What's at Stake in the Lethal Injection Arguments

The Supreme Court on Monday hears arguments in a landmark case about lethal injection — the most common method for carrying out the death penalty in the United States. Death penalty opponents argue that lethal injection is inhumane and want it stopped. Corrections officials insist that the method is indeed humane — far more so than the electric chair or the gas chamber. Here are some of the main issues at stake.

Why is the Supreme Court hearing this case now?

The court is responding to a pair of Kentucky lawsuits challenging the lethal three-drug cocktail used in most U.S. executions. Lawyers for two defendants sentenced to death argue that lethal injection violates the Eighth Amendment prohibition against "cruel and unusual punishment." They point out that animals are put to death by using a simple — and they claim more humane — single drug. They also point to a botched execution in 2006 in Ohio, where it took an hour to dispatch an inmate. At one point, according to court records, the inmate cried out, "It don't work."

Is the Supreme Court ruling on whether to abolish the death penalty?

No. The case is about the method used to execute convicted criminals, not the larger issue of whether the U.S. should abolish the death penalty.

So why is this case so important?

The last time the Supreme Court ruled on a method of execution was in 1878, when it upheld death by firing squad. The court's ruling in this case could affect how dozens of states carry out the death penalty, and it could indirectly alter the debate over the death penalty itself. A majority of Americans (69 percent) say they support the death penalty in principle, but that number is considerably lower than it was five years ago, according to surveys conducted by the Gallup organization.

When did the Supreme Court first agree to hear these cases?

Last September.

What's happened since then?

After the high court agreed to hear these cases last fall, a last-minute stay of execution in Texas was denied, and the prisoner was executed. After that, the Supreme Court granted stays of execution in numerous cases — sending a strong signal to the states to hold off on executions or risk court intervention. More than 40 people received stays of execution because of lethal injection challenges. Forty-two people were executed in the U.S. last year, the lowest number since 1994.

How exactly does lethal injection work?

The condemned inmate is strapped to a gurney and sedated with sodium thiopental, rendering the person unconscious. Then he is injected with a paralyzing agent, called pancuronium bromide, which stops the breathing muscles, and finally a dose of potassium chloride, which stops the heart.

Why do opponents call lethal injection inhumane?

Death penalty opponents argue that there is ample evidence that the current three-drug cocktail poses an unnecessary risk of pain and suffering. Anesthesiologists and end-of-life doctors contend in briefs filed with the court that if a person is not properly anesthetized, the paralyzing agent will prevent him from being able to indicate any distress, and that pancuronium bromide can make him feel as if he is suffocating. And medical experts say that if the person isn't properly anesthetized, then the third drug, which stops the heart, will be excruciatingly painful, making the prisoner feel as if his veins are on fire.

Why do most states use lethal injection to carry out the death penalty?

Because it was considered a more humane way of executing the condemned. The lethal injection method was developed in Oklahoma and first used in 1977.

How widespread is the use of lethal injection today?

Very. Of the 37 states that have the death penalty on their books, 36 use basically the same three-drug protocol for lethal injection. Nebraska uses the electric chair to execute people. (Four other states use the electric chair as an "optional" form of execution.)

What might happen after the Supreme Court ruling?

If the high court backs the procedure, it could result in a spike in the number of executions once states feel the legal ambiguity has evaporated. That's what happened in Texas in the mid-1990s. The state carried out only three executions while courts hashed out a new habeas corpus law. Within a year, the number of executions rose to 40.

With additional reporting from Legal Affairs Correspondent Nina Totenberg.

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