On paper, Tennessee's death penalty protocol looks neat.
asserted
protocol → look → paper
At 10am on the day of the execution, four syringes are prepared inside the lethal injection room.
asserted
syringes → prepare → room
Two of them contain saline solution.
asserted
Two → contain → solution
The other two contain pentobarbital, a lethal sedative most commonly used to euthanase animals.
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two → contain → animals
The inmate is restrained on a gurney, and a team of at least two physicians establishes intravenous lines and a catheter.
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team → restrain → lines
The camera turns on, the curtain goes up.
asserted
curtain → turn → ?
By 10:10am the drug has been administered and a five-minute wait begins.
asserted
wait → administer → 10:10am
If the inmate is still alive, the process repeats.
asserted
process → repeat → ?
There is no protocol for what happens if the inmate does not die.
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inmate → be → ?
There is also no mention of what death by pentobarbital overdose can look like.
asserted
death → be → overdose
By the time Christa Pike entered the execution chamber on September 30, pentobarbital had been the drug of choice for multiple death penalty states for more than a decade.
asserted
pentobarbital → enter → decade
It is a type of barbiturate, or depressant, that slows brain activity and sedates the receiver.
asserted
that → slow → receiver
To many Australians it's better known as Nembutal, a euthanasia drug, referred to by advocates as the "peaceful pill".
asserted
it → know → pill
But its effects on the central nervous system are severe, according to Andrew Crowe, an associate professor in pharmacology at Curtin University.
uncertain
effects → accord → University
"In the central nervous system, there are … neurons that are excited, [and] then we have inhibitory neurons," he told the ABC.
asserted
he → be → neurons
"They try to tell the other neurons: 'I've had enough of that, let's just suppress and go to sleep.'
asserted
's → try → sleep
"What the barbiturates do is tell the inhibitory neurons they can work a lot better, they can work longer."
The drug inhibits the respiratory sensors and cardiovascular sensors, according to Professor Jonathan Brett, a clinical toxicologist at the NSW Poisons Centre.
uncertain
drug → tell → Centre
"You essentially gradually stop breathing and then your blood pressure drops, your heart rate drops and eventually your heart stops as well,"he said.
asserted
heart → stop → ?
Many states began using lethal injection as a "more humane" alternative to other execution methods, according to the Death Penalty Information Center.
uncertain
states → begin → Center
In a medical scenario, the safe dose to sedate a human being is 1-5 micrograms per millilitre.
asserted
dose → sedate → millilitre
A toxic dose is about 1 gram of the drug, according to the US Food and Drug Administration.
uncertain
dose → accord → Administration
Tennessee's execution protocol calls for two syringes containing a total of 5 grams of pentobarbital.
asserted
protocol → call → pentobarbital
But the drug will only dissolve in an extremely strong solution, according to Dr Crowe.
uncertain
drug → dissolve → Crowe
"As soon as we start moving to the execution level … it has to be injected, and therefore it must be in a solution," he said.
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he → start → solution
"
Tissues 'annihilated', risk of 'drowning' while alive
The human body works in a very narrow pH range, close to neutral, or water.
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body → annihilate → range
Pentobarbital, on the other hand, is a highly alkaline substance, with a pH closer to household detergents or cleaners, according to a federal review of lethal injection protocol.
uncertain
Pentobarbital → accord → protocol
The US Justice Department review found that the drug would only dissolve in either a highly acidic or a highly basic solution.
asserted
drug → find → acidic
That same review found using pentobarbital ran the risk of "extreme pain upon the initial injection", and something called "flash pulmonary oedema".
asserted
using → find → injection
"In essence, the drug's pH level is so high that it damages the blood vessels in the lungs and causes them to fill with fluid, leading to the feeling of drowning,"the review said.
asserted
review → damage → feeling
In Christa Pike's case, experts have speculated that the drug did not enter the vein, but the tissue surrounding it.
asserted
drug → speculate → it
If that happened, Dr Crowe told the ABC, it would mean the pentobarbital and the solution it was mixed into did not have the chance to dilute into the bloodstream.
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it → happen → bloodstream
"And so it stays there, and unfortunately your body tends to be quite soluble in pH 11, and so it starts dissolving your tissues and dissolving your blood vessels," he said.
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he → stay → vessels
"Any pain receptors that are there before they get annihilated are going to be sending some very strong signals to the brain.
asserted
they → annihilate → brain
"And so those pain receptors are triggering like crazy and causing excruciating pain, while the tissue itself is going to end up dying where that base has been injected.
asserted
base → trigger → pain
"
Pike believed to be brain dead before waking, lawyers say
Pike, 50, had been waiting on death row since 1996 after being convicted of the murder of a classmate, Colleen Slemmer, when she was 18.
She received two doses of pentobarbital on September 30 before being rushed to a nearby hospital from a maximum security prison in Nashville.
asserted
She → believe → Nashville
Pike is the only person on record to receive the lethal injection drug and survive, according to the Death Penalty Information Center.
uncertain
Pike → receive → Center
Overnight her legal representatives told the media they had believed her to be brain dead and on life support on Monday.
asserted
her → tell → Monday
By Tuesday, she was awake and talking, lawyer Randy Spivey said.
asserted
Spivey → talk → Tuesday
"What we do know is that Christa has a long road to recovery," he said.
asserted
he → know → recovery
"She has a blood clot in one of her arms, she has pneumonia, she is not able to swallow yet, so she has not eaten.
"
asserted
she → have → pneumonia
…and 7 more, not listed.
The Aporia
