Pfizer restricts the resale of lethal injection drugs

As pharmaceutical companies continue to restrict access to lethal injection drugs, states must deal with the repercussions that has on capital punishment.

Photo by Ken Plokowski

The pharmaceutical giant Pfizer announced that it is implementing a system of controls on the distribution of its drugs to keep its products from being used in executions.  Pfizer is following suit of over 20 American and European drug manufacturers who have implemented similar restrictions for either moral or business reasons.  Pfizer restricted the sale of seven of its products that have been part of lethal injection protocols in some states.  “Pfizer makes its products to enhance and save lives of the patients we serve.  Consistent with these values, Pfizer strongly objects to the use of its products as lethal injections for capital punishment,” the company announced.

The purpose of the newly imposed restriction… is to ensure that Pfizer’s products will not be used in state-sponsored executions.

The restriction requires a more tightened control of the resale of the pharmaceutical products.  It also requires the governmental entities that purchase any of these products to certify that the purchased Pfizer product will not be used for penal purposes.    The purpose of the newly imposed restriction on the resale of drugs used in lethal injections is to ensure that Pfizer’s products will not be used in state-sponsored executions.  Pfizer’s decision is followed by the announcement of the American Pharmacists Association to restrict pharmacists’ affiliation in state-sponsored executions.  “The American Pharmacists Association discourages pharmacists’ participation in executions on the basis that such activities are fundamentally contrary to the role of pharmacists as providers of health care,” APhA Executive Vice President and CEO, Thomas E. Menighan stated.

United Nations Human Rights High Commissioner Zeid Ra’ad Al Hussein welcomed new Pfizer measures on the sale of the lethal drug injections.  “Businesses, across many industries, can help prevent human rights violations from occurring,” he stated. “It is heartening that to see companies playing an active role in furthering the trend towards ending use of the death penalty.”  High Commissioner Hussein urged the businesses to “avoid causing or contributing to adverse human rights impacts through their own activities, and … seek to prevent or mitigate adverse human rights impacts that are directly linked to their operations, products or services.”

This has forced states to scramble for alternative ways to obtain lethal injection drugs, following some botched executions.

It has become considerably harder for states to obtain lethal injections.  According to Maya Foa, a representative of London-based human rights advocacy group, after Pfizer’s announcement, all F.D.A.-approved lethal drug manufacturers have now blocked their sales of drugs for various purposes.  This has forced states to scramble for alternative ways to obtain lethal injection drugs, following some botched executions and experiments with new lethal injections.  For example, Texas has been using a three-drug cocktail for its state-sponsored executions for over thirty years.  However, as a result of pressure from death penalty opponents and drug manufacturers’ restrictions on the resale of the drugs, Texas had to switch solely to pentobarbital, a barbiturate that will cause respiratory failure.

A number of other states had to replace a three-drug cocktail resulting in numerous botched executions.  In Arizona, Joseph Randolph Wood III suffered one of the longest executions in U.S. history.  His execution lasted almost 2 hours before he was pronounced dead.  Wood gasped 660 times before he died.  Wood’s lawyers had sufficient time to file an emergency appeal during the execution but he died before the judge could rule on it.  Executioners used a sedative, midazolam.  Arizona temporarily postponed executions as a result of Wood’s botched execution.

Oklahoma carried out one of the worst lethal injection protocols.  Executioners placed an IV catheter into Clayton Lockett’s groin instead of his bloodstream, resulting in the drugs filling the tissue instead of the vein.  Lockett grimaced and writhed and the executioners attempted to halt the execution.  Lockett eventually suffered a heart attack and passed away.

Such a law prevents the disclosure of the identity of the drug manufacturers…

Ohio decided to postpone its executions until 2017 because of the lethal drug shortages.  Just like Texas, Ohio went from using a three-drug cocktail to a single-drug protocol.  Ohio is one of 31 states that have approved strict secrecy laws.  Such laws prevent the disclosure of the identity of the drug manufacturers or compounding pharmacies that supply the lethal injection drugs to the prisons.  The states that approved the secrecy laws argue that it was necessary to protect the drug manufacturers for fear of reprisal from death penalty opponents.  Others claim that the laws are structured to prevent manufacturers from finding out that the supplied drugs are used for lethal injections.

The current shortage of lethal drug injections has originated back in 2009 when drug manufacturer Hospira (later purchased by Pfizer) discontinued its production of sodium thiopental.  The drug has been mainly used in a three-drug cocktail injection.  Sodium thiopental is an anesthetic used to manage pain. It is followed by a muscle relaxant and a medication that stops the heart.

In the wake of drug manufacturers’ restrictions… the Supreme Court of the United States agreed to examine the constitutionality of Oklahoma’s lethal injection procedure.

Capital punishment has been a contentious issue in the United States and worldwide.  In the wake of drug manufacturers’ restrictions on the sale of the lethal injection drugs, the Supreme Court of the United States agreed to examine the constitutionality of Oklahoma’s lethal injection procedure.  In Glossip v. Gross a divided Supreme Court rejected claims by death-row inmates that a potential drug to be used in their executions would produce an unconstitutional level of suffering.  The inmates’ claim involved the use of a sedative named midazolam.  They claimed that the drug injection violates the Constitution’s prohibition on cruel and unusual punishment.  The ruling makes it clear that states have latitude in carrying out the death penalty.

The Supreme Court has recently upheld a stay of execution for Alabama inmate Vernon Madison.  The stay was originally issued by the United States Court of Appeals for the Eleventh Circuit.  Madison claims that he was mentally incompetent to understand his death sentence because he suffered several strokes and had vascular dementia.  Multiple strokes and dementia left Madison in a state of confusion and inability to comprehend the gravity of pending execution.  The 4-4 decision comes in light of the Court’s previous ruling that inmates with mental illness must be capable of a “rational understanding.”   This means that the inmates must recognize that they are going to be executed and the reason for the execution.  Lower courts decide what these items mean in the individual cases.

In Florida, a Miami judge ruled that the State’s overhauled capital punishment law is unconstitutional because it does not require a unanimous vote among jurors to approve executions.  “A decedent cannot be more or less dead.  An expectant mother cannot be more or less pregnant.  And a jury cannot be more or less unanimous.  Every verdict in every criminal case in Florida requires the concurrence, not of some, not of most, but of all jurors – every single one of them,” the judge announced in his order.

The only body capable of imposing unifying rules regarding drug acquisition, disclosure, and capital punishment may be the Supreme Court.

The only body that is capable of imposing unifying rules regarding drug acquisition, disclosure, and capital punishment may be the Supreme Court.  However, the Court so far has chosen to leave the matter with lower courts.  Until the Supreme Court agrees to take up the issue, the impasse between death penalty states, the judiciary, and the regulators is likely to drag on.

Public approval of capital punishment is at an all-time low.  As a result of pressures from capital punishment opponents and newly imposed drug restrictions, the number of executions has diminished threefold in the last 15 years, a trend that will likely continue.

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About Olga Ivanushko, Senior Staff Writer Emeritus (13 Articles)
Olga Ivanushko is a 2017 graduate of Campbell Law School and served as a Senior Staff Writer for the Campbell Law Observer. Olga is originally from Belarus, but has lived in Hollywood, Florida, then Raleigh, North Carolina for the past 13 years. She earned BA in Political Science from the University of North Carolina at Chapel Hill. Between undergrad and law school Olga worked as a paralegal at a plaintiffs’ medical malpractice and personal injury firm in Chapel Hill, North Carolina. After her first year in law school, Olga interned at the North Carolina Medical Board. Olga now interns with the Honorable John M. Tyson at the North Carolina Court of Appeals.