The planned execution of Kenneth Eugene Smith using nitrogen gas on Thursday is set to be the first of its kind, taking place in a small south Alabama town. But many people are urging the governor to call it off, citing how the method is untested.

Kenneth Eugene Smith, 58, is set to die by nitrogen hypoxia—or suffocation on nitrogen gas—sometime between 12 a.m. on Thursday, January 25, and 6 a.m. on Friday, January 26. The execution will take place at William C. Holman Correctional Facility in Atmore.

But whether it goes off as prison officials plan will depend on the federal appeals courts, including the U.S. Supreme Court.

National and international organizations are asking Gov. Kay Ivey to call off the execution, which would be the first nitrogen execution in the country. Other states have approved the method of execution, but none have used it or released a plan about how they intend to use it.

The method that the Alabama Department of Corrections plans to use is untested.

Nitrogen hypoxia executions are designed to work by providing an inmate pure nitrogen to breathe without a source of oxygen, causing the inmate to lose consciousness and die.

The lawmaker whose bill authorized the new method believes it will be a humane form of capital punishment. Former state Sen. Trip Pittman of Baldwin County sponsored the bill that authorized the method, and Alabama lawmakers approved Pittman’s bill in 2018. Their approval came at a time when lethal injection, the state’s main form of execution, faced battles with litigation and availability of the lethal drugs.

How is it supposed to work?

A redacted version of the nitrogen protocol was released last year, revealing the nitrogen would flow through a mask to the inmate. Here is what the protocol says will happen leading up to the execution.

• The condemned inmate will be escorted to the execution chamber and placed on a gurney. A pulse oximeter will be secured on the inmate.
• The execution team will place and adjust a mask on the inmate’s face. One team member will monitor the pulse oximeter while the execution team captain verifies that the mask is properly placed. The pulse oximeter will be monitored continuously for two minutes.
• The inmate’s spiritual advisor will be escorted to the execution chamber to carry out any previously approved written plan.
• The warden will order the curtains to the witness rooms opened after verifying there are no last-minute stays.
• The warden will read the execution warrant.
• The inmate will be allowed up to two minutes to make a final statement. The warden and assistant warden will leave the execution chamber.
• The warden will make a final check with the commissioner of the Alabama Department of Corrections that there are no last-minute stays.
• The execution team will conduct a final inspection of the mask and its placement.
• The warden will activate the nitrogen hypoxia system.
• Nitrogen gas will be administered for 15 minutes, or five minutes following a flatline indication on the EKG, whichever is longer.
• Once the execution is carried out, the execution team captain will be notified via radio and will close the curtains.
• The spiritual advisor, if any, will be escorted from the chamber.

Praying before the execution

Smith’s spiritual advisor, The Rev. Jeff Hood, plans to be in the execution chamber. He has been vocal about his concerns regarding the untried method, asking the prison to ensure their ventilation system and oxygen meters will prevent an unknown leak of nitrogen. He sent a letter of demands to the prison last week, but said he wasn’t given a response.

Smith will be allowed to pray with Hood prior to putting on the mask.

Hood and other spiritual leaders delivered letters to Ivey this week asking for a stay of execution.

Previously, Hood also filed a lawsuit against the prison system, arguing his life could be in danger in the execution chamber. He signed a form from the prison that stated: “However, in the highly unlikely event that the hose supplying breathing gas to the mask were to detach, an area of free-flowing nitrogen gas could result, creating a small area of risk…”

The form said that area of risk would be about two feet from the mask.

The legal arguments

Currently, Smith’s case is being litigated in federal court appeals courts. His lawyers have already asked the U.S. Supreme Court for a stay of execution. If the court doesn’t call off the execution, it will be the second time Alabama attempts to kill Smith. He was set to die in November 2022, but survived after workers at the Alabama Department of Corrections couldn’t start an intravenous line for the lethal injection drugs before the state’s execution warrant expired at midnight.

Following that attempt, the U.S Supreme Court ruled in favor Smith, siding with his lawyers who argued he should be allowed to die by nitrogen hypoxia.

In court recently, attorneys for Smith argued the execution method “exposes Mr. Smith to the risk of superadded pain” which is not allowed under the U.S. Constitution. But Alabama Attorney General Steve Marshall’s office said the method is humane.

Anesthesiologists, state officials, Smith and others testified during a December hearing, with much of it focused on the risk of vomiting, what Smith might experience and what would happen if he were not to receive pure nitrogen because of a faulty mask fitting.

Dr. Robert Jason Yong, an assistant professor of anesthesiology Harvard Medical School who testified on behalf of Smith’s case, said low oxygen can result in nausea and vomiting, creating a risk of choking on aspirated vomit. He also said that if a person is exposed to less than 100% nitrogen, there is a risk they could experience the sensation of suffocation or be left in a vegetative state instead of dying.

And a medical doctor with experience in assisted suicides called out risks in Alabama’s protocol, according to court documents. Part of that was concerns that air would leak around the mask and prolong death or leave Smith with injuries, or that Smith could vomit into the mask and choke.

A district judge, in his order denying Smith’s request to block the execution, wrote that the doctor believed that Alabama’s protocol could lead to “incomplete cerebral hypoxia” and leave Smith in a “vegetative state with permanent brain damage.”

The Associated Press contributed to this report.