Today, Ohio killer Dennis McGuire is sentenced to die in prison, using a drug cocktail which has never before been used to kill inmates.
Because of a chronic shortage of drugs, after European manufacturers banned prisons from using their drugs in executions, prisons in the US have nowhere to source their killer injections.
Now the Ohio Department of Rehabilitation and Correction has approved two drugs, never used before, to be used to kill McGuire; midazolam, a sedative, and hydromorphone, a painkiller.
Dennis McGuire, the man who is set to be executed by the drug cocktail today
Lawyers say that the new cocktail means McGuire, who has been on death row for over 25 years for the rape and murder of 22-year-old Joy Stewart, will suffocate to death in agony, which the prison authority denies.
Harvard anaesthesiologist Dr David Waisel has warned in a filing intended to stop the execution that McGuire may experience “the terror of air hunger during the first five minutes of the execution”.
What is certain is that nobody can predict exactly what will happen to him when the drug is injected into his veins at the Southern Ohio Correctional Facility in Lucasville.
But implications of the drug shortage in the US reach far further than McGuire's cell.
Midazolam and hydromorphone have other uses, life-saving ones. Midazolam is a a sedative used in surgery and to treat seizures. Hydromorphone is an opiate pain-killer.
Hospitals are now facing a shortage of these drugs as they are stockpiled by prisons, according to campaigners.
The American Society of Health-System Pharmacists warned last month the US is facing current shortages of both midazolam and hydromorphone.
Reprieve, an anti-death penalty legal charity, told HuffPost UK that stockpiles of the drug exist in Florida and Ohio, who are expected to see further supplies.
Joel Zivot, Medical Director of the Cardiothoracic Intensive Care Unit at Emory University Hospital, has advised the charity that the USA is facing a “public health emergency” because of the shortages, saying he is “shocked and appalled” that vital drugs are being kept from hospitals to use on prisoners.
Maya Foa, Director of Reprieve’s death penalty team said: “It is a scandal that executioners are hoarding medicines in order to kill, while those who want to use them to save lives face shortages.
"Regardless of anyone’s views on the death penalty, surely we can all agree that saving lives should take priority over executing prisoners.
"This is yet another sign of how blinkered, cruel and unthinking US executioners have become in their desperate drive to keep on killing.”
Support for the death penalty is on the decline, according to an analysis published by the New York Times in December 2013, with executions at a low point, partially attributed to the drugs shortage.
In 2013, 80 people were sentenced to death, compared with 315 in 1994.
The Death Penalty Information Center, a private group in Washington told the paper it believed that “a societal shift is underway.”
Maryland abolished the death penalty in 2013, leaving 32 states who still impose the punishment. For the last two years, only nine states have actually carried out executions.
In 2012, California voters rejected a proposal to end the death penalty and give life without parole to those on death row.