Wait, wait -- save yourself the effort of explaining why it shouldn't matter that condemned murderers, as they're being put to death over at Central Prison, might experience some, ah, discomfort. Not to mention the agony of both suffocating and having a heart attack while being too paralyzed to even say "Ouch!"

Didn't the murderee, whether shot, stabbed, hacked, burned or poisoned, experience more than his or her share of discomfort as well? Without having volunteered for the privilege? A little turnabout is fair play, in many people's book.

Yet if we actually wanted to guarantee that someone being executed would suffer as much as the murder victim, we'd find ourselves returning to the sort of grisly practices we've come to regard as barbaric. Even the trusty hot squat has fallen out of favor, as has the gasp chamber.

Instead, in those states that haven't given up on the death penalty altogether as more bother than it's worth, lethal injection has become the preferred method of dispatch. Why, the killer just gets to drift off to sleep...

What we've been hearing of late from advocates for the condemned, though, is that this peaceful picture may often be an illusion.

Consider an affidavit signed last Wednesday for submission in federal court as North Carolina prepares for the Oct. 8 execution of Sammy Perkins, convicted of what surely was a dreadful crime: the 1992 rape and murder in Greenville of 7-year-old Lashenna "Jo Jo" Moore.

The affidavit is signed by Mark J.S. Heath, M.D., an assistant professor of anesthesiology at Columbia University. Heath (medical degree from UNC-Chapel Hill) is a leading voice in what has become a national debate over pain risks associated with lethal injection.

Although other experts discount the idea that injection carries any significant likelihood of severe pain, Heath sees some real problems. And it turns out those problems are especially worrisome in North Carolina.

Heath summarizes the method of lethal injection used at Central Prison based on what he says is a description by warden Marvin Polk. Five syringes, each containing one drug, are successively pushed into an IV line. The first contains 1,500 milligrams of sodium pentothal, a short-acting barbiturate, which is supposed to render the inmate unconscious. The second syringe contains heart-stopping potassium chloride. The third contains muscle relaxant/paralyzer pancuronium bromide, which puts a stop to breathing. The fourth contains more potassium chloride, and the last another 1,500 mg hit of sodium pentothal.

"I am aware of no other jurisdiction in which lethal injection is carried out using this five-drug sequence," Heath says in his affidavit. And while many states use the sodium pentothal barbiturate, he says, he's aware of only one other using such a low initial dose.

Not only is the dosage low, but Heath says that in his opinion, failure to administer the chemical continuously through the procedure "places the condemned inmate at a needless and significant risk for the conscious experience of excruciating pain and suffocation while simultaneously experiencing paralysis rendering the prisoner unable to cry out."

The second sodium pentothal slug doesn't do any good, Heath says, because by then, either the inmate is dead or he is "emerging from anesthesia, in which case the prisoner necessarily suffered extreme distress during the execution."

Heath goes on to discuss his review of toxicology reports from the autopsies of several executed North Carolina inmates. He observed a large variation in barbiturate levels from blood samples, but in at least one case -- that of Desmond Carter, executed in 2002 -- there was only a trace amount.

What that signaled to him was that Carter may not have been zonked when he was zapped, so to speak. Carter evidently didn't show any signs of distress, but "it is clearly possible that the execution was torture, and that the agony was concealed by the administration of the paralytic drug pancuronium."

In fact, some other inmates have had a conspicuously rough time of it on the Central Prison gurney. Heath notes reports of "writhing and convulsing," "trembling and struggling" -- perhaps suffering from the effects of potassium chloride.

"As it travels in the bloodstream from the site of injection towards the heart, potassium chloride activates all the never fibers inside the vein," Heath says. "This causes excruciating pain and would be agonizing for an inmate who is not properly anesthetized."

Questions about whether lethal injection -- which we like to regard as a humane way to dispatch our most heinous killers -- might sometimes amount to cruel and unusual punishment already are filtering through the courts. If Heath's analysis holds up, North Carolina may find itself back at the drawing board, devising a means of execution that at least couldn't be confused with torturing people to death.

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