Some states find signs that executions can be painful. Why Missouri can’t know for sure

The last words Amber McLaughlin spoke as she was being executed by the state of Missouri were, “It hurts.”

As a deadly dose of pentobarbital coursed through her veins, Rev. Lauren Bennett held onto McLaughlin’s shoulder and hand. McLaughlin, 49, took three deep breaths, her pulse weakened and she lost consciousness.

Her body was released to the Office of the Coroner in St. Francois County. Officials marked her death as a homicide. Unlike most states where executions have taken place in recent years, an autopsy was not performed.

Deputy coroner Gregory Armstrong said the cause and manner of death in executions is “known and well documented by the Missouri Department of Corrections.”

Michael Tisius was executed Tuesday. Karen Pojmann, a spokeswoman for the Missouri Department of Corrections, said an autopsy will not be conducted.

Missouri, Mississippi and Texas do not conduct autopsies on people who have been executed. In Tennessee, it is up to the prisoner, county medical examiner or the district attorney. Alabama, Arizona, Florida, Georgia and Oklahoma conduct the autopsies. Some of those have shown evidence of pain, calling into question the constitutionality of lethal injection.

The autopsy of Donald A. Grant found mild pulmonary edema, a 10-page report obtained by The Star shows. The 46 year old, convicted of murdering two hotel workers, was executed last year in Oklahoma. In the lead up to his execution date, he chose death by firing squad as an alternative to Oklahoma’s three-drug protocol, the Associated Press reported. His request was denied and the lethal injection was administered in January 2022.

Pulmonary edema — where a frothy fluid leaks into lung tissue and airways — causes the sensation of drowning.

Dr. Joel Zivot, an expert on physician participation in lethal injection at Emory, has reviewed upwards of 40 autopsies on people who have been executed. Seventy-nine to 80% of the time he has found evidence of pulmonary edema.

“This is not a rare event,” he said.

Another autopsy showed the execution team used a “cut down,” where they slice into the person’s arm to find a vein to insert the IV line.

“The technical part of execution is important,” Zivot said, pointing to the Eighth Amendment which prohibits cruel and unusual punishment.

Zivot said states like Missouri that do not conduct autopsies are “cowards.”

“You think you’ve got an execution method that’s constitutional? Why should we trust you by simply saying it’s so?” he said. “Let’s just see it, let’s open it up. Start with autopsies. Do them every time.”

‘Heartbreaking honor’

Bennett, the spiritual advisor who was with McLaughlin when she was executed, said she did not know what was causing McLaughlin’s pain. She did not know if it was supposed to be that way. But she does believe the death penalty is inhumane.

As McLaughlin’s January execution date neared, she decided she wanted a spiritual advisor.

Bennett, a pastor at Metropolitan Community Church of Greater Saint Louis, first connected with McLaughlin, a transgender woman, around Thanksgiving.

Eight months before, the U.S. Supreme Court ruled spiritual advisors can pray and touch a prisoner in the execution chamber.

“I immediately just loved her,” Bennett said.

McLaughlin, she said, had a sweet spirit and was looking to grow closer to God. She was also sorry for what she had done: In 2003 in St. Louis County, McLaughlin raped and killed her ex-girlfriend, Beverly Guenther. McLaughlin was convicted by a jury, but sentenced to death by a a judge, a loophole called “a flaw in Missouri’s capital sentencing scheme,” by seven retired judges.

On the morning of Jan. 3, Bennett spent time with McLaughlin in a cell at Eastern Reception, Diagnostic and Correctional Center in Bonne Terre. They talked about life, McLaughlin’s regrets, heaven. McLaughlin believed she would be met by clouds and family members who had died.

She was at “peace in a big way, in a way I was astonished with,” Bennett said.

Later that evening — execution warrants go into effect at 6 p.m. — Bennett returned to the prison. On the way in, she saw a huge pink cloud around the horizon that she later described to McLaughlin. Pink was her favorite color.

Bennett was accompanied by a guard who took her to a waiting room and then ushered her into the execution chamber. She and McLaughlin talked for a few minutes that “went by really fast.”

Then the pentobarbital was administered. McLaughlin was pronounced dead at 6:51 p.m.

“It was a heartbreaking honor to be there with her,” Bennett said.

Bennett said if an autopsy helps officials understand what someone is going through or could help show the qualifications of the execution team, then it would be a helpful tool.

In a one-page report, the St. Francois County Coroner’s Office listed McLaughlin’s cause of death as respiratory failure.

Five weeks later, the state executed Leonard Taylor, a man convicted in a quadruple murder who maintained that he was innocent. His cause of death was listed as mixed drug intoxication.

Michelle Smith, co-director of Missourians to Abolish the Death Penalty said not conducting autopsies on people who have been executed was “on brand” for the Missouri Department of Corrections.

“They try to maintain secrecy because they know if these things become public, there will be an outcry,” Smith said. “We want transparency.”

Pojmann, the DOC spokeswoman, said the department requests an autopsy when there is a question about the cause of death of anyone who dies in custody.

“In an execution, we know the cause of death is 5 grams of pentobarbital,” she continued. “Other states might have statutes in place requiring post-execution autopsies. Why Missouri doesn’t have such a statute is really a question for the General Assembly or the Attorney General. The Department of Corrections doesn’t make laws.”

Fifteen men remain on Missouri’s death row, according to the Department of Corrections. One has had a date set: Johnny Johnson is scheduled to die by lethal injection on Aug. 1, though appeals are pending.