By Linh Nguyen
In an open letter to death penalty states, healthcare workers and medical experts across the country asked death penalty states to surrender execution drugs to doctors who need the sedatives and paralytics to treat COVID-19 patients.
As the coronavirus pandemic persists and depletes medical facilities of vital resources including ventilators and masks, healthcare workers also struggle with the diminishing supply of medicine to treat COVID-19 patients. In fact, some of these medicines are the same drugs used in lethal injection executions in state correctional facilities in the 28 states with the death penalty. The American Society of Health-System Pharmacists lists four execution drugs—midazolam, vecuronium bromide, rocuronium bromide and fentanyl—on the shortage list. The Food and Drug Administration also listed midazolam and fentanyl on shortage. These drugs are sedatives and paralytics used on ventilated patients.
Nine pharmacists, intensive care unit doctors and public health experts wrote an open letter to state correctional facility directors to release their supply of execution drugs to healthcare workers in their states to treat COVID-19 patients. They noted that the medicines needed to treat patients are the same drugs used in lethal injection executions.
“These medicines were never made or developed to cause death,” they wrote, adding “to the contrary, many were formulated to connect patients to life-saving ventilators and lessen the discomfort of intubation.”
There are 28 states in the United States that retain the death penalty, including California, Florida, Louisiana and Texas (California is a death penalty state although Governor Gavin Newsom halted executions in 2016 in an official moratorium). Of all the states with the death penalty, these states have amassed over 10000 confirmed positive cases of COVID-19.
Although many states do not disclose the number of vials of medicines they stockpile in execution chambers, public information from other states suggest that stockpiled execution drugs could be used to treat over a hundred COVID-19 patients. Furthermore, when including states that did not release this data, the number of patients who could be treated can rise to hundreds.
The signers of the letter note that hundreds may be a mere fraction of the hundreds of thousands of people in the United States that might die from coronavirus, according to estimated projections 
based on the current trajectory of the virus.
“[I]t is a central ethical directive that medicine values every life,” they wrote. “Those who might be saved could include a colleague, a loved one, or even you.”
The pandemic has already delayed some lethal injection executions. In Texas, two executions initially scheduled in March were delayed 60 days due to COVID-19.
“Every state that intends to go forward with an execution during this health crisis will have legal issues,” said Robert Dunham, the executive director of the Death Penalty Information Center. “When you’re in the final weeks before an execution, access to a client is an absolute necessity and access to the courts is an absolute necessity. Where that access is impaired because of a public health emergency you simply can’t go forward.”
In response to the medicine shortage, the U.S. Drug Enforcement Administration is allowing pharmaceutical manufacturers a 15 percent increase in the production of controlled substances used in COVID-19 care, including fentanyl. In addition, they are also approving increases in imports of medications needed for patients on ventilators, including midazolam.
In addition, the DEA is also expediting individual requests from pharmaceutical manufacturers to increase the limit of production of necessary medicines.
“DEA is committed to ensuring an adequate and uninterrupted supply of critical medications during this public health emergency,” said DEA Acting Administrator Uttam Dhillon. “This will ensure that manufacturers can increase production of these important drugs, should the need arise.”
Last week, the DEA issued a temporary exception to its regulations so that manufacturers can increase their inventory of certain controlled substances to ensure that the production and distribution of these drugs are uninterrupted.
Pharmaceutical giant Pfizer is responding to the DEA’s announcement by ramping up production of fentanyl, morphine, hydromorphone and other medicines for ventilator patients, according to company spokesperson Kimberly Bencker.
Still, the healthcare workers and experts believe that lethal injection drugs should be allocated to a more critical need at this time, as “every last vial of medicine could mean the difference between life and death.”
In the conclusion of the letter, the signers write, “We urgently ask you to send any execution drug supplies in your storerooms to hospitals where they are needed to treat critically ill COVID-19 patients. At this crucial moment for our country, we must prioritize the needs and lives of patients above ending the lives of prisoners.”
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