Tennessee's attempt to execute death row inmate Krista Pike last week ended with an unusual result even for American practice - she survived after being injected with two doses of the deadly drug pentobarbital and was taken to hospital in critical condition, Reuters notes.
Authorities later reported that she remains unconscious and on a ventilator. The case was the second failed execution attempt in Tennessee this year alone and led to a halt to all subsequent executions in the state until the end of the year, as well as the resignation of the head of the local prison system. The incident has once again raised the question of why, despite decades of practice, American states continue to experience serious difficulties in carrying out death sentences.
At first glance, the problem seems technical, but in fact there are much deeper reasons, writes the newspaper "Guardian". Lethal injection is conceived as a relatively "simple and humane" procedure, in which a drug or combination of drugs should lead to death without prolonged suffering. In reality, however, for this to happen, state authorities must ensure reliable access to appropriate drugs, qualified staff and a working procedure, without being able to rely on the normal medical system. Pharmaceutical companies have for years refused to allow their products to be used in executions, which forced states to seek alternative suppliers and often keep the origin of the drugs secret.
The problem with drugs began more than a decade ago, the newspaper points out. In 2011, the American manufacturer "Hospira" stopped producing the substance sodium thiopental - one of the main drugs used in executions by lethal injection at the time. European pharmaceutical companies also began to restrict the export of drugs that could be used for executions. As a result, states began to look for new combinations of drugs and use other suppliers. However, this made the system significantly more unpredictable and led to a series of lawsuits over the origin, quality and storage of the drugs used.
This also explains why the problem is not simply a matter of whether the state has enough pentobarbital, notes "The Guardian". Authorities often refuse to publicly disclose who the manufacturer or supplier of the drug is. The state of Tennessee, for example, has come under criticism for the secrecy surrounding its execution protocol and the origin of the drugs. According to human rights organizations, the lack of transparency makes it difficult to verify whether the drugs were properly manufactured, stored and used. This creates a paradox: the state seeks to implement a court decision to impose the death penalty, but at the same time it has to find a way to obtain medical preparations whose manufacturers are actively trying to prevent their use for this purpose.
The other big problem is the insertion of an intravenous system itself, the publication comments. In a simple medical procedure, an unsuccessful insertion of an intravenous system is usually not a fatal problem - the medical team can try again, use a different blood vessel or apply a different technique. In an execution, however, any mistake can turn the procedure into a long and painful ordeal. That is exactly what happened to Pike. Her lawyers had warned in advance that her health condition and small veins could make it difficult to insert an intravenous system. During the procedure itself, according to lawyers, repeated attempts were made to insert a needle, and the drug did not reach Pike's bloodstream normally.
Pike's case is not an isolated problem, writes the "Washington Post". In May 2026, another execution in Tennessee had to be halted due to the inability to provide the necessary intravenous system. In Idaho, in 2024, the execution of Thomas Creech was halted after eight unsuccessful attempts to insert an intravenous system. These and similar cases show that the difficulties are not only related to the specific drug, but also to the fact that states must perform a complex invasive medical procedure in conditions in which medical professionals are often reluctant to participate due to professional and ethical restrictions.
The reluctance of medical professionals to participate in executions is a serious element of the problem, the publication points out. Doctors and medical organizations are generally dedicated to strictly observing the ethical principle of treating and saving human life, not causing death. Therefore, state authorities have difficulty creating teams comparable to those in hospitals. This creates additional risks in the executions of death row inmates who suffer from chronic diseases, damaged veins, obesity or other medical problems after decades in prison. Pike's case is particularly indicative precisely because her vein problems were known in advance, but the courts considered that she had not proven convincingly enough that Tennessee's execution protocol would lead to serious suffering.
The paradox is that the more pharmaceutical companies distance themselves from the death penalty, the more states are trying to develop alternative methods, commented "The Washington Post". In recent years, nitrogen hypoxia and firing squad have come to the fore, and some states are once again considering the possibility of execution by electric chair. Alabama already uses nitrogen hypoxia, but this method is also controversial because of the way in which death occurs and concerns about possible suffering. Thus, the technical problem with lethal injection is gradually becoming a broader question: is there even a method of execution that is reliable, predictable and acceptable from a medical, legal and ethical point of view?
At the same time, American practice shows that difficulties in carrying out executions do not mean the disappearance of the death penalty, notes the Associated Press. On the contrary, in 2026, a number of states continued to carry out death sentences, with Florida far ahead of the rest in terms of the number of executions. This shows the strong dependence of the system on the politics of individual states. While some state authorities are looking for ways to speed up the execution of sentences, others – like Ohio - have effectively blocked executions due to medication issues, as well as political and legal uncertainty surrounding them. Ultimately, what happened in Tennessee demonstrates that the question is no longer just whether the United States wants to retain the death penalty, but whether it can carry it out in a way that the state can defend as safe and humane, the agency concludes.