The sedative midazolam, which some states have been using as part of a cocktail of lethal drugs to execute inmates
CREDIT: AP Photo/File
Thanks to a new policy adopted by a major doctors’ group this week, the country has quietly taken a big step toward putting an end to lethal injections as a means of executing inmates.
The American Pharmacists Association (APhA) is officially discouraging its 62,000 members from participating in executions, declaring that helping states carry out the death penalty runs contrary to what it means to be a pharmacist. While the new policy is not legally binding, the positions of the APhA — which is responsible for setting ethical standards for the pharmacists practicing throughout the country — do carry significant weight in the field.
Using chemicals to kill people isn’t medical care.
The move also brings pharmacists in line with the rest of the health community. Groups like the American Medical Association, the American Public Health Association, the American Board of Anesthesiology, and the American Nurses Association have already explicitly prohibited their members from assisting in executions, saying it conflicts with doctors’ moral obligation to heal their patients.
“It is in some ways unremarkable that pharmacists would reach the same conclusion that nurses, physicians, and anesthesiologists all already have,” Bill Fassett, a member of the APhA and a professor of pharmacy law and ethics at the University of Washington School of Pharmacy, told ThinkProgress. “Using chemicals to kill people isn’t medical care. As health professionals, we can have no part of it.”
In other ways, however, the move could have implications that are quite remarkable. As states have recently been left scrambling to figure out how to procure the lethal drugs they need to carry out executions, the APhA’s decision threatens to have a ripple effect that could change the landscape of the death penalty as a whole.
Over the past two years, pharmacists have come to play a key role in the executions of condemned prisoners. As pharmaceutical companies have begun to refuse to allow states to use their products to execute inmates, and the international supply of lethal drugs has dried up, states are facing a growing shortage of the drugs they need to perform lethal injections. So state officials have been forced to turn to “compounding pharmacies,” which are facilities where pharmacists can create drugs from scratch without going through a drug company. The pharmacists who work at compounding pharmacies — often called “compounders” — have quickly become critical to the states that continue to execute inmates on a regular basis.
But that’s all poised to change. The APhA has made it harder for individual pharmacists to justify their participation in supplying death penalty drugs. And the ethical dimension to the ongoing debate comes on the heels of a similar move from the International Academy of Compounding Pharmacists (IACP), the leading trade group representing compounders. Last week, the IACP released a statement last week discouraging its members from supplying lethal drugs in order to avoid potential legal repercussions.
One of the really interesting things… is how quickly pharmacists moved to shut off the supply of drugs.
The movement in this area is the culmination of a year of activism spearheaded by SumOfUs, a group that allows citizens to organize to advance social justice causes. Last year, members of SumOfUs started pressuring the pharmacy group to forbid their members from assisting in the execution of inmates. They partnered with dozens of human rights groups to send a letter to the APhA about the issue, as well as attended the group’s last annual meeting to discuss a way forward.
“We would not have done this without the work of the folks at SumOfUs,” Fossett acknowledged. “They raised our awareness.”
According to Kelsey Kauffman, an activist from Indiana who led the SumOfUs campaign, the American Pharmacist Association was initially unaware that their members were suddenly playing a central role in the death penalty. Once the leaders of the group learned more, they acted swiftly to amend their code of ethics. “One of the really interesting things in this story is how quickly pharmacists moved to shut off the supply of drugs,” Kauffman told ThinkProgress.
She thinks that trend will continue. Bolstered by the policy change within the APhA, activists are now turning their attention to state pharmacy boards, which are the entities responsible for actually licensing pharmacists.
Many state boards already have regulations in place that suggest pharmacists should not be supplying death penalty drugs. In Michigan, for instance, R 338.490 stipulates that “a pharmacist shall not fill a prescription if the pharmacist has reason to believe that the prescription could cause harm to the patient.” Other states say that pharmacists cannot legally fill a prescription when a pharmacist knows “that no valid physician-patient relationship exists,” which is certainly true for death row inmates and the state officials who execute them. SumOfUs wants to pressure states to more explicitly clarify those positions, which will prevent compounders from continuing to make lethal drugs.
Moving forward, it’s certainly logical to assume that it will only get more difficult for prison officials to get their hands on the drugs they need to carry out lethal injections.
“The noose is tightened around the supply. States basically are not going to be able to get the drugs, unless they do something drastic,” Kauffman said. “I think a handful of hardcore death penalty states are going to move to adopt other means of executions. Texas, Utah, Oklahoma — they’re going to find some other way to kill the people they have on death row. But I think the other states are basically going to drop out.”
States basically are not going to be able to get the drugs, unless they do something drastic.
Some states are already making moves in this area. Missouri’s attorney general, for instance, recently suggested that officials could circumvent medical professionals altogether by creating state-run pharmacies to manufacture lethal injection drugs. Utah, meanwhile, recently became the only state to authorize the firing squad as a legal method of executing inmates when lethal injection drugs are not available.
Critics of the death penalty suggest that, once the execution of inmates is no longer shrouded behind lethal injection — a more sanitized method of killing people that may give the appearance of being more medically professional than, say, the firing squad or the electric chair — public support for the policy will wane. “The desire to sanitize execution has made a terrible policy even worse,” an editorial in Bloomberg News argued earlier this month. “States should stop trying to mask the violence of the act.”
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