According to the New York Times, the muscle relaxant pancuronium bromide may render a person helpless without dulling pain. Used in about 30 states in combination with two other drugs that cause death, the drug may leave inmates wide awake as other medications cause them to suffocate slowly.
Two years ago, Tennessee made it a crime for veterinarians to use the drug when putting pets to sleep. More recently, a judge there found it had "no legitimate purpose," and merely "gives a false impression of serenity to viewers, making punishment by death more palatable."
"The subject gives all the appearances of a serene expiration when actually the subject is feeling and perceiving the excruciatingly painful ordeal of death by lethal injection," Davidson County Chancellor Ellen Hobbs Lyle wrote in a decision where, despite those concerns, she upheld the legality of lethal injection.
Lyle made her ruling on the appeal of a death row inmate, Abu-Ali Abdur'Rahman, who has been sentenced to die for a 1996 murder. Besides their claim that lethal injection constituted cruel and unusual punishment, Abdur'Rahman's supporters say he is mentally ill. The European Union has written to Tennessee's governor pleading for clemency.
Of the 38 states with the death penalty, 37 use lethal injection; in 29 it is the only method, while in the other 10 prisoners can choose between fatal drugs and an alterative method, such as hanging or gas. Nebraska uses electrocution only.
There were 71 executions in the United States last year. One was by electrocution, the others all by lethal injection.
Lethal injections typically consist of three drugs: a short-acting barbiturate sodium thiopental, pancuronium bromide and potassium chloride to stop the heart. Sodium thiopental can wear off in minutes, The Times reports, while the pancuronium bromide paralyzes the victim and potassium chloride causes extreme pain.
"You're in a chemical tomb," said anesthesiologist Mark Heath, a witness in Abdur'Rahman's appeal.
Another person who testified for Abdur'Rahman, Carol Weihrer, had eye surgery five years ago in which she was given anesthesia and pancuronium bromide. The anesthesia failed to dull the pain but she was unable to tell doctors that she was fully conscious for the very painful procedure.
"I remember using every ounce of my strength to try to move," Weihrer testified, calling the sensation "worse than death."
According to The Times, the warden who developed Tennessee's injection method did not seek medical advice in doing so. The first state to develop a lethal injection method, Oklahoma, did so on the advice of a physician who claimed the combination of barbiturate and pancuronium bromide is "a rapid, pleasant way of producing unconsciousness." That physician stands by his assessment.
Arguing against Abdur'Rahman's appeal, the state said that since lethal injection in practiced by about 30 other states it cannot be considered cruel or unusual. It argued the law barring veterinary use of pancuronium bromide does not apply to Abdur'Rahman because he is not a "nonlivestock animal."
Opponents of the use of pancuronium bromide suggest replacing the three-drug cocktail with a single, lethal dose of sodium pentobarbital, a barbiturate.