According to the Death Penalty Information Center, Christa Pike has become the first prisoner in U.S. history to survive a complete execution attempt, with her case described as “the worst we’ve seen and unlike any other botched execution in the modern era.” This unprecedented event may significantly impact the future of lethal injection as a method of execution, raising critical questions about its reliability and ethical implications.
About 7,000 people were executed in the U.S. between 1900 and 1976, and 1,683 people after 1976. Since 1900, only 0.6% of those executed have been women. Pike is now the second woman on death row who the U.S. Supreme Court declined to rescue from a botched execution.
A similar case occurred in 1953, when Ethel Rosenberg’s execution by electric chair failed due to improper settings for her size. A doctor examined her and informed the state that she was not dead, and she had to be electrocuted a second time. This case highlights the risks and challenges associated with executing women.
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Lethal Injection Protocol
The lethal injection protocol was originally pioneered by Oklahoma’s state medical examiner, Jay Chapman, in 1977. It was later adapted by Jack Kevorkian as a method of “medicide.” The U.S. Supreme Court sanctioned state executions again in 1977, seeing lethal injection as a “sanitized, quasi-clinical procedure” that upholds the Eighth Amendment.
However, over time, the lethal injection protocol has deviated from the standard devised by Chapman. The lethal injection protocol requires an intravenous line insertion, which requires competent personnel because the people facing execution often have veins that are tricky to access. A disturbing report in 2022 found that more than a third of executions are botched because of unskilled personnel.
The American Medical Association and the American Nurses Association state that it is unethical for medical providers to participate in any way in executions. This has led to a struggle for state prisons to find skilled personnel to handle lethal injection, resulting in many failed attempts.
Christa Pike’s Case
Christa Pike’s case is novel not only because it’s the first time in legal history a prisoner has survived a completed execution procedure but also because of the “hot mess” clinical ethics case that has emerged. When Pike remained alive after the failed procedure, she was rushed to the hospital for lifesaving treatment.
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Pike initially remained intubated and unconscious, but then she awoke and spoke, raising new questions about her neurological status. Her attorneys state that there is still a lot of cognitive confusion, but she is very aware that the state tried to execute her. Any clinical ethicist would advise that Pike may fully regain decision-making capacity and is already showing signs of understanding and appreciation.
Bioethicists have been actively debating this case, with consensus that if Pike were deemed to be incapacitated, a court-appointed surrogate decision-maker would be necessary. Pike’s biological family has provided insight into her childhood, which would also raise questions about authentic surrogacy. Because of Ford v. Wainwright, incapacitated prisoners cannot be executed, so if Pike regains capacity, the legal road is unclear.
As of this writing, it’s impossible to predict Pike’s ultimate prognosis or fate, but the legal and medical issues in the Pike case are on a collision course. The case has exposed the procedural flaws of lethal injection, and it’s likely that medical expertise will become a requirement for states that want to continue using this method of execution.
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Pike’s case has also raised questions about the role of health care providers in executions. Physician Mark Fowler, who was involved in the failed execution case of Tony Carruthers, was reportedly involved in Pike’s failed execution as well. The majority of health care providers maintain that participating in executions is unethical, and the presence of a health care provider can provide a false impression that lethal injection is being supervised by doctors.
Christa Pike remained in restraints, handcuffed and shackled to her bed, which complicated her care, and her health care team planned to remove life support in the belief that she was progressing to brain death.
Implications for Lethal Injection
The Pike case has significant implications for the use of lethal injection as a method of execution. If medical expertise becomes a legal requirement for lethal injection, but no reputable health care provider will participate, then the use of lethal injection may be significantly limited.
