Between 2019 and 2023, out of the 92 executions conducted in the United States, 89 of them were carried out using lethal injection. The remaining three executions were performed using the electric chair. Typically, a combination of three drugs, including an anesthetic, a paralytic, and a heart-stopping chemical, is used for lethal injections. However, several American pharmaceutical companies have ceased supplying these drugs due to their reluctance to be associated with the death penalty.

The European Union has prohibited the export of any drugs that could potentially be used for executions. As a result, certain states in the United States are searching for alternative methods. Five states, including Idaho in 2023, have given approval for execution by firing squad, a method that was last employed in Utah in 2010. Additionally, three states—Alabama, Mississippi, and Oklahoma—have authorized the use of nitrogen gas for executions.

Nitrogen, which constitutes 78% of the air we breathe, is safe only when mixed with oxygen. However, during an execution, the inmate inhales pure nitrogen through a mask, leading to asphyxiation.

Asphyxiation is the state of being deprived of oxygen, typically caused by the inhalation of pure nitrogen, leading to suffocation. The research on death by nitrogen exposure is limited, primarily consisting of records of accidents or suicide attempts found in medical journals. Studies on oxygen deprivation indicate that it can produce pain resembling that of a heart attack.

Nitrogen hypoxia can result in prisoners experiencing involuntary bowel movements or vomiting while still being conscious. According to the euthanasia guidelines of the American Veterinary Medical Association in 2020, nitrogen hypoxia is deemed as an unsuitable method of euthanasia for most mammals due to the distress it causes. Additionally, if the prisoner's mask is not properly positioned, there is a risk of nitrogen leakage, potentially endangering others present in the room, such as a spiritual advisor.

Euthanasia is the deliberate action of ending the life of a person or an animal, usually with their consent in the case of humans or the consent of their owners in the case of animals. This is done to alleviate their suffering caused by a terminal illness or an incurable condition.

Just a few weeks prior to Mr. Smith's scheduled execution, the United Nations Office of the High Commissioner for Human Rights cautioned that the procedure could be considered as a form of torture. However, the Supreme Court of the United States dismissed a last-minute attempt by the prisoner's legal team to prevent the execution from taking place.

Witnesses reported that Mr. Smith remained conscious for a few minutes after the procedure started and appeared to be in severe pain. The Reverend Jeff Hood, who was Mr. Smith's spiritual advisor, described the distressing sight as minutes of someone fighting for their life. According to those present, it took approximately 22 minutes for Mr. Smith to pass away.

Alabama has a troubled past when it comes to executions, much like other states. One of the challenges it faces is the difficulty in finding qualified medical personnel who are willing to carry out lethal injections. This is because both the American Medical Association and the American Board of Anesthesiology prohibit their members from participating in such procedures.

The initial effort to execute Mr. Smith was cancelled due to difficulties encountered by the staff in inserting an intravenous line in his arm. This incident marked the third consecutive execution attempt in which Alabama officials faced challenges in administering lethal injections. In a separate case, one inmate managed to survive the procedure, while another, there was a three-hour struggle during the execution, which posed a major challenge for the officials involved. (IPA Service)