Big Pharma Fighting Lethal Injection, Explained

Everything you need to know about why and how pharmaceutical companies are going head to head with states against the use of their drugs for executions.

Puppy writing in a notebook

The fight to eliminate capital punishment in the United States is not new. However, the conversation has started to hit news headlines again this month because of Arkansas’ recent decision to execute 8 inmates in 11 days simply because its supply of a critical drug for lethal injection is set to expire on April 30th.

Some of you may be wondering why this is such a big deal, why companies are even getting involved in the issue and how we got to this point. This primer should help.

Get your notebooks out and prepare for some pretty depressing stuff…


What is lethal injection?

Lethal injection is a method of execution for capital punishment in the United States. Texas was the first state to use lethal injection in December 1982.

Typically there are three drugs involved:

(1) Midazolum, which is used as an anesthetic.

It is the most controversial of the three because it has been the focal point of previously botched executions with inmates who appeared conscious (and in pain) while being executed. In February, the Supreme Court declined to hear a case to determine if the use of Midazolum could fall under “cruel and unusual punishment.”

What cruel irony that the method that appears most humane may turn out to be our most cruel experiment yet… Execution absent an adequate sedative thus produces a nightmarish death. The condemned prisoner is conscious but entirely paralyzed, unable to move or scream his agony, as he suffers what may well be the chemical equivalent of being burned at the stake.
— Justice Sonia Sotomayor, in her dissent

(2) Vecuronium Bromide, which is used to cause paralysis.

(3) Potassium Chloride, which is used to stop the heart.

Some states, like Texas, use a one-drug protocol with pentobarbital.


What states use lethal injection as a form of capital punishment?

Capital punishment is legal in 31 states in the US, all of which use lethal injection as the primary method of execution.

Many states have formally or informally placed a moratorium on executions, largely due to their inability to obtain the drugs needed for lethal injections. According to The Marshall Project, only 4 states are currently carrying out lethal injections while 10 states are considering other methods of execution.


Why is there a shortage of Lethal Injection drugs?

It started in 2009 when the company Hospira began experiencing a supply issue and later announced it would no longer be producing sodium thiopental, which was used as the anesthetic in lethal injections at the time. Given that Hospira was the only approved manufacturer of the drug in the United States, this led to a nationwide shortage that delayed and stalled executions in several states.

Things started to come to a head when activists in Europe (where capital punishment is illegal) discovered that drugs from European companies were being used as a replacement. They weren’t here for it and demanded that companies and governments take action.

No no no

So as states began to replace sodium thiopental with other drugs — or even changing their three-drug protocol to one — pharmaceutical companies in the US began blocking the use of their drugs in lethal injections and the EU implemented an export ban.

Hospira provides these products because they improve or save lives and markets them solely for use as indicated on the product labeling. As such, we do not support the use of any of our products in capital punishment procedures.
— Dr. Kees Groenhout, Hospira’s clinical research and development vice president

Now states are increasingly turning to compounding pharmacies to obtain the drugs needed for lethal injection. Compounding pharmacies are less regulated as the FDA does not approve the products. They don’t even have to register with the FDA or inform the agency about what drugs they make. (Hence, the next level of controversy on the issue.)

Unfortunately, states like Arkansas began passing laws that keep the source of lethal injection drugs a secret — which ultimately protect the less regulated compounding pharmacies.


How are companies fighting against the use of their drugs for capital punishment?

Starting in 2011, pharmaceutical companies began banning sales of their drugs to prisons for the use of lethal injections, of course citing moral and ethical concerns.

The use of the medicines in lethal injections runs counter to the manufacturers’ mission to save and enhance patients’ lives, and carries with it not only a public-health risk, but also reputational, fiscal and legal risks.
— Fresenius Kabi USA and West-Ward Pharmaceuticals Corp. in a court brief in two Arkansas inmates’ lawsuits

Many pharmaceutical companies now have contractual agreements with its manufacturers and suppliers to restrict such sales. In cases where companies discover that their drug has been obtained for possible lethal injection use, they will request that it be returned due to the clearly stated restrictions.

But let’s be real, these decisions and statements made by pharmaceutical companies aren’t altruistic. I believe it boils down to the fact that, given activist pressures, they really don’t want their brands associated with capital punishment in any way.

Whatever the reason, I hope this is the beginning of the end of capital punishment in the United States.


More resources:

Comment below if you have additional resources to share!

ABL Footer.png

If you liked this post, you might enjoy the Above the Bottom Line newsletter with weekly updates on how the world's most influential companies are taking a stance on the issues you care about. Subscribe here 

Nikita T. Mitchell