By: Svetlana Akbasheva, Staff Editor
This March, both the International Academy of Compounding Pharmacists (IACP) and American Pharmacists Association (APhA) updated their official positions regarding the pharmacist provision of drugs for lethal injections as part of executions.1,2 The IACP stated that “while the pharmacy profession recognizes an individual practitioner’s right to determine whether to dispense a medication based upon his or her personal, ethical and religious beliefs, IACP discourages its members from participating in the preparation, dispensing, or distribution of compounded medications for use in legally authorized executions.”1 Six days after this announcement, the APhA issued a statement that “[it] discourages pharmacist participation in executions on the basis that such activities are fundamentally contrary to the role of pharmacists as providers of health care.”2
Currently, 32 states as well as the federal government implement capital punishment, with lethal injections serving as the standard method of execution.3 However, corrections facilities have faced difficulty in obtaining drugs for lethal injections in recent years as a result of shortages and pharmaceutical company opposition to the use of their drugs for this purpose. In response, many state officials have turned to compounding pharmacies to obtain these drugs.4
There is no question that the death penalty is a very controversial subject in the United States and worldwide. By providing drugs for lethal injection, pharmacists are not only helping perpetuate this practice but we are also influencing the public’s perception of our profession. Compounding and dispensing drugs for lethal injections goes against the essential nature of the pharmacy profession. As medication therapy experts, our job is to apply our knowledge of therapeutic dosing and adverse effects of drugs to treat disease states, not to manipulate this information to overdose drugs for their toxic effects. We are concerned with two major aspects of drug therapy – safety and efficacy. This is the opposite of the aim of lethal injections, which is deathly toxicity. You never see an FDA indication in a drug’s prescribing information stating, “For lethal injection: X dose.” Providing drugs for lethal injection goes beyond simple off-label use into a questionable land of politics, ethics, and the law.
Another issue is that shortage of the standard drugs historically used for lethal injections – a combination of a barbiturate/anesthetic, a paralytic, and potassium chloride to induce cardiac arrest – has led to the use of experimental concoctions that could lead to excessive suffering or even be ultimately ineffective.5 There is no evidence-based medicine here and no regulation, two factors that are at the core of the pharmacy profession. At least until these two factors are incorporated, if ever, it seems that there should be no role for pharmacists in the provision of drugs for lethal injections.
- IACP adopts position on compounding of lethal injection drugs. Pharmacy Times. http://www.pharmacytimes.com/association-news/IACP-Adopts-Position-on-Compounding-of-Lethal-Injection-Drugs. Published March 24, 2015. Accessed April 12, 2015.
- APhA House of delegates adopts policy discouraging pharmacist participation in execution. Pharmacy Times. http://www.pharmacytimes.com/association-news/APhA-House-of-Delegates-Adopts-Policy-Discouraging-Pharmacist-Participation-in-Execution. Published March 31, 2015. Accessed April 12, 2015.
- States with and without the death penalty. Death Penalty Information Center. http://www.deathpenaltyinfo.org/states-and-without-death-penalty. Accessed April 12, 2015.
- Compounding pharmacies and lethal injection. Death Penalty Information Center. http://www.deathpenaltyinfo.org/compounding-pharmacies. Accessed April 12, 2015.
- Sanburn J. Ohio’s lethal injection experiment. Time. http://nation.time.com/2014/01/15/ohios-lethal-injection-experiment/. Published January 16, 2015. Accessed May 8, 2015.
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