NC death penalty also puts pharmacists in ethical bind

Akorn, the manufacturer of the drug used in Oklahoma’s lethal injection process, has asked the state to return any supplies it might have obtained and not to use its products to execute prisoners.
Akorn, the manufacturer of the drug used in Oklahoma’s lethal injection process, has asked the state to return any supplies it might have obtained and not to use its products to execute prisoners. AP

The N.C. Senate will soon vote on a bill that would allow executions to go forward without a physician’s supervision. The lawmakers who introduced this legislation say they believe it will help clear the way for executions to resume in North Carolina by eliminating the hurdle of finding a doctor willing to break his oath to do no harm.

However, doctors are not the only medical professionals involved in the death penalty in North Carolina. Pharmacists play the critical role of supplying drugs for lethal injection and are also being asked to violate their profession’s ethical code by participating in executions.

Across the United States, pharmacists are increasingly being asked to play the role of executioner. Pharmaceutical companies that make drugs previously used in executions, for good reason, have decided they want to be in the business of curing, not killing, patients and have refused to sell their drugs to executioners. One drug manufacturer even has asked states to return any of its drugs purchased for executions.

The result is a drug shortage that has led prison officials to experiment with new drug cocktails, some of them manufactured by compounding pharmacists.

Were North Carolina to restart executions, it would almost certainly be forced to turn to similar methods of procuring drugs. That is presumably the reason legislators added a last-minute provision to their bill that, in addition to removing doctors from the execution chamber, would keep secret information about who carries out executions, what types of drugs are used and from where those drugs come.

Pharmacists should not be part of such human experimentation,

In the past few months, both the American Pharmacists Association and the International Academy of Compounding Pharmacists have announced that supplying execution drugs constitutes a violation of pharmacists’ ethics. A pharmacist who violates the rules of his own professional associations unnecessarily opens himself up to the possibility of professional discipline or an expensive lawsuit.

Every pharmacist takes an oath to “consider the welfare of humanity and relief of suffering my primary concerns” and to apply “my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.” Whether or not you support the death penalty as a matter of public policy, providing the drugs for an execution clearly violates this oath.

In 2006, I retired after 30 years as executive director of the N.C. Board of Pharmacy. In no way would helping to kill a person fit in with my life’s work to protect public health and welfare.

The reasons for pharmacists to sit out executions go beyond simple ethics.

Lethal injection is a complicated medical procedure with the potential to go terribly wrong. The series of botched and torturous executions we have seen in states such as Oklahoma, Ohio and Arizona make that abundantly clear.

If the legislature’s current bill passes, North Carolina will have even fewer safeguards against botched executions than those states do. For a process in which errors have become rampant, we should be increasing scrutiny and safeguards, not eliminating them. The public has a right to know whether an execution method is torturous.

As pharmacists, we rely on the public’s trust that we have our patients’ best interests at heart. It would embarrass and compromise our profession to participate in a process conducted in secrecy, that has the potential to cause an agonizing death and that violates our promise to relieve suffering.

David Work lives in Wilmington.