Nitrogen hypoxia: what you need to know about this new execution method

Alabama's planned execution of a death row inmate on Thursday evening will be carried out under a procedure never used for capital punishment in the United States.

The inmate, Kenneth Smith, who was convicted of a stabbing murder in 1988, will be put to death by inhaling nitrogen gas, a method known as nitrogen hypoxia.

Proponents of the method say it is quick and painless. But earlier this month, the United Nations Human Rights Office urged Alabama to halt the execution it could amount to torture and violate the human rights treaties to which the United States has agreed.

Alabama would be the first state to adopt nitrogen hypoxia, but other states are interested in adopting the method.

What is nitrogen hypoxia?

Hypoxia is a medical term for a condition of insufficient oxygen in the body. Nitrogen, a colorless and odorless gas, makes up about 78 percent of the air breathed by humans. But according to the method of nitrogen hypoxia, the person inhales only nitrogen, which leads to unconsciousness within minutes and then death from lack of oxygen.

How is the nitrogen administered?

According to the protocol Released by Alabama prison officials, members of the 'execution team' Mr. Strapping Smith to a gurney in the state execution chamber in Atmore. A mask will be placed on his head and it will release nitrogen, depriving him of oxygen. Many experts liken this process to placing a plastic bag over someone's head, although in that situation the person is breathing carbon dioxide instead of nitrogen.

Why is this method used now?

The standard method of execution since the 1980s has been the lethal injection of heart-stopping drugs. But states have had problems with lethal injections for years.

Some states have struggled to obtain sufficient quantities of drugs for lethal injections.

Even when dosed correctly, many executions have failed because the team administering the injection failed to locate the correct veins.

This is what happened to Mr. Smith in Alabama. He was scheduled to be executed by lethal injection in November 2022, but a team of people repeatedly failed to properly insert an intravenous line.

This problem often arises because medical ethics rules prohibit physicians and other healthcare professionals from assisting in an execution. The injections are therefore usually administered by inexperienced prison staff Dr. Joel Zivotassociate professor of anesthesiology at Emory School of Medicine and an expert on physician participation in lethal injections.

Lethal injections also involve drugs that, if administered incorrectly, can cause significant pain and suffering.

Proponents of using nitrogen hypoxia believe that it is an easier and more humane alternative because it does not require an injection and is quick and painless.

Has nitrogen hypoxia been used in other situations?

A few years ago, Dr. Philip Nitschke, an Australian physician and founder of Leave International, which advocates medically assisted suicide, developed a pod in which a patient could flip a switch and release the flow of nitrogen. He recently told The New York Times that he had witnessed about 50 deaths from nitrogen hypoxia.

Is there research into the impact of nitrogen on humans?

Very little, which is why some people believe it should not be used in state executions. Most reports in medical journals concern nitrogen exposure from spills and industrial accidents that kill workers, as well as suicide attempts.

In a 1963 experiment to study the effect of brief hypoxia on three healthy volunteers: “Most of them had seizures within 15 to 20 seconds of inhaling pure nitrogen,” said Dr. Zivot.

What are the disadvantages of this method?

Doctors say the inmate was able to vomit into his mask, which not only suffocated him but also loosened the seal, allowing oxygen to flow in and diluting the nitrogen.

Mr. Smith's lawyers have argued as much this is a likely scenario for Mr. Smithwho, they said, has been vomiting continuously in recent days, which they associate with the PTSD he suffered from the botched execution in 2022.

Corrections officials in Alabama said Mr Smith would not be fed after 10am on Thursday morning to reduce the chance of vomiting while on the stretcher.

Mr. Smith's head and body will be securely strapped to the stretcher to prevent flogging and mask displacement. It is not known whether he will be given a sedative before the execution, which would further reduce the chance of a beating. But Dr. Zivot noted that sedating a patient is a medical procedure and typically requires the intervention of a doctor.

Veterinarians have generally stopped using nitrogen to euthanize animals that showed severe signs of distress. Critics and supporters of the method absolutely disagree about whether nitrogen would bother a person.

“Nobody really knows what's going to happen,” says Dr. Jeffrey Keller, chairman of the American College of Correctional Physicians. 'So he'll suffocate? Will he throw up? Does the mask fit or is the nitrogen leaking out? Will that nitrogen be harmful to anyone else standing nearby? Nobody knows anything about this. It's an experiment.”