Lethal Injection

Anesthesiologist Says Lethal Injection Creates Moral Dilemma for Physicians

Lethal injection as practiced in U.S. executions "is an impersonation of medicine populated by real doctors who don't acknowledge the deception," Dr. Joel Zivot (pictured), an anesthesiologist and associate professor of anesthesiology at Emory University School of Medicine, writes in an op-ed for CNN. Setting aside the question of the rightness or wrongness of capital punishment itself, he says, "it's time to reject lethal injection" as the method of execution. Dr. Zivot's op-ed describes how the medicalization of executions has created an ethical problem for doctors. He cites as an example the recent Virginia execution of Ricky Gray, which used midazolam and potassium chloride from a compounding pharmacy, along with a paralytic drug. He calls lethal injection, "a trick of chemistry" that "does not cause a cruelty-free death," explaining, "Virginia used a paralytic drug that may obscure the failure of midazolam to create the sort of deep unconsciousness contemplated by lethal injection proponents." He says that, because lethal injection "approximates a medical act," it "fall[s] within the purview of physicians who now find themselves wittingly or unwittingly cast in the role of execution adviser." These physicians must choose between their profession's ethical prohibition against killing—both the American Medical Association and the American Board of Anesthesiology have issued statements condemning physician involvement in executions—and their ethical imperative to reduce suffering, especially in the face of botched executions. "An inmate facing death is not a patient by virtue of being connected to an intravenous device and having a doctor in a lab coat standing by. Physicians can only work with patient consent," Zivot says. He asks, "What is the role of the doctor in the execution chamber? When does the alleviating of suffering become physician-assisted homicide?" Because of these ethical dilemmas, and the failure of lethal injection to offer a cruelty-free execution, Zivot concludes, "If capital punishment continues, it needs another method."

California Agency Rejects Proposed Execution Protocol

In a new setback to efforts to restart executions in California, the state's Office of Administrative Law (OAL) has rejected the new lethal injection protocol proposed by the California Department of Corrections and Rehabilitation. On December 28, 2016, the OAL, which is responsible for reviewing regulatory changes proposed in California, issued a 25-page decision of disapproval, citing inconsistencies, inadequate justification for certain parts of the proposal, and a failure to adequately respond to public comments. The agency gave the Department of Corrections four months to address problems in the protocol. The proposed protocol would have changed California's previous three-drug procedure to a one-drug procedure, calling for 7.5 grams of one of four barbiturates. The OAL questioned whether the 7.5 gram dose met California's requirement that a regulation be "necessary," noting that corrections officials had said 5 grams of the barbiturate would be lethal and had provided no rationale as to why they chose a larger dose. It also requested clarification of numerous ambiguities in the new regulations, including the steps taken by correctional officials in the days leading up to the execution, what steps would be taken during the course of an execution if the prisoner did not immediately die, and what would be involved in monthly inspections of the execution chamber. Among the inadequate responses to public comments, the OAL noted that "[t]he Department's response does not address the issue of 'using methods that are untested or poorly understood' or 'human experimentation' as it pertains to the use ... for lethal injection purposes" of two of the drugs in the protocol. Executions in California have been on hold since 2006 because of legal challenges to the state's lethal injection procedure. In November, voters narrowly passed Proposition 66, which proposes to speed up executions. Implementation of that proposition was blocked by the California Supreme Court, pending the outcome of a lawsuit.

Texas Sues Food and Drug Administration Over Seizure of Execution Drugs

The Texas Department of Criminal Justice filed suit on January 3, 2017 against the federal Food and Drug Administration (FDA) over the FDA's continued detention of drugs Texas had attempted to import for executions. In October 2015, Texas and Arizona attempted to import sodium thiopental, an anesthetic commonly used in executions prior to 2010, from Harris Pharma, a supplier in India. The FDA halted both shipments, saying that their import violated federal law. The FDA does not comment on litigation, but has previously said that sodium thiopental has no legal uses in the United States. The agency has indicated in the past that an injunction issued by a federal district court in Washington in 2013, and which later was upheld by the United States Court of Appeals for the District of Columbia Circuit, requires it to halt importation of the drug. No U.S. manufacturer currently produces sodium thiopental, and so the drug is unavailable from domestic sources. Texas argues that the drug should be allowed to be imported under a "law enforcement exemption" to usual importation rules. In a statement about the lawsuit, Texas Attorney General Ken Paxton attacked the agency, saying "[t]here are only two reasons why the FDA would take 17 months to make a final decision on Texas’ importation of thiopental sodium: gross incompetence or willful obstruction." Texas has used an alternative drug, pentobarbital, in executions since 2012. A spokesman for the Texas Department of Criminal Justice said, "We cannot speculate on the future availability [of] drugs, so the agency continues to explore all options including the continued use of pentobarbital or alternate drugs to use in the lethal injection process."

Ronald Smith Heaves and Coughs During Alabama Execution After Tie Vote in Supreme Court Denies Him A Stay

After a divided U.S. Supreme Court twice temporarily halted the execution of Ronald Bert Smith, Jr. (pictured), Alabama put Smith to death on December 8 in a 34-minute execution in which Smith heaved, coughed, clenched his left fist, and opened one eye during one 13-minute period. Smith's jury had recommended by a vote of 7-5 that he be sentenced to life without parole, but, in a practice permitted by no other state, his trial judge overrode that recommendation and sentenced Smith to death. At the time his execution was scheduled to begin, Smith had a stay motion and a petition for certiorari pending in the U.S. Supreme Court arguing that judicial override violated his Sixth Amendment right to a jury trial and was unconstitutionally arbitrary under the Eighth Amendment. After Alabama announced its intention to proceed with the execution despite the pending petition, Justice Thomas granted a temporary stay, a procedure to allow time for the full Court to act. Half the Court—enough to review a case—voted to grant Smith a stay, but five votes are required to halt an execution. Smith's lawyers then filed a motion for reconsideration, criticizing as arbitrary the rule that allows four votes to grant review of a case, but requires five to stay an execution. His motion argued that when four justices vote to hear a case, "all certiorari petitioners, public and private parties in civil and criminal cases of every kind" are entitled to have their cases reviewed except condemned prisoners facing an imminent execution. He asked the Court to reconsider his stay motion "[b]ecause the Court’s inconsistent practices respecting 5-4 stay denials in capital cases clash with the appearance and reality both of equal justice under law and of sound judicial decision-making." Justice Thomas granted another temporary stay so the full Court could consider that motion; after about an hour, the Court denied the request and also rejected a last-minute challenge to the state's lethal injection procedure. Alabama used a three-drug procedure in its execution, beginning with midazolam, a sedative that has contributed to botched executions in several other states and that was the subject of a challenge before the Supreme Court in 2015. Though midazolam is intended to render the inmate unconscious and therefore protect against the pain and suffering that would be experienced from the second and third drugs, witnesses reported that Smith showed signs of consciousness after it was administered.

Supreme Court Stays Execution of Tommy Arthur in Alabama

The U.S. Supreme Court has stayed the execution of Tommy Arthur, who was scheduled to be executed in Alabama at 6:00 p.m. Central Time on November 3. Around 10:30 p.m. Eastern, the Court first issued a temporary stay of execution through Circuit Justice Clarence Thomas "pending further order" of the Court. Anticipating a second ruling by the Court, Alabama continued preparations for the execution. Then, just before midnight in Washington, the Court issued a full stay to permit it to consider a petition for writ of certiorari Arthur had filed earlier in the day. Arthur's lawyers had filed two stay applications and petitions for writs of certiorari. One petition sought review of the Alabama Supreme Court's summary dismissal of his challenge to the constitutionality of Alabama's death penalty statute under the Supreme Court's January 2016 decision in Hurst v. Florida. Hurst struck down Florida's death penalty statute because it required a judge, rather than a jury, to find critical facts that were a prerequisite to imposing the death penalty, and Arthur had argued that Alabama's statute suffered from the same defect. The other petition sought review of the denial of Arthur's lethal-injection challenge by a divided 2-1 panel of the U.S. Court of Appeals for the Eleventh Circuit. In its opinion, that court had ruled that Arthur had not met the burden imposed by the Supreme Court's 2015 decision in Glossip v. Gross of showing that an alternative method of execution was available to Alabama because the firing squad -- his proposed alternative -- was not "readily available" under Alabama law. The dissent wrote: "By misreading an Alabama statute, the Majority creates a conflict between the claim and state law. The Majority then resolves that faux conflict in favor of state law, taking the unprecedented step of ascribing to states the power to legislatively foreclose constitutional relief. These missteps nullify countless prisoners’ Eighth Amendment right to a humane execution." The Supreme Court granted Mr. Arthur's stay application in the lethal-injection case. Four Justices voted to stay the execution, with Chief Justice Roberts providing the fifth vote "as a courtesy." Justices Thomas and Alito dissented. Without the time constraints imposed by the death warrant, the Justices can now consider whether to grant review in the case. This was the seventh time Mr. Arthur's execution has been stayed.

Nevada's Search for Execution Drug Suppliers Turns Up Zero Bids

After having "solicited thoroughly for vendors," the Nevada Department of Corrections announced that no pharmaceutical company has offered to sell the state drugs for use in executions. James Dzurenda, director of the Nevada Department of Corrections issued a statement on October 7 saying that the Department had sent 247 requests for proposals to pharmaceutical suppliers on September 2 and, in response, had received no bids to supply the state with lethal injection drugs. In August, Dzurenda informed the state Board of Prison Commissioners that one of the two drugs the state used in executions—midazolam and hydromorphone—had expired and that Pfizer, Inc., which produces both of the drugs, refused to provide the state with new supplies. Pfizer announced restrictions on the distribution of its medicines in May in an effort to prevent states from using them in executions. At the time, the company said, "Pfizer makes its products to enhance and save the 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." Having failed to identify a drug supplier, Dzurenda said the Department "will work closely with the attorney general, the governor and the Legislature to examine our options and decide the best course of action moving forward." The state legislature would have to approve any change to an alternative method of execution. The state's $858,000 new execution chamber is expected to be completed by November 1, but no executions are imminent, and none could be carried out without a supply of drugs. Nevada's last execution was in April 2006. Officials said the space will be used for storage and attorney-client meetings if no executions are scheduled.

Tennessee Death Row Prisoners Challenge Lethal Injection, Argue Protocol Would Break the Law to Carry Out Executions

Lawyers for 30 Tennessee death row prisoners argued before the state's supreme court on October 6 that Tennessee's lethal injection protocol violates the Eighth Amendment prohibition against cruel and unusual punishment. Tennessee, which has not carried out an execution since 2009, intends to use a one-drug protocol of pentobarbital that it says would be obtained from a compounding pharmacy. The prisoners argue that the Tennessee Department of Correction's lethal-injection protocol creates an unconstitutional risk of lingering death and requires physicians to illegally prescribe controlled substances. Their lawyers argue that states may not break their own laws or federal statutes to carry out executions and that physicians who prescribe pentobarbital for executions would be violating federal drug laws. Assistant Federal Public Defender Michael Passino said, "You cannot perform a lawful act in an unlawful manner. To the extent that TDOC is doing that, the protocol is unconstitutional." Justice Sharon G. Lee raised concerns about the possibility of botched executions like those that have occurred in other states, in which prisoners writhed and gasped during prolonged executions. Associate Solicitor General Jennifer Smith, arguing on behalf of the state of Tennessee, conceded that "there is no guarantee that an execution is not going to have a problem." Justice Lee asked Smith further, "So how do we know our execution would not be botched?" Smith responded, "We don't."

Missouri Execution Pharmacy Calls Sale of Drugs to State 'Political Speech,' Claims First Amendment Right to Secrecy

A pharmacy that has received more than $125,000 in cash payments from Missouri for providing lethal injection drugs that the state has used in 16 executions has argued in a court filing that its identity should remain secret, claiming that selling execution drugs to the state's Department of Corrections is political speech protected by the First Amendment. The supplier's information was requested in a subpoena by Mississippi death row inmates who are challenging that state's execution protocol, and seeking information about other state practices as part of their lawsuit. The pharmacy, which is identified in court documents as "M7," filed a motion stating that its "decision to provide lethal chemicals to the Department was based on M7’s political views on the death penalty, and not based on economic reasons. ...The fact that M7’s expression of political views involves a commercial transaction does not diminish M7’s First Amendment rights." BuzzFeed News reports that Missouri paid the pharmacy $7,178.88 for two vials of pentobarbital per execution, which it describes as well above market value, amid concerns that the cash payments may have violated federal tax laws. Analyzing M7's claim, Bloomberg News columnist Noah Feldman described the pharmacy's constitutional argument as "deeply flawed." Feldman writes that "there’s an enormous difference between speaking and acting—particularly when that action is a for-profit commercial transaction with the government. ... [I]n a democracy, it’s crucially important for the government to disclose its vendors, both to avoid corruption and to promote transparency." M7 asserted in its filing that releasing its identity could subject the pharmacy to harassment and boycotts, relying on statements from a security consultant, Lawrence Cunningham, whose previous statements about the potential threats to execution drug suppliers have been exposed as unsupported or exaggerated. "The M7 situation helps demonstrate why it’s so dangerous to treat corporations as though they have fundamental constitutional rights while doing business," Feldman writes. "Those basic rights are designed to protect individuals against government power. They aren’t supposed to be used to exempt businesses from regulation or publicity whenever it’s convenient for them."

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