HOW DOES EXECUTION BY NITROGEN GAS WORK?

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The state of Alabama executed inmate Kenneth Smith on January 25, 2024, by forcing him to breathe 100% nitrogen gas. It was the first known execution in the United States by this method.

Smith was 58 years old. He was sentenced to death for his role in a 1988 murder. Smith’s lawyers had expressed that death by inhaling nitrogen would cause excessive pain and would be a form of torture. Appeals failed, and the execution went forward.

The procedure occurred at the William C. Holman Correctional Facility in Atmore, Alabama. Smith was fitted with a mask, and that mask was connected to a device that administered the nitrogen gas. The execution process began at 7:53 p.m., and Smith was pronounced dead at 8:25 p.m., thirty-two minutes later.

Thirty-two minutes? Not a swift execution.

How would nitrogen gas kill a person? The air we’re all breathing at this moment contains 21% oxygen and 78% nitrogen. The oxygen is essential for us to stay alive and well. Nitrogen serves no role in our normal breathing. If we breathe an atmosphere of less than 21% oxygen, we’re in danger of dying from inadequate oxygen to our brain and heart. A low amount of oxygen in the blood is termed “hypoxia.” Hypoxia is an extreme danger to life. During general anesthetics, anesthesiologists commonly administer a concentration of 50% oxygen to assure a margin of safety if there is difficulty with a patient’s airway, breathing, or circulation. The extra margin of oxygen is a safety net. No anesthesiologist would ever administer less than 21% oxygen to a patient.

Entering the search term “death by nitrogen gas” into the medical search engine PubMed yields just one article relevant to this execution. The article is “Case report of suicide by inhalation of nitrogen gas.”  The article states: “Nitrogen is an inert gas that is a normal constituent of the air that we breathe. It is a suffocating gas that does not support life and that can be a cause of death by the displacement of oxygen in the atmosphere. The majority of deaths associated with nitrogen have occurred in the setting of scuba diving. Although other suffocating gases have been used as a means of committing suicide, the literature contains little information about the use of nitrogen as a suicidal agent. A case of a 50-year-old man who committed suicide using a homemade suicide device and nitrogen gas is presented.”

There seems to be no published medical research on the method of death used to execute Kenneth Smith. And why would there be? Doctors are in the business of saving lives, not ending them.

If you and I were observers, what would the death of a person dying by nitrogen gas look like? A lack of oxygen would be the theme that describes this form of death. In a way, the individual would be drowning in an oxygen-free environment. It would be somewhat like drowning in water, an equally oxygen-free environment. The individual would begin by gasping for breath, hoping to find some oxygen somewhere in the inhaled gas. As the oxygen level in the individual’s bloodstream and brain plummeted, there would be symptoms of confusion, panic, and decreased consciousness. As the oxygen level in the individual’s bloodstream and heart plummeted, there would be rapid heart rate, rapid breathing, and eventually angina pain and a failure of the heart to pump anymore. Would this process be fast? No, a physician would predict this entire descent into an oxygen-free state to last ten minutes or more. Would it be like torture? Yes, in all likelihood it would be like torture.

We’re all going to die someday. This is not a method of death you’d desire or request.

Per the CNN coverage of Kenneth Smith’s execution: “Nitrogen flowed for about 15 minutes during the procedure, state corrections commissioner John Hamm said in a news conference. Smith, who was on a gurney, appeared conscious for ‘several minutes into the execution,’ and ‘shook and writhed’ for about two minutes after that . . . That was followed by several minutes of deep breathing before his breath began slowing ‘until it was no longer perceptible for media witnesses.’ . . . Smith appeared to be holding his breath ‘for as long as he could’ and may have also ‘struggled against his restraints. There was some involuntary movement and some agonal breathing, so that was all expected and is in the side effects that we’ve seen and researched on nitrogen hypoxia,’ Hamm said. ‘So nothing was out of the ordinary of what we were expecting.’”

Also per CNN: “Smith’s spiritual adviser, the Rev. Jeff Hood, witnessed the execution and described it in more graphic terms, saying it was ‘the most horrible thing I’ve ever seen.’”

In contrast to execution by breathing nitrogen, execution by lethal injection is essentially an anesthetic overdose which intends to kill a convicted inmate quickly. If correctly administered, there should be no pain or torture. A key problem with execution by lethal injection is that most MDs want no part of killing someone. Because of this value, who is going to start the IV? Who is going to prescribe the fatal intravenous recipe? Who is going to administer the fatal intravenous recipe?

Executing prisoners isn’t within the scope of medical doctors.

And let’s hope that this method of executing prisoners by having them breathe nitrogen gas is “a one and done” event.

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2 thoughts on “HOW DOES EXECUTION BY NITROGEN GAS WORK?”

  1. Thank you. This article was remarkable for its clarity. Suffocating to death while in pain would be a terrifying way to die. That is torture, not punishment. I I would not wish this death on anyone.

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  2. I wonder what the visual effect will be of the nitrogen coming out of tissue solution as the body reequilibrates with room air. Will there be skin “bends”, with air bubbles in the skin, or will all bubbles be internal; is 10-15 minutes pure nitrogen at one atmosphere pressure sufficient to cause this effect?

    Reply

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