Double Standards for Two Death-Dealing Drugs

Vecuronium bromide is a drug that relaxes skeletal muscles and can be used in conjunction with surgical anesthesia. That is its usual medical application.

Some states also use it in connection with capital punishment: it is one of several drugs used together to execute prisoners. Vecuronium bromide paralyzes the prisoner’s breathing. Potassium chloride is then used to stop the heart.

Vecuronium bromide hit the headlines recently in conjunction with the effort of Arkansas to carry out multiple executions in late April 2017. The state wanted to speed up executions because its stock of drugs used for capital punishment was rapidly approaching its expiration date, and numerous pharmaceutical manufacturers have decided to refuse to sell their products to states for executions. Pfizer, which makes vecuronium bromide, bans sales of the drug for capital punishment because the company says it serves life. “Pfizer makes its products to enhance and save the lives of the patients we serve. Consistent with these values, Pfizer strongly objects to the use of its products as lethal injections for capital punishment.” Roche, Akorn, Hikma, Lundbeck, and Hospira, which all manufacture drugs that can be used in executions, also ban their sales for that purpose.

As applied in the United States, capital punishment is usually accompanied by numerous last minute efforts in various courts, state and federal, to find some way to stay an execution. Among the cases Arkansas has had to defend was how it got vecuronium bromide. McKesson, the pharmaceutical distributor which supplied the drug to Arkansas says he was duped, claiming a prison doctor sought and obtained the drug on his medical license. McKesson insisted that, had it known that the Arkansas Department of Corrections intended to use the drug for executions, it would never have dispersed it. McKesson sought to get the drug back, refunding its charges but Arkansas refused. McKesson then went to court, claiming the drug was obtained fraudulently and that failure to return the drug would harm McKesson by inferring it did not follow manufacturer policy or control its disbursements against fraud.

The moral issues in the current controversy are numerous. Catholic moral theology has, in general, become increasingly opposed to capital punishment. Pope John Paul II, in his encyclical Evangelium vitae (#56), maintained that when the state can protect society against murderers by other means, the case for capital punishment—especially under modern penal conditions—is “rare, if practically non-existent.” The Catholic bishops of the United States, as a national episcopal conference as well as individually and in local conferences, have also been long opposed to capital punishment.

Let’s look at the issue of vecuronium bromide.

States have turned to capital punishment through lethal injection because they believe the method combines reliability with minimum suffering. The traditional methods of execution in the United States—primarily lethal gas or electrocution (although a few states still retained hanging or shooting)—have fallen into disfavor. Executing prisoners by lethal injection was thought to be more “humane,” akin to the euthanizing of animals. (Of course, how using the analogy of animals makes something more “humane” makes sense perhaps only to the transhumanist.)

Capital punishment by lethal injection seems to check a couple of boxes in the American psyche. We don’t like death, and states which still used “Old Sparky”—the electric chair—found it was difficult to conceal visually that they were putting somebody to death. Capital punishment by lethal injection looks much more like sleep; pace Dylan Thomas, we prefer they go “gentle into that good night.”

When states began to adopt lethal injection as their form of execution, they also ran into a problem: who would administer it? Injections are usually administered by medical personnel. But medical personnel swear to serve a patient’s health and not to do harm. If physicians were to be executioners, were they not prostituting their art?

(Of course, physicians today are increasingly being pressured to do just that. Some medical schools no longer administer the Hippocratic Oath so as to accommodate newly-minted pro-abortion physicians. And in some jurisdictions where euthanasia is legal, doctors are increasingly expected to provide the “service” to which their consumers have a “right.” But this is precisely what John Paul presciently warned against in Evangelium vitae, when he cautioned that trafficking with any part of the culture of death would make it increasingly harder to restrict it.)

There are, of course, some who argue that a doctor’s job is to “alleviate suffering,” and so the a physician should help dispatch a prisoner a state is set on executing with minimal pain. Most doctors—and the American Medical Association—disagree. One recent New York Times physician-correspondent tried to square the circle: killing someone at his request (so-called “physician-assisted suicide”) is permissible because, by doing what is asked and, thus, “keeps faith with the dying,” but since prisoners presumably don’t want to be executed, physicians should steer clear. (What would Dr. Sulkowicz do with Gary Gilmore, the murderer Utah shot in 1977, who said he wanted to die? Presumably, Sulkowicz would say the key point is that Gilmore was not dying, but then one could ask whether most “diagnoses” of “lethal” conditions are also accurate.)

The manner Arkansas got its vecuronium bromide raises ethical issues. The drug has a legitimate medical use, and that is what Pfizer manufactures it for. Pfizer has explicitly said, as a matter of company policy, that it will not make the drug available for executions. Arkansas is trying to accelerate its execution schedule because its drug stockpile is expiring and obtaining new drugs is increasingly difficult, in part because death penalty opponents have pressured pharmaceutical companies not to make their drugs available for lethal purposes, in part because of the companies’ own policies.

It is clear that Arkansas was, at a minimum, not forthcoming with why it was buying vecuronium bromide from drug distributor McKesson, and should return the drug to the company.

But I also note a paradox. I thought corporations are not “persons” and so can’t have “consciences.” I thought that if you are in business, you sell to buyers. They might use your product as you intended, or they might not (which is what confuses the Arkansas issue). Why can Pfizer have a corporate conscience and refuse to allow its drugs to be used for lethal purposes, but Hobby Lobby cannot have a corporate conscience and refuse to allow its money to be used to fund lethal drugs (abortifacients) under its health plan? Or why can Pfizer say it disagrees with what the recipient of its product is going to do with it and refuse to do business with the recipient of its products—the State of Arkansas—but Arlene’s Flowers of Washington cannot disagree with what the recipient of her services will solemnize with her floral arrangements and refuse to do business with a private citizen? Arguably, Mr. Ingersoll had a better chance of getting more flowers in Richland, Washington for his “wedding” than the State of Arkansas would in getting more vecuronium bromide in Little Rock for its executions. And, after all, what Arkansas was doing was legal, too.

As I said, I agree with McKesson distributors and Pfizer—we should respect their corporate conscience and Arkansas should return the drugs. My only question is why Pfizer gets away with having a conscience, but Hobby Lobby had to fight and Arlene Stutzman just got shafted.

Pfizer could also say that the State of Arkansas intended to use vecuronium bromide for a purpose other than that intended by the manufacturer and/or approved by the FDA. That’s true, but then it raises another question.

Digoxin is a heart medication. It is FDA-approved as a cardiac drug, specifically for persons with certain arrhythmias and heart failure.

But there is a dirty little secret out there. Digoxin is often used in late term abortions. The abortionist injects a massive dose into the unborn child to induce coronary failure—a heart attack. Why?

It all comes back to the corruptive influence of Roe et al. v. Wade. If abortion is a fundamental “Constitutional right” that cannot essentially be regulated at any time before birth, if the abortion establishment (and the Democratic Party—but I repeat myself) insists that no abortion, no matter how late or near birth is ever unjustified, then you have a problem.

The problem is that Roe is on a collision course with that pesky 14th Amendment. See, the 14th Amendment actually invests anybody “born” in the United States with rights.

Partial birth abortion, however, engages in Constitutional casuistry; its leaps of logic would have amazed even the most rigid casuist: how to protect the “fundamental right” to kill your baby before birth from… birth (and the nasty rights that accompany it).

The solution: make sure the kid comes out dead. And the way you do that is by inducing heart failure before birth occurs, because you cannot “kill” a “non-person.” (Of course, how do “non-persons” have beating hearts?) Digoxin, marketed officially for another purpose, is standard part of the unstandard protocol for late term abortions. We even have a nice, euphemistic name for what we are doing: “fetal demise.” I guess “prenatal capital punishment” would be too blunt.

Somehow, I don’t see the same hue and outcry about digoxin being used for an unauthorized, lethal purpose. Maybe Arkansas can get some. If we found out that an overdose of digoxin causes pain by shutting down the heart, we might think twice about prenatal pain. (Oh, forgot, that doesn’t exist. After all, the New York Times said so.)

Don’t you just wish digoxin manufacturers might develop a corporate conscience at least as sensitive as Pfizer’s?

John M. Grondelski

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John M. Grondelski (Ph.D., Fordham) is former associate dean of the School of Theology, Seton Hall University, South Orange, NJ. All views expressed herein are exclusively his own.

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