punishment unconstitutional, was not intended to eliminate pain from capital punishment. However, he said an execution can't show reckless disregard for pain caused in an execution. If evidence shows that the three-drug method of lethal injection is prone to complications, the protocol for lethal injection might be adjusted.

Barron disagreed and said medical information is hard to come by in executions, especially in regard to pain.

"The patients are dead, they can't tell you if they were in pain," he said.

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