John Oliver prepares to talk about lethal injections on Last Week Tonight

Lethal injections have been promoted as the kinder, gentler way to execute people in the modern world. John Oliver wonders if this is really true

“For some reason, lethal injections aren’t something people want to think about,” said host John Oliver.

State-approved killing isn’t exactly dinner table conversation. Even if it may horrify your mother and father, however, we’ve got to talk about it. Merely letting things continue as they are have serious moral implications.

First, let’s acknowledge that people may have different views on the death penalty. For many, including Oliver, they don’t support any iteration of executions. It’s expensive, doesn’t seem to have any effect on crime, and is also morally wrong. Oliver took care to lean into that final point. Consider also the number of people who are wrongfully convicted, some of whom have sat on death row. A few who have already passed on could have been innocent, though most legal bodies get too squeamish to consider the possibility once someone has already died.

Even if you do support the death penalty, you have to think about the actual process of it all. It’s been a subject of consideration for many generations, especially if the still-living people want to consider themselves “humane”.

How did we get here?

Lethal injections became popular because the electric chair and other methods were painful and traumatizing. Electrocution, one of the more popular methods prior to the rise of lethal injection, is “objectively horrifying”, said Oliver. So, aren’t injections objectively better? They’ve been presented as a straightforward way of putting someone to sleep, forever.

Well, that might be so if it weren’t for the complications. For one, it’s not medically kosher. Doctors and other medical professionals are almost never involved in lethal injection executions because of the Hippocratic oath. “First, do no harm,” doesn’t clear a physician to kill someone with a chemical cocktail, no matter how gentle it may or may not be for the prisoner strapped to the table.

This means that people who actually administer the injections don’t have the right training. Under the best circumstances, they are amateurs. Under worse circumstances, it can become utterly gruesome.

For context, let’s talk about the process currently in use. Most states administer lethal injections in three steps. First, an anesthetic is injected into the condemned person’s veins, followed by a paralytic. That second drug is more for the benefit of viewers, keeping the person being executed still. Flailing limbs do not sit well with the moral consciousness of witnesses. The third injection is meant to actually kill the person via cardiac arrest.

If the first injection goes wrong, an individual can be paralyzed but still conscious while they are put to death. They may feel as if they are suffocating while the paralytic takes over their body. The final injection can also be very painful.

Medical “professionals”

This means that properly administering a general anesthetic is critical. Sodium thiopental was initially the drug of choice, but it’s no longer available in the United States. Other states attempted to purchase sodium thiopental from straight-up illegal sources from outside of the country. Even with morally questionable buying methods, those sources have also diminished to nothing.

Now, midazolam is more widely used. It has greater availability, but a crucial flaw: it’s a sedative, not an anesthetic. Midazolam also doesn’t have any painkilling properties.

How did midazolam rise to prominence? That’s thanks largely to Dr. Rozwell Lee Evans, who hasn’t done any studies concerning sedatives or anesthetics. He hasn’t even administered an anesthetic to a person himself, though he’s a teacher of pharmacy at Auburn University.

Some condemned inmates have pleaded against the use of midazolam in their own executions. Arizona has said that inmates can provide their own lethal injection drugs, which has a bit of a snag when you consider that incarcerated people don’t really have access to highly restricted drugs.

Clayton Lockett

If you need a more personal view, consider the end of Clayton Lockett, an Oklahoma inmate executed in 2014. The process took over 40 minutes. Lockett attempted to rise up off the table, writhed, spoke to others, and moaned during the process. An inexperienced medical attendant repeatedly tried to insert an IV and failed, even striking an artery and creating a bloody mess.

Lockett was also accidentally given intramuscular injections, not intravenous injections into his veins. The people in charge of the proceedings looked up information on “Wikileaks or whatever” and thought things would be okay. They were so sure, apparently, that they didn’t bother having a backup supply of drugs or a secondary plan.

Statistically speaking, lethal injection has the highest rate of botched executions. Some inmates have actually requested executions via electric chair because they believed it would be more reliable and less painful.

Frankly, lethal injections are not the peaceful alternative many believe them to be. Lee Kozinksi, a now-disgraced federal judge, even said that the guillotine would be better and more reliable.

What to do?

What are the alternatives? Techniques currently used in assisted suicide don’t work because methods for ill people don’t necessarily work on potentially healthy inmates. It’s also unlikely that drug companies will want to work with executions. Intentional opioid overdoses have been attempted, but take too long.

Other techniques also have their own deep problems. Cyanide gas chambers were so bad that one made an attorney general vomit. The attending warden at that 1992 execution also threatened to resign if he had to oversee another cyanide gas-based execution.

At one point, you may begin to wonder: why execute criminals at all? It seems there is no way to remain “humane” in the matter. “It is a show,” said Oliver, one put on for people who are in favor of the death penalty without being willing to confront its fundamental brutality.

Why should be care about death row inmates anyway? Aren’t they generally vile people? “It isn’t about who they are. It’s about who we are.” In the end, this decision is more about deciding who we are as a society, and what we can live with when we confront the reality of state executions.