On June 29, 2015, in a 5-4 decision, the U.S. Supreme Court issued its opinion in Glossip v. Gross, ruling that the anti-anxiety medication midazolam is constitutional for use as the first drug in a three-drug lethal injection formula. The case was brought by death row prisoners in Oklahoma, who argued that the state’s use of midazolam in this manner creates an “objectively intolerable risk of harm.”
A statement from Dale Baich, one of the attorneys for the death row prisoners, can be accessed here: Statement from Attorneys for Petitioners
A link to the U.S. Supreme Court Opinion and Dissents in Glossip v. Gross can be accessed here: U.S. Supreme Court Opinion
On April 29, 2015, the United States Supreme Court heard oral argument in Glossip v. Gross, a case which challenges the use of the anti-anxiety drug midazolam in lethal injection executions. Petitioners argue in their brief to the Court that there is “undisputed evidence. . . that midazolam cannot reliably ensure the ‘deep, comalike unconsciousness’ required where a State intends to cause death with painful drugs” (Brief for Petitioner at p. 29). Use of this drug to carry out executions by lethal injection does not comport with the Eighth Amendment’s prohibition on cruel and unusual suffering. In the last year alone, midazolam was used in several botched executions.
In Baze v. Rees (2008), the Supreme Court reviewed the three-drug protocol then used for lethal injection by at least 30 states, in which the first drug, an ultra short-acting barbiturate, rendered the prisoner unconscious, and the second and third drugs, a paralytic and potassium chloride, paralyzed the prisoner and stopped the heart. The Court noted that the first drug, the barbiturate, causes a “deep, comalike unconsciousness” and therefore “ensures that the prisoner does not experience any pain associated with the paralysis and cardiac arrest caused by the second and third drugs.”
The Oklahoma drug protocol challenged in Glossip is also a three-drug protocol that uses a paralytic and potassium chloride as the second and third drugs, but it substitutes the benzodiazepine midazolam for the first drug, creating risk of “severe pain, needless suffering and a lingering death.”
As the Brief for Petitioner states:
“In Baze, there was consensus that sodium thiopental, if properly administered, would produce deep comalike unconsciousness. With midazolam, the opposite is true. Midazolam is not approved for use as the sole anesthetic for painful surgery. Clinical studies showed that midazolam does not reliably induce deep unconsciousness; when used in surgery, patients felt pain. The medical consensus is that midazolam cannot generate deep, comalike unconsciousness. There is also no substantial practice among the states of using midazolam for lethal injections. Although sodium thiopental was widely used in lethal injections for years, only four states have used midazolam in an execution, and only two have tried to use it as anesthesia. On these undisputed facts, the use of midazolam to create deep comalike unconsciousness presents an “objectively intolerable risk of harm” (Baze, 553 U.S. at 50).” (p. 26)
Midazolam is not a barbiturate, but a benzodiazepine commonly used in pre-operative settings to alleviate anxiety. It is the shortest-acting drug in the same class of anti-anxiety drugs as Xanax, Atavan and Valium. All of the experts who testified in a three-day hearing in Oklahoma in December 2014, including the state’s expert, agree that midazolam has a ceiling effect, above which additional dosing has no additional effect, and no analgesic (pain-relieving) qualities (Joint Appendix to Brief for Petitioner, medical testimony from three-day hearing at pp. 199, 256, 274).
The four states which have used midazolam in lethal injection executions are Arizona, Florida, Ohio and Oklahoma. Three executions that used midazolam triggered formal state investigations into why they did not go as planned (Brief for Petitioner at p. 31). In all of these botched executions, the prisoners initially appeared to lose consciousness, but then started moving and demonstrating signs of struggle and suffering.
Glossip v. Gross originated in federal court in Oklahoma as a response to the botched execution of Clayton Lockett on April 29, 2014. Charles Warner was originally one of the Petitioners, but the Court denied a stay of execution in his case, and he was executed using midazolam in a three-drug formula on January 15, 2015, just eight days before the Court accepted this case for review. On January 28, 2015, the Court stayed the executions of the three Petitioners, Richard Glossip, John Grant and Benjamin Cole, who are Oklahoma death row prisoners. In their Petition for Certorari, Petitioners asked the Court to “provide urgently needed guidance” to prisoners and courts addressing new, experimental lethal injection protocols.
In her dissent from the denial of a stay for Charles Warner, Justice Sonia Sotomayor, joined by three other justices, recognized that the district court relied on a “single purported expert” who testified from suspect sources and in a manner that contradicts empirical data. Justice Sotomayor explained, “In contending that midazolam will work as the State intends, Dr. Evans cited no studies, but instead appeared to rely primarily on the Web site www.drugs.com. Here, given the evidence before the District Court, I struggle to see how its decision to credit the testimony of a single purported expert can be supported given the substantial body of conflicting empirical and anecdotal evidence.”