Europe's dangerous death penalty gesture
According to political stereotypes, Europeans are worldly, realistic moral relativists while Americans, with our "exceptionalism" and periodic crusades to democratize the world, are comparatively idealistic. On one issue, though, the roles are reversed. America retains the death penalty, with all of its gloomy assumptions about human nature and grim moral trade-offs. Europe, by contrast, views it as immoral per se, a violation of human rights and basic human dignity. No country that practices capital punishment can be a member of the European Union.
I don't happen to agree that the issue is quite so black and white, and even wrote a small book to explain why. Still, I try to accept Europe's moral absolutism on the death penalty in good faith -- the criminological equivalent of pacifism, not a cheap anti-American posture. Europe's hectoring may even benefit the United States, to the extent that it forces us to confront the very real imperfections in our system.
But just when I'm giving them the benefit of the doubt, some Europeans go and do something irresponsible like restricting the export of sodium thiopental, an anesthetic, to the United States -- because some death penalty states use it in lethal injections. Not only is this gesture unlikely to prevent any executions -- it actually could put the lives and health of innocent Americans at risk.
Here's why. Sodium thiopental has long been a mainstay of general anesthesia; the World Health Organization lists it as an "essential medicine" for any health-care system. In the United States, a newer drug, propofol, has mostly -- but not entirely -- replaced thiopental. According to the American Society of Anesthesiologists, sodium thiopental "is still considered a first-line anesthetic in many cases including those involving geriatric, neurologic, cardiovascular and obstetric patients, for whom the side effects of other medications could lead to serious complications."
Dr. Mark Warner, the organization's president, told me that sodium thiopental's unique properties sometimes make it especially useful in treating certain brain injuries. Doctors use it to induce comas that help the brain "rest" during recovery, so that patients emerge with less loss of function.
Recently, though, the United States has been short of sodium thiopental. Hospira, the only domestic supplier serving more than 3,400 medical facilities, stopped producing it in late 2009, due to problems obtaining its active ingredient from another company. For various business reasons, Hospira found that Italy was best place to restart production, and planned to do so last month.
But, in December, the Italian parliament demanded that Hospira essentially guarantee that none of its made-in-Italy thiopental would be used in lethal injections. Understandably, Hospira could not take that risk; the firm abandoned plans to make thiopental in Italy and ceased production of the drug altogether.
To be sure, the European Union as a whole exempts medically useful sodium thiopental from its human-rights related export controls. But, as Italy showed, that does not bind individual countries. In addition to the Italian action, Britain is planning new licensing requirements on thiopental exports to the United States. Germany's health minister wrote to German pharmaceutical makers, urging them not to export sodium thiopental for executions in the United States; some firms agreed.
The upshot is that the United States must scramble for new sources of thiopental and will probably have to pay premium rates for what it finds. Existing supplies are dwindling. After Hospira announced its decision, the American Society of Anesthesiologists issued a strongly worded statement saying it was "extremely troubled" by Hospira's forced exit from the market and criticizing the anti-death-penalty movement for "using" thiopental supplies to make a point. The doctors noted the "unfortunate irony that many more lives will be lost or put in jeopardy as a result of not having the drug available for its legitimate medical use."
I suppose European restrictions on thiopental might be justifiable if they save a lot of lives on Death Row. They probably won't. U.S. executioners have indeed used thiopental as the first drug in a three-drug lethal injection "cocktail." Thiopental puts a prisoner to sleep. Then two more drugs follow to stop his lungs and heart. But substitutes for thiopental as an execution drug are readily available; Oklahoma uses U.S.-made pentobarbital, as does Ohio, which has moved to a one-drug lethal injection consisting essentially of a massive overdose of that sleep-inducing drug.
Officials in Texas, which executes more people than any other jurisdiction, told me that the state has enough sodium thiopental on hand to conduct the two executions scheduled for February, and is developing plans for later ones. They're not being specific, but my guess is that they will substitute pentobarbital, as Ohio did.
What we have here is not a serious, effective protest, but an exercise in feel-good politics that puts innocent people at risk. You would have thought our friends in the Old World would know by now: In morality, as in economics, there is no free lunch.
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