There Is No Such Thing as a Safe Execution

Never mind all that talk about Oklahoma’s botched execution of Clayton Lockett, who was supposed to be put to death yesterday by lethal injection and instead died of a massive heart attack when one of the lines running into his arm blew out, causing the vein to rupture. He’s dead, ain’t he? Job done.

That’s one of the historical problems with the whole business of executions, of course: they are designed to end a condemned person’s life, but the process is supposed to be conducted just so—cleanly, predictably, ceremonially, so that the sanctioned taking of a life is somehow distinguished from the homicide for which the condemned person is usually dying. That’s the reason too for some of the absurdities in the execution rituals, like loading one of the guns used in a firing squad with a blank, so that all of the riflemen can later tell themselves they may have done no killing; or using an alcohol swab on the spot on the arm into which a needle will be inserted, which prevents germs on the skin from entering the body and causing an infection later on—hardly necessary when later on will come long after the person is dead.

But the thing is, even the most carefully designed medical procedure—and whatever else an execution via lethal injection is, it’s that—is not entirely without risk. In 2010, the National Institutes of Health conducted a study on 333 patients to determine whether ultrasound should be used to help guide the insertion of a central venous catheter, a line threaded into one of the body’s major vessels to deliver fluids or steady doses of medication. The procedure carries up to a 15% rate of complications, including infection, bleeding, clots around the catheter and, depending on placement of the line, collapsed lungs. And that’s when highly trained people are working on large, hard-to-miss vessels.

(Read More: Every Execution in U.S. History in a Single Chart)

Much of the debate swirling around the Lockett case involves the mix of three chemicals that were used in the execution, which had never been tried in Oklahoma before, and the increasing unavailability of more familiar drugs as pharmaceutical companies balk at allowing their use in capital punishment. Similarly, as medical personnel also refuse to participate in executions, the job is often being done by prison officials whose training may be inadequate.

But let’s assume the best-case scenario—with just the right drugs and just the right experts injecting them. The Death Penalty Information Center has compiled a list of 44 botched executions—32 of them by lethal injections—many from the 1980s and 1990s, when those ideal conditions prevailed. There was the 1988 execution of Raymond Landry in Texas, which went south when the line administering the drugs came loose, spraying the deadly cocktail of chemicals around the room; there was John Wayne Gacy in Illinois in 1994, whose execution was stopped and restarted when the drugs mysteriously hardened, forming a clot in the line; there was Joseph Cannon in Texas in 1998, whose vein collapsed during the procedure, causing the needle to pop out. “It’s come undone,” the condemned man informed the witnesses, which may or may not have been his last words.

Often, problems during lethal injections are caused by poor veins resulting from a history of intravenous drug abuse. But other times, the prisoner is fit. In the case of Lockett, the director of the Oklahoma Department of Corrections blamed vein failure, but Lockett’s attorney, David Autry, disagrees.

(Read More: Oklahoma’s ‘Constitutional Crisis’ Ends With Execution Date Set)

“I’m not a medical professional,” he told the Associated Press, “but Mr. Lockett was not someone who had compromised veins. He had large arms and prominent veins.” If that’s so, and a full investigation of the mess is still very much under way, the problem could instead have been caused by the multiple lines—one in each arm, which doubles the odds of error—or the untested nature of the particular drug combination.

Whatever the cause, the great certainty is that executions have never been—and will never be—foolproof. Nooses fail to kill cleanly, electrocutions set fire to skin, asphyxiating gases cause convulsing and head banging. There is no denying that many of the people we put to death are the worst of the worst; Gacy raped and killed at least 33 boys and men. “If a man ever needed dyin’ he did,” as the song lyric once went. But it’s still for us to decide how we want to answer that need—either by execution or, even in the case of a monster like Gacy, life behind bars. If we do decide to kill, we should not pretend we’ll ever get it completely right.