Doctors Demand Restrictions On Another Execution Drug

PANCURONIUM_BROMIDE lethal injection drug death penaltyOver the past year numerous pharmaceutical companies have tried to distance themselves from lethal injections (sometimes voluntarily, sometimes under pressure).  Until now, all these efforts involved the use of an anesthetic, the first drug in 3-drug execution protocols, or the only drug in one-drug protocols.  First Hospira, then Novartis, Lundbeck, Kayem and Naari have all objected to the use of their anesthetic products in U.S. executions.

Now, Hospira is under fire for pancuronium bromide, which is the second drug in all 3-drug execution protocols in the U.S.  Hospira is the sole provider of this drug for executions; it’s a muscle-relaxant that in executions is used to induce paralysis.  Paralysis during executions makes the condemned look like he’s peacefully falling asleep even if he’s in excruciating pain.  This makes the witnesses to the execution feel better.  Ironically, this masking of possible pain is why pancuronium bromide is widely banned in the euthanizing of animals.

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Georgia's Shady Death Penalty Drug Deals

As George Costanza once said: “This thing is like an onion:  the more layers you peel, the more it stinks!

On June 23, Georgia intends execute Roy Blankenship.  For the first time they plan to use Nembutol, the anesthetic they acquired to replace sodium thiopental in their lethal injection protocols (their supply of sodium thiopental was seized by the DEA).

Lundbeck, the Nembutol’s Danish manufacturer has written a second letter demanding that their drug not be used in state killing, now pointing out that the they “cannot assure the associated safety” of the drug.

You can read both letters here.

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Georgia Execution Drugs Seized by DEA

Yesterday, the DEA seized Georgia’s supply of sodium thiopental, the anesthetic most states use as the first drug in a three drug cocktail to execute prisoners, explaining that there are “questions about how the drug was imported to the U.S.”

States have been importing sodium thiopental because the one US-based, FDA-approved manufacturer, Hospira, has ceased production over concerns about its use in executions.  Georgia, Arizona, Arkansas, California and Tennessee have all imported this drug from non-FDA approved sources in the U.K., and Nebraska recently acquired a large quantity from a non-FDA approved source in India.

Attorneys in Georgia in particular have objected that the drug came from a “fly-by-night supplier operating from the back of a driving school in England.” Raised in advance of the execution of Emmanuel Hammond in January, these concerns, though ignored by the courts, apparently were noticed by the DEA.

Outside the U.S., Swiss-based Novartis, the company responsible for a generic, non-Hospira version of sodium thiopental recently announced its intention to prevent its drug from being used in executions.  And Denmark-based Lundbeck, maker of pentobarbital, the substitute drug currently being used by Oklahoma and Ohio, has also strongly objected to the use of their product in the killing of prisoners.

The fundamental problem is this: carrying out executions with drugs meant for healing is an unresolvable and unsustainable breach of basic medical ethics (not to mention human rights). States like Georgia sneaking around and skirting the rules to import the drugs just makes it worse.

Medical Ethics and Executions: A New Development

lineedleThis weekend, the Washington Post reported that the American Board of Anesthesiology (ABA) decided in February to censure any of its members who participate in executions.  As the document outlining the policy states, bluntly: 

 ”… anesthesiologists may not participate in capital punishment if they wish to be certified by the ABA.”

As members of the medical profession, anesthesiologists are bound by the oath to “do no harm,” and of course helping the state kill a prisoner violates that oath in the most fundamental and basic way.  According to the Post, anesthesiologists have been employed by executioners to “consult prison officials on dosages,” or “insert catheters and infuse the three-drug cocktails.”

This is not too big of a deal, since most states do not now use anesthesiologists, but the new policy is significant in that it has teeth.  Instead of being just another resolution decrying participation in executions (almost every association of medical professionals has already passed a resolution like that),  this one promises actual punishment and de-certification for anesthesiologists who chose to help the state put someone to death.   It will be interesting to see if other medical professions which have passed resolutions – physicians, emergency medical technicians (EMTs), nurses  – will follow suit and implement policies with some real consequences.

Ultimately, any states that still use anesthesiologists can simply stop using them, or alter their execution protocol, so this decision is likely to have little effect on executions.  But the American Board of Anesthesiology’s stand is symbolic of a growing recognition that the death penalty not only contradicts the ethics of one of our nation’s most prominent professions, but directly conflicts with one of our society’s most basic values:  the preservation of life.