When Jonathan Groner put his dog to sleep, he knew the procedure would be quick and painless. He said he trusted the veterinarian because she euthanized dogs daily, and thought the procedure would be humane since dogs lacked a perception of time. On the other hand, he said there was no humane way to kill a human.

Since the botched execution of Joseph Clark last May, critics of Ohio’s lethal injection protocol have been pointing toward the immanent risk of torture in the execution chamber if a licensed anesthesiologist is not present.

"A humane execution is the ultimate paradox," said Groner at his Columbus Children’s Hospital office. The doctor of pediatric surgery and associate professor at Ohio State University College of Medicine and Public Health said he was troubled to see how the rise in Ohio executions was accompanied by the belief that lethal injections were non controversial. He drew a parallel between lethal injection procedures in the U.S. and concentration camp euthanasia programs in Nazi Germany (see sidebar interview).

The dilemma is this: In order to execute people without "inflicting torture" the state would have to employ licensed doctors to administer the chemical cocktail. But medical professionals are bound to an oath to do no harm, and are ethically unable to participate in executions. Groner refers to this vicious circle as the "executioners’ paradox." He believes that, ultimately, Ohio may have no choice but to halt executions and review its stance on the death penalty.

Last June the U.S. Supreme Court opened the door to challenges when it allowed death-row inmates to contest the deadly cocktail of chemicals used in executions. Four Ohio inmates (Richard Cooey, Jeffrey Hill, Arthur Tyler and Johnnie Baston) joined a lawsuit at the 6th U.S. Circuit Court of Appeals in Cincinnati, arguing that the state’s lethal-injection protocol constituted cruel and unusual punishment. Their claim was fueled by the May 2 execution of Joseph Lewis Clark, which had taken nearly ninety minutes. The state’s execution team had to close the public curtain when, roughly four minutes into execution, Clark said he felt pain in his arm. The lethal drugs were collecting under his skin rather than flowing into the vein. Clark raised his head from the gurney five times to say, "It don’t work."

This is why Groner thinks the state should call off executions altogether. "Do Ohioans really want to choose between torturing inmates to death or putting executions in the hands of doctors?" he wrote in an op-ed piece for The Toledo Blade. "This dilemma is inherent in lethal injection, because it puts killing in the hands of healers. The only way for Ohioans to avoid this untenable choice is to call for a moratorium until capital punishment can be re-examined."

Medical Doctor Says Ohio is Torturing Prisoners

Dorian Hall, the supervisor of investigators for the Ohio public defender’s office, said she heard "loud, intense, guttural moans and groans, like someone was in agony" during Clark’s execution. She testified at a Sept. 22 hearing to challenge Maryland’s execution protocol, saying that the noises were audible through the walls and window after the staff closed the curtain.

The three-step protocol for executing an Ohio prisoner includes:

  • Strapping the prisoner to a wheeled stretcher and injecting him/her with anesthetic sodium pentothal. Without anesthesia the inmate would experience asphyxiation, a severe burning sensation, and cardiac arrest. The drug’s purpose is to alleviate the pain and preserve the impression that lethal injection is a near-painless death.
  • Now unconscious, the prisoner is injected with pancuronium bromide (Pavulon), which paralyses muscles including the lungs and diaphragm. Pavulon is commonly used to immobilize patients during surgical procedures.
  • The two drugs are followed by an injection of potassium chloride, which causes cardiac arrest. This would also produce tremendous pain if given to a conscious inmate.
  • In 2005, a study published in the British medical journal, Lancet, gave credence to the claim that lethal injection was in fact inflicting pain. The authors found that on the basis of toxicology reports from six states, 43% of prisoners may have remained conscious after their dose of sedatives. That means the prisoner would have slowly suffocated under the muscle-paralyzing drug, perhaps suffering intense pain as the potassium chloride worked its way through the body.

    "It would be a cruel way to die: awake, paralyzed, unable to move, to breathe, while potassium burned through your veins," concluded Lancet in an editorial accompanying the study. The study’s authors compared lethal injection protocols with the ethical standards of the American Veterinary Medical Association, finding that in 19 states, including Ohio, these same neuromuscular blocking agents were prohibited when killing animals.

    Twenty-three death-row prisoners have died by injection since Ohio resumed executions in 1999. And since 2004 Ohio has executed 15 prisoners, which is more than any other state but Texas. Most of the state’s 195 death-row inmates are now housed at the Ohio State Penitentiary (OSP), a few miles East of downtown Youngstown, and off of state Route 616. One day before the execution the prisoner is transported to the death house at Southern Ohio Correctional Facility, in Lucasville.

    Donald K. Allen, who runs a veterinary clinic on 4501 Market St. in Youngstown, says he euthanises ill and elderly animals almost every day and usually administers twice the required dosage of anesthesia, to ensure that they are dead. When asked if the animal felt any pain, he speculated. "I think they taste it because almost always their tongues lick."

    The veterinarian, who supports the death penalty, said he doesn’t care much whether death-row prisoners suffer during executions. "These people feel a sting and then they’re gone," he said. The lethal injection controversy wasn’t a reason to end the death penalty. "As far as people’s characters go, I don’t have a lot of faith that you’re going to change them," he surmised.

    When California held hearings on the lethal injection protocol last month, Columbia University Medical School anesthesiology professor, Mark Heath, testified that prisoners were still breathing several minutes after personnel had administered pancuronium bromide, the muscle-paralyzing drug. At that point the prisoners were supposed to be deeply sedated, to protect them from the pain of the third drug.

    "If someone is breathing like that, they may not be in a deep plane of anesthesia. They may not even be unconscious," Heath said. Coincidentally, Ohio’s public defender asked Heath to give his expert opinion for use in the lawsuit, Cooey v. Taft. In it, Heath pointed out that Ohio uses only 2 grams of the barbiturate pentothal, a dose that’s considerably lower than what is prescribed in many other lethal injection states.

    Heath argued that Ohio’s lethal injection protocol created an "unacceptable risk that the inmate will not be anesthetized to the point of being unconscious and unaware of pain for the duration of the procedure."

    More Than One Way To Skin A Cat

    Lawyers representing both sides are expecting a federal appeals court ruling any day, regarding whether or not Ohio’s lethal injection protocol will go to trial. When asked what the state might do to improve the protocol, Heather Gosselin, a Senior Deputy Attorney General in the AG’s Capital Crimes Division, acknowledged that there was "more than one way to skin a cat."

    Gosselin said that the medical doctors who reviewed the state’s execution protocol disagreed with Dr. Heath’s assessment. "Our experts say that the 2 grams of sodium pentothal would render most individuals unconscious for a period of about two hours," she said. "All of these drugs are administered in a lethal dose. So if Ohio were to give the first drug and the first drug only, eventually the inmate would die."

    Does Ohio have medically trained staff on hand to prevent an execution from being botched? Gosselin said that licensed emergency medical technicians, paramedics and nurses are present. "We have a doctor who does not participate in the actual execution. His participation is limited to pronouncing the death at the conclusion of the three drugs being administered."

    When asked about the selection criteria for the execution team, Gosselin said she wasn’t at liberty to disclose further details. "The Cooey litigation is stalled right now on an interlocutory appeal. And as a result we haven’t gone through the formal discovery. I am not at liberty to give facts that haven’t made part of that affidavit."

    In his analysis of Ohio’s protocol, Mark Dershwitz, an anesthesiologist at the University of Massachusetts Memorial Medical Center, found no significant risk of the pain and suffering alleged by Richard Cooey’s attorneys. The professor noted that the risk that a prisoner would experience any pain associated with the infusion of lethal doses of pancuronium bromide and potassium chloride was "exceedingly small."

    Gregory W. Meyers, chief counsel for the Ohio public defender, whose lethal injection lawsuit on behalf Cooey dates back to 2004, said that Dershwitz’ opinion was only theoretical. "Who knows whether in practice it works out the exact way Dershwitz says?" Myers pointed out that recent lethal injection trials in Missouri and Maryland had demonstrated that the devil was in the detail. "Low and behold, they discovered in the Missouri case that the actual doctor involved there was dyslexic, and was altering how much of the pentothal to give according to his fancy. In Maryland, you learn that the actual execution team members were basically buffoons. They were made to look like a fool when it came down to whether or not they were even familiar with the protocol."

    In a letter from death row, Richard Cooey, who has met the members of the Ohio execution team first-hand, stated that the process didn’t seem to involve much medical expertise. "In July of 2003, I spent approximately 36 hours in the death house and am alive today only because of an eleventh hour stay of execution," Cooey wrote in a letter dated Sept. 28. The inmate noted that correctional officers were present, the vast majority of whom had at most a high school education, as well as EMT qualified medical staff, of course, the warden. "But none are qualified as doctors, cardiologists or neurologists. They are just average people who work the blocks and hallways at Southern Ohio Correctional Facility, nothing special."

    Two Murder Victims Weigh In

    For Rodney Bowser the question of whether lethal injection could amount to torture wasn’t the point. What mattered more was why the man who raped and killed his 21-year-old sister, Trina, had to be killed at all. The convicted killer, Glenn Benner, was executed by lethal injection on Feb. 7. Bowser thinks that Benner’s life would not have ended strapped to a gurney had there been more support for the idea of bringing the prisoner together with the victim’s family.

    Trina’s brother hadn’t always thought in this way. He had spent two decades cursing the former childhood friend who killed his sister in 1986. But as the execution date approached, he decided he wanted to talk with Benner and repeatedly tried to set up a meeting with him at the Ohio State Penitentiary in Youngstown.

    This endeavor was more complicated than he’d expected. He described how the state’s prosecutor, the victim’s advocate, and family members all strongly advised him against meeting the man who’d murdered his sister.

    When they finally met, on the day of the execution, and after two longer conversations on the phone, Bowser said he was ready to forgive his former childhood friend. "He was upfront and honest with me," Bowser recalled. "He didn’t do what everyone said he would. He didn’t go off and yell and scream and all that kind of stuff. He answered all the questions that we wanted to know for more than 20 years. He told me the truth."

    Bowser said he wished there would have been a way to stop the execution, and that Benner had considered his legal options more wisely. "He knew he could have stopped the execution at any time. All he had to do is file an amendment to the lethal injection lawsuit. That would have bought him enough time to make it through the 2006 election. And then, when you get a Democratic Governor you’re just not going to be executed. He knew he could have stopped this."

    For the brother of another murdered Ohio woman, Dawn McCreery, this type of forgiveness didn’t seem possible. Robert McCreery said he hoped Richard Cooey (one of the four death-row prisoners who filed the lethal injection lawsuit) would suffer as their loved one had the day she was raped and murdered in 1986.

    Cooey, 39, is on death row at OSP for kidnapping, raping, assaulting, and murdering 20-year-old Dawn McCreery and Wendy Offredo, 21. He has admitted to raping Offredo, but denies killing the two women, blaming his friend Clint Dickens, who at 17 couldn’t get the death penalty and is serving two life sentences at Warren Correctional Institution.

    Robert McCreery said he hopes Cooey is conscious during the execution process. "This punishment would be fitting the crime, wouldn’t it?" he asked. "It’s much less cruel and unusual punishment than strangulation, rape, and beating someone to death."

    The father of three acknowledged that Cooey’s death wouldn’t bring his sister back – a young woman who had been a University of Akron student at the time of her death. "But it’s going to make me feel that justice has finally been served," he said. "They set a verdict for punishment 20 years ago that still has yet to be carried out."

    Questioning the Eye for an Eye Society

    What would you do if someone murdered your wife or daughter?

    This is absolutely the hardest question to answer, said James Tobin, a board officer for Ohioans To Stop Executions. Tobin, who is Catholic, said that if he had lost a family member he hopes he would be able to come to a state of mind where he was able to control his anger. "I would tell people, ‘You know I really don’t want that person out in society. But I don’t want him dead either.’"

    Tobin said the fight over the lethal injections protocol is important, but perhaps not the most important initiative. He said he was afraid that Ohio would come up with just another drug cocktail. After all, hadn’t governments always argued that one execution method was more humane than the other, regardless of whether they used electric chairs, lethal gas, hangings, firing squads or the guillotine?

    He considered the arbitrariness of the death penalty to be the most important argument against it. In Ohio less than 2% of murders result in death sentences for convicted killers. From 1983-2000 there were 10,585 murders in the Buckeye state, but only 201 individuals were sentenced to death. "It seems that executions in Ohio are symbolic political rituals that single out a few offenders to die," Tobin said.

    Back in Dr. Groner’s Columbus Children’s Hospital office, I noticed a photo depicting the Western Wall in Jerusalem. The name of the embattled city meant "Heritage of Peace." Yet, the people living there hadn’t seen much peace. The idea of "humane executions" was another irony. I asked the professor what he would say to people who supported lethal injection.

    "All of Europe does not execute people," Groner said. "Our founding fathers’ conscious decision was that we wouldn’t be an ‘eye for an eye’ society. I would also say that you can judge a society by its prisons. How we take care of society’s ill off reflects on a society at large. And there is nobody worse off than a death-row inmate."