Thank you. It would be nice if you could cite some court case.

@IKnowNothing - A court case for what? As far as I'm aware, this isn't a question that a court has previously ruled on.

Ok, then do you know of any examples where someone overdosed on a drug that makes someone unconscious and that caused them to come out of unconsciousness?

People survive overdoses almost every day. What sort of "example" are you looking for?

It's obviously uncommon but it does happen that hospital anesthesia fails and the patient ends up feeling the operation but being unable to communicate. bbc.com/future/article/… Presumably one of the questions that the experts would weigh in on is how likely that is with an untrained person trying to administer the drugs.

Isn't it possible that someone could attend medical school and learn just as much about anesthesiology as a surgical anesthesiologist would know, but then not take any oath, so ethics rules wouldn't be binding? That would only work if that person only administered anesthesia to prisoners being executed, so it might be a practical issue even if it's a legal possibility?

@Someone - Maybe. Not sure how such a person would deal with residency. They'd need to be a doctor and be bound by ethics rules. You could theoretically find a board certified anesthesiologist that agreed to publicly take part in an execution knowing it would cause them to lose their license. Then you'd have the question of whether the law cared about a licensed doctor or merely someone that had all the appropriate training. But no doctor is going to agree to lose their license for the chance to participate in a handful of executions a year.

@Someone: The pragmatic approach would be to hire someone who lost their license and believed regaining it was unlikely.

@JustinCave, But you wouldn't need to "learn just as much about anesthesiology as a surgical anesthesiologist would know" because surgery requires a very careful and specific level of unconsciousness to be maintained, (often via IV) over a significant period of time, (oftentimes hours!) and the goal is that they come back unharmed. Really all you would need to know is how to affix a mask, dial a regulator to the appropriate pressure, open a valve, and monitor heartbeat for some number of minutes until it stops.

Let us be clear about something. Nitrogen is benign: what would kill the condemned is LACK OF OXYGEN, since the air that would surround him is pure nitrogen. Ordinary air is about 80% nitrogen, and it doesn't hurt you at all, but nearly all of the rest is oxygen, without which you would die in a few minutes.

I'm not sure I see the need for extensive medical training here? What are the possible failure modes of the anesthetism? ... a) You accidentally kill the patient .... oh well, nbd. b) the patient is still conscious ... well ... that's no worse than it previously was, right? you still perform the same execution on the patient.

From some brief googling (granted, that's in no way a thorough search of the literature, but still ...) I see no evidence of cases where the anesthetism itself was painful ... only cases where the patient experienced the pain of the procedure that followed the failed anesthetism.

General anesthesia is complicated because care has to be taken to not cause damage to the patient. The dosage has to be calculated carefully, as too high of a dosage can later cause health complications. But if the prisoner will die anyway, this is not an issue. If the needle is not sterile and the prisoner contracts HIV, it's not an issue, etc.

Another practical issue that regularly pops up in Dutch news reports about executions in the US is that pharmaceutical companies are simply refusing to sell their drugs to be used for the death penalty. They don't want to be associated with it. For example this article from 2014, and this more recent one from 2021 both mention pharmaceutical companies not wanting to provide drugs for executions anymore...

... and the 2021 article also mentions states trying to find a way around that by using just 1 injection, instead of three (the first of which would generally be an anesthetic agent). According to Wikipedia, most execustions prior to the latest one done with nitrogen were done by lethal injection. This makes it seem to me that the most recent case is just another case of 'trying to find a way to make it work'.

The paralyzed but awake patient scenario isn't an issue with execution. General anesthesia has goals beyond just making the patient unconscious. One of them is to prevent the patient from moving during surgery, for obvious reasons. Drugs called paralytics are used for this purpose. Nightmare scenarios where the patient is aware during surgery happen because the paralytics prevent the patient from indicating that they are still conscious. In an execution scenario, paralytics would not be needed, so that entire scenario is not a factor.

@barbecue The point of this is presumably to ensure that the prisoner doesn't suffer during the execution, so we don't violate "cruel and unusual punishment". If the prisoner is conscious and suffering, it doesn't matter whether they can tell the executioner, it's already happened.

@Barmar you missed my point. Another commenter brought up the anesthesia scenario where a patient is aware and can feel, but unable to move or express themselves. These cases are awful, but they only happen during medical anesthesia. This scenario simply would not happen. The prisoner's state of consciousness would be obvious. If the goal is to kill the prisoner, there's no point in using anesthesia procedures whose purpose is to preserve life. My personal opinion is that the entire long, drawn-out ceremony of execution is itself fairly cruel, but that's not going to change.

The other potential side effects of bad anesthesia, like paralyzing the diaphragm, might result in execution via suffocation, which in the rare case of them not going under...

What I don't get is why they don't use seized drugs off the street. They should have no difficulty obtaining ten times a lethal dose of fentanyl these days.

At the risk of sounding overly cynical, you don't need an MD to conduct anesthesia. You need someone who had the training in the past. There are ex-doctors no longer bound by their oaths who were booted for reasons that don't put their capability in question. They'd represent a potential recruiting pool.