Drug shortages and lethal injection

January 23, 2011 5:09 PM

Yesterday, the drug manufacturer Hospira ceased its production (corporate statement) of Sodium thiopental, the first drug used in the three drug cocktail for lethal injection. (Sodium thiopental shortages previously)

This was due to the Italian government asking the company not to make any drug that would be used in executions in Italy, the location of the companies drug factory. Beyond the use, as the first drug in the classic three drug procedure, Sodium thiopental has also been used as the sole drug in executions in Ohio. However, beyond the use of sodium thiopental as an execution drug, it is also on the WHO list of Essential Medicines (PDF).

However, some states have already found solutions. Oklahoma has switched to pentobarbital, a drug commonly used for anesthesia and euthanasia of animals. (It can also be used to treat epilepsy in dogs.)

Despite the attention the loss of access to this drug has drawn in the United States, it is a different drug, Pancuronium bromide, a muscle relaxant, that in the past has prompted court cases. In 2007 the Supreme Court heard and dismissed the claim that Pancuronium Bromide was cruel and unusual punishment (news story, Court Opinion (PDF)). This case prompted former Conservative MP, Michael Portillo (warning, horrible flash interface), to seek a humane manner of execution in early 2008. This was documented in the BBC Horizons series "How to Kill a Human Being" (Google Video, 50m). Spoiler: The solution he comes up with is hypoxia through the inhalation of pure nitrogen gas, which kills painlessly and causes the executed to feel a state of euphoria while dying.

With the laws now probably having to be rewritten, as only Oklahoma has laws on the books allowing any fast acting barbiturate to be used, the "medical charade" (the second video) of lethal injection will probably only experience a slight hiccup in its use. While this could be a time to switch to a more humane method of execution, there are objections to a practice like hypoxia, when such things are discussed at all.

Many believe that no matter than manner of execution, there is no such thing as a humane execution. However, with recent polls putting support for the death penalty at 64%, and opposition at 29%, it seems probable that the death penalty will not be vanishing from America in the near future.

posted by Hactar (61 comments total)

I wanted to limit my editorializing in the FPP as much as possible, so I'm writing this in a comment. I fall into the 29% in opposition. However, as I said, it doesn't look like the death penalty is leaving anytime soon, so I think this is something that should be talked about.
posted by Hactar at 5:11 PM on January 23, 2011 [2 favorites]

Previous discussion here.
posted by briank at 5:14 PM on January 23, 2011

(ooh, sorry, didn't notice you linked that, too.)
posted by briank at 5:19 PM on January 23, 2011

I'm not against the death penalty because I believe no one deserves it; I'm against the death penalty because I don't believe government should have that kind of power.
posted by ZenMasterThis at 5:26 PM on January 23, 2011 [25 favorites]

I'm all for the death penalty the moment you can unkill people after you discover you've executed an innocent person.
posted by eriko at 5:27 PM on January 23, 2011 [27 favorites]

Is it because of capital punishment, or is because drug companies want to raise prices for generics through (artificial) scarcity as well as withholding product altogether from governments that put price controls on drugs?
posted by Blazecock Pileon at 5:28 PM on January 23, 2011

I'm not against the death penalty because I think no one deserves it. I'm not against the death penalty because I don't believe the government - in principle - should have that kind of power.

I'm against the death penalty because the actual state and governments we have, and the judicial system we actually have, have proven themselves totally incapable of administering the death penalty in a way that is not screamingly inconsistent, irregular, racist, and otherwise incompetent.
posted by Tomorrowful at 5:29 PM on January 23, 2011 [21 favorites]

...I think it's because Italy told them to stop making it, Blazecock. If they don't manufacture the drug, how would a scarcity help the company?
posted by maryr at 5:32 PM on January 23, 2011

The only method I can think of for human execution is explosion. I don't agree with the death penalty for the most part, but if you're going to do it in a way that is sure to cause no pain, use high powered explosives.

Ah, but this will never happen, because somehow that's more icky than causing people to die with drugs and unknown amounts of suffering.
posted by swimming naked when the tide goes out at 5:32 PM on January 23, 2011 [2 favorites]

"human execution" should be "humane execution"
posted by swimming naked when the tide goes out at 5:33 PM on January 23, 2011

I'm for the death penalty because some people have demonstrated that they are unwilling to live within certain bounds that we as a society decide are necessary. But I would like to see it used less often.
posted by Kraftmatic Adjustable Cheese at 5:36 PM on January 23, 2011

The only method I can think of for human execution is explosion. I don't agree with the death penalty for the most part, but if you're going to do it in a way that is sure to cause no pain, use high powered explosives.

Ah, but this will never happen, because somehow that's more icky than causing people to die with drugs and unknown amounts of suffering.

It's funny, the idea that much more violent, gruesome means of execution could actually be less painful and protracted - the charity the state shows to its victims being not for the comfort of the victim, but for the comfort of the audience.
posted by Sticherbeast at 5:37 PM on January 23, 2011 [5 favorites]

According to an NPR report in 2004, a quarter of all death row inmates the Innocence Project was able to find DNA evidence for were innocent of the the crime they were convicted of. Assuming the ratio is the same for cases where there is no DNA, 25% of the people the state kills are innocents.

Draw your own conclusions.
posted by clarknova at 5:40 PM on January 23, 2011 [3 favorites]

...I think it's because Italy told them to stop making it, Blazecock. If they don't manufacture the drug, how would a scarcity help the company?

Supply shortages of sodium thiopental are affecting more countries than the US and appear to be part of a larger pattern of important drug shortages across the world, for which there are several causes that have less to do with Hospira deciding about the morality of capital execution (or liability issues surrounding it).

Given increased controls over what supplies remain, I wouldn't be surprised if some company somewhere — a partner of Hospira or its shareholders, even — is making significantly higher profits off of these shortages.
posted by Blazecock Pileon at 5:41 PM on January 23, 2011

I'm against the death penalty because I think killing people is wrong.

I am, however, conflicted on the question of Michael Portillo - loathsome politically, but really quite good on the telly.
posted by a little headband I put around my throat at 5:42 PM on January 23, 2011

I think death by explosion is just a matter of time. Think of the PPV money!
posted by Malor at 5:43 PM on January 23, 2011

I was against the death penalty. Then I was against the state. Then I was against the phrase "legitimate violence". Then I stopped caring.
posted by doublehappy at 5:48 PM on January 23, 2011 [1 favorite]

I think death by explosion is just a matter of time. Think of the PPV money!

(does so, explodes, dies)
posted by Sticherbeast at 5:49 PM on January 23, 2011 [1 favorite]

There is nothing unequivocally good that can happen between the time death is initiated and its ending.

The moments that the prisoner is conscious and aware of the instantiation and continuation of the terminal execution process should be as few as possible.

The 16t weight is my favorite. It just can't get more instantaneous than that! Plus, the killer will walk funny afterward, kinda like an accordion.

There are those who would want to draw out the process. I suspect poisons would be their preference.

Personally, for the few bucks a year it costs me to keep Canadian serial-killers alive, I'll roll with those who somehow manage to feel it's better to keep serial-killing sociopaths well-cared for.

If we had to kill them, I might be okay with killing serial killers by heroin overdose. I understand it to be a good trip out. If it can't be instantaneous, not unpleasant is a good second.

Personally, I'd be okay with providing serial killers with a heated doghouse, a dog, and a yard big enough for the dog to stay healthy. Treat them as equals: the same level of care.

The dog might get slightly better treatment, ie. time in a dog park, because it didn't kill twenty people.
posted by five fresh fish at 6:01 PM on January 23, 2011 [2 favorites]

I suspect the big problem with execution as used in the USA is that a lot of the death row inmates aren't what you'd conventionally call a "sociopathic serial killer."
posted by five fresh fish at 6:05 PM on January 23, 2011

I say this in every death penalty thread: Capital punishment is far too merciful to the guilty, and far too horrible to the innocent.
posted by notsnot at 6:08 PM on January 23, 2011 [5 favorites]

Supply shortages of sodium thiopental are affecting more countries than the US and appear to be part of a larger pattern of important drug shortages across the world, for which there are several causes that have less to do with Hospira deciding about the morality of capital execution (or liability issues surrounding it).

Given increased controls over what supplies remain, I wouldn't be surprised if some company somewhere — a partner of Hospira or its shareholders, even — is making significantly higher profits off of these shortages.

This is approaching derail territory, but I’m really interested in these accusations. Does anyone have any evidence of this practice?
posted by spitefulcrow at 6:09 PM on January 23, 2011

Killing people is wrong.
posted by furiousxgeorge at 6:18 PM on January 23, 2011 [3 favorites]

Killing people is wrong.

According to... ?

Seeing things in black and white is wrong.
posted by xmutex at 6:23 PM on January 23, 2011

It's funny, the idea that much more violent, gruesome means of execution could actually be less painful and protracted - the charity the state shows to its victims being not for the comfort of the victim, but for the comfort of the audience.

I've always felt this way. I can imagine few things more terrible than experiencing the slow, methodical, clinical way in which we execute prisoners. Inspected by doctors. Being strapped to a gurney in a sterile, cold room. The low hum of the machinery of death. Your life slowly draining away beneath ugly fluorescent light.

Somehow that's supposed to be more humane than, say, firing squad? Don't get me wrong; I'm not exactly reserving my place in line for the firing squad. That would also be pretty terrible. But I'd volunteer for a firing squad execution every day of the week and twice on Sunday before the gradually building horror that is lethal injection. Under the open sky, sun on your face, a light breeze. It may not be humane but it is a hell of a lot more human.

And the electric chair? Jesus christ. Anybody participating in any manner in a death by electrocution should themselves be behind bars.
posted by Justinian at 6:27 PM on January 23, 2011 [1 favorite]

When the time comes that medical science can no longer provide me with an acceptable quality of life, I want to go out in a nitrogen tank.
posted by chimaera at 6:29 PM on January 23, 2011

Seeing things in black and white is wrong.

According to... ?
posted by furiousxgeorge at 6:34 PM on January 23, 2011 [7 favorites]

I'm against the death penalty because the actual state and governments we have, and the judicial system we actually have, have proven themselves totally incapable of administering the death penalty in a way that is not screamingly inconsistent, irregular, racist, and otherwise incompetent.

I've never found it very reassuring that the biggest proponents of capital punishment seem to be the same people who think the government is too incompetent to manage a postal service, train system, or universal health care.
posted by Combustible Edison Lighthouse at 6:40 PM on January 23, 2011 [44 favorites]

This singular focus on protesting death penalties has always struck me as an unsound idea. There is a long list of things the State can do to you that are morally and ethically objectionable. Death is quite a ways from the worst.

I'm not against the idea in principle of a state, as the method of expressing the collective will of its people, having the power to end lives. I don't see killing in a judicial context as much different in principle from killing in the context of military action (arguably it is more moral than killing civilians), or killing as euthanasia whether voluntary or not. The morality of killing people--as with anything else--is about the reasons why it should or shouldn't be done, the benefits and costs, and the availability and practicality of alternatives.

As currently practiced, it's a crock. Fails on reasons why, fails horribly on benefits and costs, and there are plenty of available and more practical alternatives.
posted by aeschenkarnos at 6:52 PM on January 23, 2011

swimming naked to your death,

hypoxia via nitrous oxide always seemed like a great way to go, nitrogen sounds OK to me. Of course, I'm 100% against the death penalty, but if they're going to do it...
posted by polyhedron at 6:52 PM on January 23, 2011

Killing people is wrong, from first principles, the quick-and-sloppy-Internet-forum version:

- I think therefore I am.
- All other knowledge may stem from an illusionist toying with my senses.
- Therefore all possible explanations for the nature of existence should be considered.
- In the absence of a priori knowledge supporting any single explanation, the questionable evidence of my senses must be accepted until a more likely explanation is produced.
- Existence is therefore tentatively assumed to conform to the description provided by my senses.
- From the sense data I've gathered it appears that when my body dies, the entirety of my self is utterly annihilated and even my scant a priori assertion of identity goes with it.
- Death is therefore a complete and total loss in every possible sense.
- My senses suggest that the world is inhabited by other beings for whom this is also true.

This prompts a personal moral maxim: where possible, don't die. The prisoner's dilemma extends this to others. Apologies if this is insufficiently rigorous for those of you with more than Intro to Philosophy under your belts, I'm a bit short on time this evening and this is just a quick one-off Metafilter comment and not a personal thesis I'm interested in seriously defending.
posted by Ryvar at 6:52 PM on January 23, 2011 [5 favorites]

D'oh. Old tab. Shoulda previewed. Back to the conversation at hand.
posted by polyhedron at 6:53 PM on January 23, 2011

It looks like California's stocking up on the sly to get enough Sodium thiopental for themselves and maybe some close, personal friends until 2014.
posted by mwalimu at 7:05 PM on January 23, 2011

This prompts a personal moral maxim: where possible, don't die. The prisoner's dilemma extends this to others. Apologies if this is insufficiently rigorous for those of you with more than Intro to Philosophy under your belts, I'm a bit short on time this evening and this is just a quick one-off Metafilter comment and not a personal thesis I'm interested in seriously defending.

And, here you've nicely encapsulated human morality as the outcome of a formula. Which, of course, as anyone who has ever lived and breathed can tell you, from like first principles, is not at all how it works.
posted by xmutex at 7:05 PM on January 23, 2011

The Death Penalty is essentially a pagan ritual, practiced by unsophisticated cultures, where a token sacrifice is demanded to release the overall tension which the group collective feels in a stressful environment.
posted by ovvl at 7:18 PM on January 23, 2011 [6 favorites]

I don't believe in the death penalty. But I do believe in deep, dark holes behind thick steel doors.
posted by Cool Papa Bell at 7:24 PM on January 23, 2011

Killing people is wrong.

Sure, but so is throwing someone in a cage and keeping them there, most of the day, for years on end. Yet we have prisons.

There's absolutely nothing we do to punish people in the justice system that wouldn't be disgustingly awful if it wasn't done as punishment for a crime. If executions are state-sanctioned murder, then prison is state-sanctioned kidnapping and fines are state-sanctioned theft.
posted by Tomorrowful at 7:29 PM on January 23, 2011 [1 favorite]

Humane execution is a paradox.
posted by bwg at 7:46 PM on January 23, 2011

Letting murderers walk free is wrong. Kidnapping them is less wrong. Killing them is more wrong than kidnapping them.
posted by furiousxgeorge at 7:47 PM on January 23, 2011 [2 favorites]

It's funny, the idea that much more violent, gruesome means of execution could actually be less painful and protracted - the charity the state shows to its victims being not for the comfort of the victim, but for the comfort of the audience

My first thought was along the same lines: Why are we asking about the humanity of executions? The very act of capital punishment seems inhumane no matter how its performed.

Maybe if the audience wasn't as comfortable we'd get around to asking if we should be doing it in the first place.
posted by ibfrog at 8:11 PM on January 23, 2011 [1 favorite]

The death penalty, like taxes, health care, and real estate valuation, could be wisely and judiciously provided by an enlightened state. Here is the Onion's take on why it's done in the USA. I believe them.
posted by aeschenkarnos at 8:27 PM on January 23, 2011 [1 favorite]

Letting murderers walk free is wrong. Kidnapping them is less wrong. Killing them is more wrong than kidnapping them.

This, I have no problem with. "Killing criminals is wrong, and unnecessary when we have other options that are less wrong, especially since we can't seem to run a criminal justice system that isn't horribly injust," is my basic stance on the death penalty. I just object to the logic that killing is wrong, ergo the death penalty must be ended, which disregards the fact that we, collectively, do tons of things that are wrong because we believe they're less-wrong than the alternative.
posted by Tomorrowful at 8:43 PM on January 23, 2011

It's not about what's wrong or right, it's about what the population can either stomach or ignore.
posted by doublehappy at 8:50 PM on January 23, 2011

I just object to the logic that killing is wrong, ergo the death penalty must be ended, which disregards the fact that we, collectively, do tons of things that are wrong because we believe they're less-wrong than the alternative.

Doing the right thing sometimes involves doing something wrong, but when done so to reduce overall wrongness, it is right. However, on an appropriate scale too much wrong does not balance out with right. War is wrong, but stopping it requires doing enough wrong that the right isn't worth it. It is wrong to think human minds can accurately calculate this balance to arrive at the precise area where right becomes wrong. The amount of people to be killed while still remaining right is probably somewhere in the range of 1-50,000, but in isolation of outside balancing calculations it is safe to say that killing one person is wrong.
posted by furiousxgeorge at 10:05 PM on January 23, 2011

Seeing things in black and white is wrong.

Hilarious.
posted by rtha at 10:34 PM on January 23, 2011 [2 favorites]

Only a Sith deals in absolutes.
posted by furiousxgeorge at 11:57 PM on January 23, 2011

Anesthesia will never be outlawed, and you can do pretty much anything to people after they are under proper anesthesia without them feeling a thing. If you can conduct a painless heart transplant, you can conduct an equally painless heart (or head?) removal using the same anesthesia.

But I'm against execution, and I'm especially against secretive medicalized execution. If you're going to kill people by proxy when you vote for capital punishment, you ought to see the results of your vote each time someone dies. Make it a legal requirement to show each execution live on the national morning news shows, and don't pretend that it is better if you numb them first: use a guillotine or firing squad with live cameras, live microphones, and no hoods.
posted by pracowity at 12:08 AM on January 24, 2011

I've had every kind of dental surgery. Awake with local anesthesia, laughing gas, knocked out entirely. They were all traumatic.
posted by furiousxgeorge at 12:16 AM on January 24, 2011

Seeing things in black and white

Shades of grey are nothing more than varying ratios of tiny little black and white dots.
posted by aeschenkarnos at 12:46 AM on January 24, 2011 [5 favorites]

We will get a new "humane" form of execution when an interested contractor makes enough campaign contributions to a cadre of state legislators. Provided the new solution is still horrific and painful.

As per usual, our "public dialog" will have no bearing whatsoever on any criminal justice policies.

Meanwhile I think I'll buy myself an industrial nitrogen tank.
posted by clarknova at 12:53 AM on January 24, 2011

Michael Portillo (warning, horrible flash interface)

Yep, that's Michael Portillo alright.
posted by Grangousier at 12:55 AM on January 24, 2011

I've had every kind of dental surgery. Awake with local anesthesia, laughing gas, knocked out entirely. They were all traumatic.

Maybe they intentionally or accidentally didn't put you out all the way (wouldn't want a patient not to wake up, would they?). I've had internal surgery and I don't remember anything between when the anesthesia sent me swirling away to Neverland and when I woke up in my room.

And, of course, you were slowly revived from your dental adventures to wake to gaping mouth wounds and the aches of having had your jaw yanked and twisted with pliers. If the doctors had instead put you under heavy anesthesia and then quickly and neatly lopped off your head with a very large, sharp, fast, mechanical chopper, the operation would have lasted a fraction of a second and the post-op phase wouldn't have existed at all. And you would have had no more trouble with your teeth.
posted by pracowity at 1:47 AM on January 24, 2011 [1 favorite]

But the first part is always traumatic.
posted by furiousxgeorge at 2:09 AM on January 24, 2011

Why the euthanasia drug Pentobarbital isn't already being widely used is beyond me. It's THE drug of choice for for physician assisted suicide. There is no pain and it's quick.
posted by boogiefunk at 3:39 AM on January 24, 2011

Yeah, phenobarb--linked in the post--and pentobarb are not the same drug. Pentobarb is part of the 'blue juice.' Pentobarb is sometimes used as a short-acting anesthetic, IIRC. It's on the list of IACUC protocols, anyway. I've never heard of it as an anticonvulsant--its half-life is too short to be practical. Again, IIRC.

OTOH, Fatal Plus would certainly address the issue of seizures.

/not a veterinary anesthesiologist
posted by Uniformitarianism Now! at 5:08 AM on January 24, 2011

But the first part is always traumatic.

You just need to focus on your Highlights magazine and stop listening for the drill.
posted by pracowity at 5:13 AM on January 24, 2011 [2 favorites]

I used to work with equipment that was filled with nitrogen; lean too far in, fall asleep for good. CO2 would work just as good. Why don't they just use something like that? We're not running out of those anytime soon.
posted by codswallop at 8:08 AM on January 24, 2011

Re: use of explosions

Let's throw in some capitalism and spectacle: Tie the condemned so that his/her torso blocks the business end of a large cannon loaded with plenty of black powder and maybe a bucket of large ball bearings, then have at it. A sturdy canvas, judiciously placed just beyond this to catch the results, could later be sold to the highest bidder to cover costs, and people could pay to watch, also defraying expenses.

The condemned feel nothing, the spectators are entertained, and the art world sees the dawning of a new form of "accidental" art. Everybody wins!
posted by kinnakeet at 8:28 AM on January 24, 2011

CO2 would work just as good. Why don't they just use something like that?

Unlike nitrogen, the body reacts very badly to even somewhat elevated levels of CO2 in the air: "At about 5% it causes stimulation of the respiratory center, dizziness, confusion and difficulty in breathing accompanied by headache and shortness of breath. Panic attacks may also occur at this concentration. At about 8% it causes headache, sweating, dim vision, tremor and loss of consciousness after exposure for between five and ten minutes."
posted by jedicus at 1:44 PM on January 24, 2011

Related to the OP: The strange case of Elgone Driving Academy, aka Dream Pharma
posted by Kiwi at 3:18 PM on January 24, 2011

We humanely operate on humans, so it's likely possible to humanely make a person become unconscious and unable to feel pain, then cause death.

The death penalty, as implemented by anybody, anywhere, is unjust. It gets used against the poor, minorities, the retarded and mentally ill, far more than is at all equitable.

Most of all, the choice to kill, cold-bloodedly and intentionally, makes us less. Keeping even horrible people alive is a sign that we can be better than the people we want dead.
posted by theora55 at 4:52 PM on January 24, 2011