You've heard the old adage about "the inmates running the asylum."
Now, a federal judge is raising questions about who's running executions in Tennessee.
This week, U.S. District Judge Aleta Trauger ruled that Tennessee's lethal injection protocol is unconstitutional because it "presents a substantial risk of unnecessary pain" that was known to Correction Commissioner George Little, "yet disregarded."
At the heart of the issue is Tennessee's use of three drugs -- injected through IVs -- to put condemned inmates to death.
The first drug, sodium thiopental, is supposed to put the inmate to sleep so that he isn't tortured during the rest of the execution process. The second drug, pancuronium bromide, paralyzes his diaphragm so he cannot breathe. The third drug, potassium chloride, causes cardiac arrest.
But, Judge Trauger says, the problem is that Tennessee doesn't check to make sure that the first drug has really rendered the inmate unconscious.
"It is undisputed that, without proper anesthesia, the administration of pancuronium bromide and potassium chloride, either separately or in combination, would result in a terrifying, excruciating death," Trauger wrote in her 56-page opinion.
State medical examiner Bruce Levy testified that, without sufficient anesthesia, pancuronium bromide would cause pain because "a conscious person who is paralyzed would be unable to breathe. And suffocating to death would be a most violent form of death."
"All of the expert witnesses agreed that, if conscious, the inmate would suffer a burning pain throughout his body when the potassium chloride is injected, followed by a cardiac arrest," the judge added.
In fact, there's all sort of potential for things to go wrong.
Still, the judge found the state really doesn't do much to make sure that the paramedics performing the execution really know what they are doing.
"The executioners and paramedics testified that they had not been screened for drug problems or psychological disorders before being hired and that Commissioner Little does not test any of the participants for drugs prior to the executions themselves. This is a particular issue because one of the paramedics -- IV Team Member B -- has a history of drug and alcohol addiction and psychological disorders. IV Team Member B testified that he did not take part in the Sedley Alley execution because he was hospitalized in an alcoholic treatment program during April, May and June of 2006. Further, IV Team Member B testified that he pled guilty to possession of a controlled substance in 1988 and again in 1998. While hospitalized in the Spring of 2006, IV Team Member B was diagnosed by a psychiatrist as suffering from a 'deep-rooted' depression and, as a result, he is currently taking Paxil."
Warden Ricky Bell testified that he had observed the paramedic and had "not seen anything that appeared to be out of the ordinary."
But the warden admitted that he did not do background checks on the execution team members and that he "usually" checked their credentials, "but not always."
The judge added, "When asked whether he checked to see if their certifications had ever been suspended, Warden Bell answered 'No.'"
As to the state's response, Little says: "We are looking at our options and continuing to review the existing protocol in order to respond to the issues raised in Judge Trauger's decision. We are also looking at alternative methods of execution, which may be implemented."
One of those "alternative methods" may be finding executions who don't have their own criminal history.