Lethal injection drug combination sparks debate

Photo by: Will Gentry

 

An untested drug combination scheduled for use in Oklahoma’s lethal injections later this month leaves people questioning how humane the procedure actually is.

“I believe it is fine, since they are using a sedative,” senior nursing major Sarah Philbin said. “It eliminates excruciating pain, so it’s effective.”

The drug cocktail used is a three-step process consisting of midazolam, pancuronium bromide and potassium chloride.

Among the concerns is that the sedative used, midazolam, will not be effective in tranquilizing the subject, leaving the prisoner conscious for the rest of the procedure, which will undoubtedly be painful.

“The midazolam is a very well-known drug that is used to prepare people for surgery,” Bill Luttrell, chair and associate professor of chemistry, said. “It does many different things. It’s a sedative, it makes people fall asleep, it’s an anti-anxiety drug; it’s even a skeletal relaxant, which puts a person in a state of sedation. So after that drug, the person goes to sleep, if the dose is right it gets into the system correctly. Typically from that point, people go into medical procedures.”

The second drug, pancuronium bromide, is a muscle relaxant that relaxes the diaphragm and causes the muscles involved in breathing to quit working. If the sedative works correctly, the patient will be asleep and won’t experience shortness of breath or air deprivation.

The third drug, potassium chloride, stops the heart from beating. It depolarizes the cardiac muscle, and the person dies.

“The thing that concerns me is you can’t get a physician to administer the drugs, so you can’t force a medical person to get everything set up in the execution room,” Luttrell said. “So you have people to put the IVs in and then they have a mechanism that injects the drugs into the IV lines. I question how much experience do these people have? They have to do it in the right way, or the lines can get blocked, the drugs don’t get in. How much confidence can we give for people who don’t have much experience with these medical procedures?”

The midazolan and pancuronium bromide are from a compounding pharmacy the state revealed, although the name of the pharmacy was withheld.

“[The pharmacy name] is confidential under state law,” Aaron Cooper, spokesperson for Oklahoma Attorney General Scott Pruitt, said in the Associated Press article “Oklahoma’s Execution Drug Sparks Concern.”

Previously, Oklahoma used the sedative pentobarbital to carry out its executions. Pentobarbital is a fast-acting sedative, making it desirable for lethal injections. However, the drug came from a Danish pharmaceutical company, which now bans American prisons from buying it.

Florida is the only state to have administered this combination of drugs to execute an inmate, according to the U.C. Berekely School of Law’s Death Penalty Clinic. According to inmate Charles Warner’s lawyer, Madeline Cohen, the dosage of midazolam that Oklahoma is scheduled to use is smaller than that used by Florida.

“This combination of drugs has been used in a handful of executions in Florida,” Cohen said, according to the AP article. “[It] has raised questions because midazolam is not an anesthetic drug and it is therefore unclear whether it will adequately anesthetize a prisoner prior to the second and third drugs, which will unquestionably cause pain and suffering in an inadequately anesthetized person.”

Oklahoma County Judge Patricia Parrish ruled on March 26 that inmates had a constitutional right to be provided with information about their execution drugs. Parrish also ruled that the statute protecting the secrecy of the process was unconstitutional because she could not reveal the drug supplier to the court.

“I certainly think they should [disclose the information],” Luttrell said. “A light needs to be shined upon something that is bad, so that it can be scrutinized. We already know the end result is not good. So, yes, I think they should scrutinize it closely. That might be further justification for convincing the powers that be to not do it.”

Oklahoma attorney general’s office said this ruling would be appealed. The Apothecary Shoppe in Tulsa received attention and harassment after it became known they were to provide execution drugs to Missouri. The state is now hesitant to release the names of the pharmacies providing execution drugs to Oklahoma prisons.

The state attorney office wrote a letter to Cohen stating that although two of the drugs come from a compounding pharmacy, a qualitative analysis of the drugs will be conducted and provided to the inmates’ lawyers.

“Additionally, ODOC will disclose to you the certificate of analysis provided with the raw ingredients used to compound the midazolam and pancuronium bromide,” the state wrote.

Inmates Clayton Lockett and Charles Warner are scheduled for execution by this drug combination. Lockett’s execution sentence is a result of the 1999 shooting death of a woman from Perry, Okla. Warner’s crime is the 1997 rape and murder of his girlfriend’s 11-month-old daughter.

Lockett’s execution is scheduled for April 22 and Warner’s for April 29, after being postponed from the original March date due to a lack of availability of the drug. Lawyers said both of the men would seek a stay of execution from the Oklahoma Court of Criminal Appeals.

“Personally, I think it is a good thing to be merciful,” Philbin said. “I believe it is families’ and churches’ jobs to be merciful, but the government should be focused on justice. If the criminals have had a fair trial and have been found guilty, I think that capital punishment is better than using tax money to keep them in prison for a very long time.”

Oklahoma has two alternative means of execution – a firing squad and electrocution. These, however, would only be used if lethal injection were deemed unconstitutional.

Executions are becoming less common, with the United States being the only country in the Americas to execute in 2013, according to the annual death penalty review by Amnesty International. The United States also had the fifth highest death rate in 2013, at 39 executions.

“I have always objected to capital punishment,” Luttrell said. “I think it’s the wrong thing to do. Even though I have served in the U.S. Navy and think we should protect our society, it’s a misuse of drugs that are meant for other purposes; and just the idea of executing another person, even though they may deserve death – we are called by God to teach people and to get people to change their hearts, and I have never been able to reconcile that with executing a person, because you take away their chance of changing their hearts.”