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On Thursday night, Alabama inmate Ronald Bert Smith, Jr. was executed for a 1994 murder. Smith had previously brought a lawsuit against the state of Alabama, which was dismissed in November, claiming that the state’s three-drug execution process constituted cruel and unusual punishment. His execution took 34 minutes, and for 13 of them, he was coughing and moving, according to AL.

His lawyers attest that his arm moved and his lips appeared to be forming words. Lethal injection involves three different drugs, the first of which is a sedative called midazolam. Once it is judged to have taken affect, drugs that paralyze the body and stop the heart are administered. While Smith’s executioners waited for the sedative to work, he underwent two consciousness tests, which consist of “the corrections officer calling out Smith’s name, brushing his eyebrows back, and pinching him under his left arm.”

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Death by lethal injection is widely contested as a means of carrying out the death penalty, as the efficacy of midazolam and others sedatives is in doubt. In an op-ed piece for The New York Times in 2015, Zachary Fine rounded up some of the botched executions associated with lethal injection:

In July, the execution of Joseph Wood III in Arizona spanned one hour and 57 minutes. During the process, according to reports, he “gasped” more than 600 times. Just three months before in Oklahoma, Clayton D. Lockett reportedly writhed and screamed during his 43-minute-long execution. And in January 2014, there were Dennis McGuire in Ohio and Michael Wilson in Oklahoma. Before falling unconscious, Wilson’s last words were: “I feel my whole body burning.”

In fact, NPR reports that Smith and other Alabama death row plaintiffs referenced the death of Clayton Lockett and the failure of midzalom in the lawsuit. When Smith was convicted, the jury recommended life without parole, but the judge chose the death sentence, saying that Smith’s “acts demonstrate a pitiless indifference to Casey Wilson’s fears, pains and suffering, and pleas for life.”

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Alabama is the only state that allows a judge to override the jury’s recommendation and assign the death penalty. Smith’s case was used to contest Alabama’s law in the Supreme Court, but it was denied—four justices, Ginsburg, Breyer, Sotomayor, and Kagan, were willing to grant a stay of execution, but they needed five votes.

The Chicago Tribune reports that Alabama Corrections Commissioner Jeff Dunn promises an autopsy report will be performed on Smith to see if there were any irregularities in his death, aside from it being administered by the state, saying, “I think the question is probably better left to the medical experts.”