“A Tortuous Procedure Behind Closed Doors, Then a Theatrical Performance for Witnesses”: The Rise of “Botched” Executions and Death-Row Inmates’ Pleas for an Alternative Method

Written By: Taylor Fortenberry

Experts use the term “botched” to describe any execution involving unanticipated problems or delays that arguably cause unnecessary agony for the prisoner or that reflect the executioner’s gross incompetence. The execution method of lethal injection common in most states involves a three-step process including: Midazolam, a sedative; rocuronium bromide, a paralytic; and potassium chloride, which stops the heart.  Many critics argue that Midazolam leaves an inmate suffering immense pain, even if he looks peaceful during the execution.  This led many United States and European pharmaceutical companies to begin blocking the use of their products in lethal injections, causing many states to struggle to locate and purchase execution drugs.  As a result, “botched” lethal injection executions have spiked in the United States. 

The Longest Execution in History: Continued Problems Obtaining IV Access  

On July 28, 2022, Alabama inmate Joe Nathan James suffered the longest recorded execution in United States history. James’s execution by lethal injection was scheduled to begin at 6:00 p.m. Although this process should stop the inmate’s heart shortly after administration of the drugs, James was not pronounced dead until 9:27 p.m.—over three hours later.  Witnesses were not allowed to observe the execution until 9:00 p.m., but a private autopsy confirmed that the injection had begun long before that.  

This was no ordinary execution.  Needle marks riddled James’s body. The process of shoving IV catheters into his knuckles and wrists left his skin painted hues of purple. James did not open his eyes during this procedure, nor did he make any deliberate movements. When asked, James offered no final words before his death. 

After the execution, the Alabama Department of Corrections (“ADOC”) issued a statement indicating that its team had trouble setting James’s IV line.  The ADOC refused to confirm whether James was sedated during his execution and admitted to being unsure whether James was “fully conscious” throughout the procedure.  Death Penalty Information Center Executive Director Robert Dunham claimed that the execution “[was] among the worst botches in the modern history of the U.S. death penalty.” Maya Foa, executive director of the human rights organization that funded James’s autopsy, declared that the execution had been “a tortuous procedure behind closed doors, then a theatrical performance for witnesses.”

James’s execution marked the second time since 2018 that Alabama personnel had encountered significant problems setting an IV line.  In February 2018, execution personnel failed to properly place Doyle Ray Hamm’s IV line, and he suffered for two and a half hours.  Hamm suffered 11 puncture wounds during the process before the ADOC commissioner finally called off the execution.  

Concerns Over “Botched” Lethal Injections

Alabama is not the only state that has experienced “botched” lethal injections. Oklahoma began its plan in August of 2022 to execute one man per month, equating to about twenty-five prisoners over the next two years.  According to critics and experts, this plan is troubling considering the state’s history of “botched” executions.  A number of inmates slated for execution in Oklahoma sued Oklahoma Department of Corrections officials in federal court, claiming that the sedative Midazolam would not render them adequately unconscious and could put them at risk of severe pain as they died.  They argued that such pain would violate their Eighth Amendment protection against cruel and unusual punishment.  The judge disagreed and cited Bucklew v. Precynthe, a United States Supreme Court ruling in which Justice Neil Gorsuch stated that the Eighth Amendment “does not guarantee a prisoner a painless death.”

An Inmate’s Unsuccessful Attempt at Execution by an Alternative Method

Unsurprisingly, the frequency of “botched” lethal injections has led death-row inmates to seek execution by other means—such as by nitrogen hypoxia, which deprives the inmate of the oxygen necessary to maintain bodily functions.  These proposals of execution by means of nitrogen hypoxia arose due to numerous problems with lethal injections over the past decade.  Oklahoma, Alabama, and Mississippi have approved the use of nitrogen hypoxia but have not yet attempted to use the method.

Alabama death-row inmate Alan Miller was scheduled to be executed by lethal injection on September 22, 2022.  Miller asserted that he wanted to die by nitrogen hypoxia, an untested and unproven execution method.  Miller and his attorneys pointed to James’s and Hamm’s executions to emphasize the apparent risks of lethal injection.  On September 19, 2022, a federal judge issued a preliminary injunction prohibiting Alabama from executing Miller by lethal injection.

Less than three hours before Miller’s death warrant expired at midnight on September 22, in a 5-4 order without explanation, the Supreme Court overruled the federal judge and held that Miller could be executed by lethal injection. Alabama execution personnel attempted to go forward with Miller’s execution by lethal injection before the midnight deadline.  However, the execution was ultimately called off due to time constraints from the Court’s late ruling and difficulties accessing Miller’s veins in accordance with protocol.  


The Supreme Court has never sided with a condemned inmate in any method-of-execution case in all of American history.  Because of the issues surrounding obtaining drugs for lethal injection, some states are turning to other execution methods.  Proponents of alternative methods of execution argue that given the recent “botched” lethal injections, other methods may be more humane.  Opponents of alternative methods argue that drug companies’ objections to the use of their drugs in lethal injections signal a need to abolish the death penalty.  Considering the increasing number of “botched” lethal injection executions, it is difficult to see how subjection to this method of execution escapes designation as cruel and unusual punishment.