States botched more executions of Black prisoners. Experts think they know why

By Chiara Eisner
A lethal injection gurney is seen at the at Nevada State Prison, a former penitentiary in Carson City, Nev., in 2022. Emily Najera for NPR

Studies of the death penalty have long shown racial inequality in its application, but a new report has found the disparity extends inside the death chamber itself. In an analysis of the more than 1,400 lethal injection executions conducted in the U.S. since 1982, researchers for the nonprofit Reprieve reported that states made significantly more mistakes during the executions of Black people than they did with prisoners of other races.

Reprieve, which advocates against the death penalty, found that nationwide, half of the botched lethal injection executions were of Black people, though only a third of the prisoners executed were Black. The pattern was starkest in some Southern states. In Arkansas, Oklahoma and Georgia, three quarters or more of the botched lethal injection executions were of Black people, though they accounted only for a third or less of executions in those states.

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Lethal injection requires execution workers to administer drugs intravenously to the prisoner to stop their heart. It has become the most commonly used execution method across the country, though it is also the method with the most recorded “botches,” or mistakes.

There is no standard definition of what constitutes a botched execution. For its analysis, Reprieve designated an execution as botched if it met certain criteria. Researchers checked documents and witness reports to confirm details like whether there was evidence that a prisoner made visible or audible expressions of pain, was still conscious after a drug was administered, or whether execution workers had struggled at length to find a prisoner’s veins.

That happened in 2022, when execution workers in Alabama spent three hours attempting to insert an IV line into the veins of Joe Nathan James, Jr., a Black man. His autopsy showed puncture marks and cuts in his feet, hands, wrists and arms.. A few months later, Alabama left white prisoner Kenneth Smith alive on the gurney for hours after they struggled to find a vein to use for his lethal injection execution, prompting his lawyers to ask the state to use nitrogen gas to execute him in January.

Lengthy procedures like those were not uncommon, the Reprieve analysis found. Over one third of lethal injections lasted more than 45 minutes and over a quarter took an hour or more.

The executions typically involved a three-drug regimen, though the protocol can vary. Some states have injected just one drug and others up to four. With the three-drug method, the first drug used is an anesthetic, to numb the prisoner. The second drug paralyzes the muscles, and the third stops the heart. Most executions were conducted with sodium thiopental as the anesthetic. Other states used drugs like pentobarbital, midazolam, etomidate or fentanyl in their regimens. None of the drugs have been FDA-approved for this application, and pharmaceutical companies have widely opposed their use in executions.

Still, the Reprieve analysis found that no specific drug led states to make more mistakes.

“There are botched executions, many of them, regardless of the drug, regardless of the cocktail,” said Maya Foa, the executive director of Reprieve. “Continuing to tinker with the machinery of death is not making this better.”

Reprieve determined that 73 lethal injection executions were botched; just over 5% of those conducted since 1982. The total may be conservative. Previous research has identified that the percentage of botched lethal injection executions using the same criteria could be higher than 7%, though that study did not examine the race of the prisoners, as Reprieve’s did.

“The analysis shows not only are we botching these executions and causing people torture more often than with many other methods,” said Foa, “But we are doing that to Black prisoners far, far more frequently than we are to white prisoners.”

Studies of the death penalty have previously shown racial discrimination is prevalent throughout many steps of administering capital punishment – from jury selection to the sentencing and appeals process. A 2020 report from the nonprofit Death Penalty Information Center showed that people of color have been overrepresented on death rows in the U.S., and that killers of Black people were less likely to face the death penalty than those who kill white people.

But the Reprieve analysis is one of the first times that empirical evidence has indicated that racism extends even to the final step of the death penalty: the execution itself. While the study does not explain how or why states make more mistakes when executing Black prisoners, Foa said she thinks that the fact that Black people suffer from higher mortality rates and receive poorer medical treatment in the U.S should provide clues.

Ruqaiijah Yearby, a professor of health law at The Ohio State University who studies racism in healthcare, agreed. She said that racist tropes that can limit Black people from accessing equitable medical care, like the false notion that Black people have a higher tolerance for pain, could also be involved in the administration of drugs in the death chamber. Yearby cited research that showed that nationwide, Black cancer patients received lower doses of pain medication than cancer patients who were white.

“Black people don’t have thicker skin, we don’t have bigger bones,” Yearby said. “But if you believe that, then you’re going to treat somebody differently than if you’re going to do it to a white person.”

Dr. Scott Bowman, a professor of criminal justice at Texas State University whose academic work has focused on race and law enforcement, said he would expect that sort of discrimination to show up in lethal injection executions in subtle ways.

“You can’t find a vein and you think, well, it really is hard to find veins in Black people, so I’m just going to keep sticking,” he said.

Researchers would find it difficult to identify those kinds of interactions in the death chamber, partly because they could be subtle, and because the criminal justice system lacks transparency when those in power make mistakes, he said. But insiders could know more.

NPR interviewed four workers, none of whom were Black, who collectively witnessed or helped carry out 26 executions across the country.

Craig Baxley, a former executioner from South Carolina who pushed lethal injection drugs into prisoners’ veins, said he “never noticed anything as far as treatment, or how anybody reacted to whether they were white or Black.”

Jeanne Woodford, a former warden of the state prison in San Quentin, Calif., who oversaw four executions during her tenure, said something similar.

“I didn’t see any difference at all,” she remembered.

Woodford was aware, though, of some execution workers who may have believed people of color might have been more difficult to inject with the lethal injection drugs, a common misconception.

“I heard some guys say, ‘Oh these guys are really muscular, it’s going to be harder,” she said. An execution worker in Nevada suggested that “maybe the nervous system of the Black inmate works different.”

But Jeff Hood, a spiritual advisor who has been inside the death chamber during three executions of Black people and three white prisoners in Oklahoma, Texas and Alabama, said he did witness differences in the treatment of Black prisoners while they were strapped to the gurney.

“I can definitely tell you that the restraints that I have seen on Black folk have been unquestionably tighter than the restraints that I have seen on white folk,” Hood said.

He believes that was related to the correctional officers’ fear and prejudice of Black people, something Hood says is common where he lives in Arkansas. The only times Hood said he heard execution workers discussing whether a prisoner would resist was when the person scheduled to be executed was a person of color. This may have had an impact on how Black prisoners were treated as they were put to death, he thinks.

“If your assumption is that the person who is condemned is going to resist, then you are going to take much more liberties with the body than if you believe that the person was going to be perfectly peaceful,” the spiritual advisor said. “And when you begin to take liberties with someone’s body, you leave protocol and you leave best practices. When you leave protocol and you leave best practices, of course you are going to have a botched execution.”

The authors of the Reprieve report recommended imposing a moratorium on lethal injection executions conducted at the state and federal levels, noting that there were fundamental legal, constitutional and ethical issues with the method. They called on governors of states where executions are allowed to commission investigations to better understand the issues, as well as repeal secrecy laws that may have prevented previous oversight.

“The death penalty in its application in the United States is racist,” said Foa, Reprieve’s executive director. “And we cannot continue to do this.”