The lethal injection, the primary method of execution in the United States for decades, remains controversial amid reports of botched procedures. In 2014, the execution of Clayton Lockett in Oklahoma took 43 minutes, during which he 'thrashed on the gurney, writhing and groaning'. Officials later revealed that the single vein into which the drugs were being administered had 'blown'.
The three-drug cocktail used in many states, including Arkansas, comprises midazolam (a sedative), vecuronium bromide (a muscle paralytic), and potassium chloride (to stop the heart). Midazolam, a benzodiazepine, is given at a dose of 500mg in Arkansas, far exceeding the 10mg typically needed to induce unconsciousness. However, critics allege that some inmates have appeared to regain consciousness mid-execution.
During the 2014 execution of Dennis McGuire in Ohio, which used a combination of 10mg midazolam and 40mg hydromorphone, McGuire was seen 'gasping' for air for 10 to 13 minutes of the 24-minute procedure. Similar scenes were reported during the execution of Joseph Wood in Arizona. Following McGuire's execution, Ohio raised its dosage to 50mg of each drug.
In April 2017, an Associated Press reporter witnessed the execution of Kenneth Williams in Arkansas, noting that Williams lurched and convulsed 20 times after the injection of midazolam. About three minutes into the execution, his body jerked forward 'in a series of what seemed like involuntary movements', lurching violently against the leather restraint across his chest.
Dr Joel Zivot, an associate professor of anesthesiology and surgery at Emory University in Atlanta, has criticised the use of midazolam, suggesting it may not reliably render inmates unconscious. The controversy has led some inmates, such as Alabama's Thomas D Arthur, to request execution by firing squad instead, arguing that midazolam could contribute to 'prolonged torture'. The Supreme Court denied Arthur's appeal, and he was executed by lethal injection in May 2017.
