8.2. Pharmaceutical chemicals employed in death penalty In China, Guatemala, the Maldives, Papua New Guinea, Taiwan, Thailand, Vietnam, and the United States, the intravenous administration of a lethal dose of certain pharmaceutical chemicals (“lethal injection”) is provided for as a method of execution under the law.373 Until 2010- 2011, the majority of US States that carried out lethal injection executions employed a ‘three-drug’ protocol comprising: sodium thiopental to induce general anaesthesia; pancuronium bromide to cause muscle paralysis, including of the diaphragm; and potassium chloride to stop the heart. An alternative protocol favoured by a small number of US States utilises one large dose of a barbiturate, normally either sodium thiopental or pentobarbital. However, Hospira, the sole US manufacturer of sodium thiopental, suspended production of the drug in 2010, and in early 2011 withdrew from the market altogether. As a result, a number of US death penalty States started to source stocks held in other countries including European countries. In December 2011, the European Commission revised EC Regulation 1236/2005 to include binding measures to control the export from all EU Member States of certain dual-use drugs which have legitimate medical uses but that could also be employed for the execution of human beings, such as sodium thiopental and pentobarbital.374 These measures were further strengthened with the introduction in December 2016 of an urgency procedure, empowering the Commission to expeditiously amend the list of regulated goods to include additional pharmaceutical chemicals of concern, and thereby allow EU Member States to halt transfers of such pharmaceutical chemicals to end users intending to employ them for capital punishment.375 It is unknown whether similar measures have been adopted by any non-EU CoE member States. 8.3. Recommendations:  Where they have not done so, CoE member States should introduce appropriate export controls to ensure that pharmaceutical drugs (including anaesthetic agents or psychoactive chemicals) are not transferred to those law enforcement or prison authorities who will use them for the execution of human beings by means of lethal injection, or for torture or ill-treatment.  CoE member States should ensure that clear regulations are drawn up governing the use of chemical restraint (such as sedatives, antipsychotics, hypnotics and tranquillisers) in line with CPT recommendations, to ensure they are not applied inappropriately and never for torture or ill-treatment. Such chemical restraint, should only be employed when expressly ordered by a doctor. All instances of recourse to means of chemical restraint must be systematically recorded detailing the length and frequency of individual restraint measures. 373 Amnesty International, Execution by lethal injection: a quarter century of state poisoning, ACT 50/007/2007, 4 October 2007; Amnesty International, Maldives to resume executions after over 60 years ASA 29/6764/2017, 20 July 2017; Amnesty International, Further information: Papua New Guinea plans for executions, ASA 34/003/2013, 4 June 2013. 374 EU, European Commission, Commission Implementing Regulation (EU) No: 1352/2011 of 20 December 2011, amending Council Regulation (EC) No 1236/2005, Official Journal of the European Union, 21 December 2011, L.338/31, Annex III, Article 4. 375 EU, Regulation (EU) 2016/2134 of the European Parliament and of the Council of 23 November 2016 amending Council Regulation (EC) No 1236/2005, December 2016. In December 2016, the EU also introduced a system of Union General Export Authorizations for EU exports of certain pharmaceutical chemicals to States that abolished the death penalty; and individual or global export authorizations to non-abolitionist States. 70