A Worthwhile Embargo

An unusual trio of voices is being heard these days. The German Federal Minister of Health, Phillip Rösler, medical activist Frank Ulrich Montgomery and the Association of Research-Based Pharmaceutical Companies all share the same opinion for a change: German pharmaceutical companies should not supply preparations used for executing people in the United States. Broad support for that decision is guaranteed.

The impetus for this unusual agreement is a macabre shortage of materials in the USA: Executioners have run out of poison for lethal injections. Because the thiopental used in lethal injections has gone out of fashion as an anesthetic in the medical world, American pharmaceutical companies quit manufacturing it.

As a result, several executions had to be postponed last year. The last supplies a few American prisons still have will reach their “use by” date in March of this year.

Most of the more than 3,000 inmates awaiting execution on death row were sentenced to “death by lethal injection.” In many states, any changes made to the deadly cocktail of chemicals used in execution are possible only after complicated legal procedures. In states like Oklahoma where the legal process has been simplified, they made a quick change last November from thiopental to pentobarbital, which produces similar results. The move prompted worldwide criticism because the use of pentobarbital is permissible only in veterinary medicine.

Reforms in the chemical art of killing are urgently needed. It has been known for more than five years that the supposedly “humane” lethal injection results in a slow and painful death. The reason for this is the scarcity of thiopental. This sedative, part of the barbiturate family, was preferred due to its quick effectiveness. Because of that speed, interaction with the lethal chemicals that follow the sleep phase is minimized. The advantage for the anesthetist proved to be a disadvantage for the executioner.

The method of execution since the early 1980s is to use an infusion containing thiopental in order to put the subject into a so-called “twilight sleep.” Then the second preparation (pancuronium) is administered to paralyze the respiratory muscles. Finally, an infusion of potassium chloride is injected to stop the heart.

If an insufficient dose of thiopental is administered or if the following compounds aren’t injected quickly enough, the subject awakens from the twilight sleep phase. Since the pancuronium has paralyzed the respiratory muscles, the subject has no way of communicating anything to the executioner. He is aware then of his inability to breathe and suffers the extremely painful effects of having his heart stopped by the potassium chloride.

In order to avoid doing the same to animals being put down, veterinarians use pentobarbital, which has a much longer period of effectiveness. Use of larger doses of pentobarbital alone can cause death so that use of the two other chemicals with their terrible side effects isn’t even necessary. The Swiss euthanasia organizations Dignitas and Exit therefore recommend pentobarbital exclusively for those who choose physician assisted suicide.

But the U.S. justice system has shown no interest at all in reforming methods of execution. Just two years ago, the U.S. Supreme Court ruled that use of the triple-dose execution cocktail did not infringe on anyone’s constitutional rights. Now there is hope that this medieval relic called the death penalty may be made less cruel because of a shortage of ingredients.

Great Britain, the last supply source for American prisons, stopped exporting thiopental last year, prompting a European Union-wide embargo of the substance. Italy also imposed its own restriction on export. If Germany refuses to export it to the United States, the chances are good for a modernization of America’s lethal injection practices.

But capital punishment itself enjoys broad support in the United States so there is little hope that it will eventually be done away with.