26 Grasping the nettle: Ending Europe’s Trade in Execution and Torture Technology Chapter 4 / Mechanisms to control the transfer of pharmaceutical chemicals that could be used for the purpose of judicial executions/ implementation of the death penalty Lethal injection is the practice of executing a person to implement a judicial sentence of death using a lethal combination and/or dosage of drugs administered intravenously. This method of execution is allowed by law in China,105 Guatemala,106 the Maldives,107 Papua New Guinea,108 Taiwan,109 Thailand,110 United States of America (U.S.),111 and Vietnam.112 Lethal injection is the most common method of execution in the United States.113 Until 2010-2011, the majority of U.S. States that carried out executions employed a three-drug protocol comprising: sodium thiopental (also known by the trade name Pentothal) to induce general anaesthesia; pancuronium bromide to cause muscle paralysis, including of the diaphragm; and potassium chloride to stop the heart. Doctors have expressed concern that if inadequate levels of sodium thiopental are administered (for example, through incorrect doses of thiopental, faulty attachment of the line, or precipitation of chemicals) proper anaesthetic depth will not be achieved or the anaesthetic effect can wear off rapidly and the prisoner will experience severe pain as the lethal potassium chloride enters the veins and he or she goes into cardiac arrest. Due to the paralysis induced by pancuronium bromide, they may be unable to communicate their distress to anyone. An alternative protocol favoured by a small number of U.S. States utilises one large dose of a barbiturate, normally either sodium thiopental or pentobarbital. However, Hospira, the sole U.S. manufacturer of sodium thiopental, suspended production of the drug in 2010. As a result, a number of U.S. death penalty States started to import quantities of the drug from a small wholesaler in London. Following a judicial review of the UK government’s export policy brought by Reprieve, an export control was put in place across the UK to prevent further exports of sodium thiopental to the U.S. for use in lethal injection executions in late September 2010. In order to prevent US death penalty States from seeking supplies of execution drugs from elsewhere in Europe, Reprieve, Amnesty International and Omega called on individual EU Member States and 105 Amnesty International, Execution by lethal injection – a quarter century of state poisoning, ACT 50/007/2007, October 2007, http:// www.amnestyusa.org/document.php?lang=e&id=engact500072007 (Accessed 12 April 2015). Amnesty International, Death Sentences and Executions in 2014, Act 50/001/2015, April 2015. https://www.amnesty.org/en/documents/ act50/0001/2015/en/, p.7. 106 Amnesty International, Execution by Lethal Injection– a quarter century of state poisoning, ACT 50/007/2007, October 2007, https:// www.amnesty.org/en/documents/ACT50/007/2007/en/ (Accessed 12 April 2015) . The last execution in Guatemala was carried out in 2000. 107 Amnesty International, Death Sentences and Executions in 2014, ACT 50/001/2015, April 2015, p.34. The last execution in the Maldives was carried out in 1954. 108 Amnesty International, Papua New Guinea plans for executions, ASA 34/003/2013, 4 June 2013, available at: Amnesty International, Death Sentences and Executions in 2013, Act 50/001/2014, March 2014, https://www.amnesty.org/en/documents/act50/001/2014/en/, pp.37-38. The last execution in Papua New Guinea was carried out in 1954. 109 Amnesty International, Execution by Lethal Injection– a quarter century of state poisoning, ACT 50/007/2007, October 2007, https:// www.amnesty.org/en/documents/ACT50/007/2007/en/ (Accessed 12 April 2015). Although national legislation indicate lethal injection as the method of execution in Taiwan, Amnesty International has only recorded executions by shooting including most recently in 2014. Amnesty International, Death Sentences and Executions in 2014, AI Index ACT 50/001/2015 (April 2015), https://www.amnesty.org/en/ documents/act50/0001/2015/en/pp. 7 and 39. 110 Amnesty International, Death Sentences and Executions in 2009, AI Index ACT 50/001/2010 (March 2010), p. 6. The last executions in Thailand were carried out in 2009. 111 Amnesty International, Death Sentences and Executions in 2014, Act 50/001/2015, April 2015, available at https://www.amnesty.org/ en/documents/act50/0001/2015/en/, p.21. 112 Amnesty International, Lethal Injection Looms for 117 Prisoners, Urgent Action, UA 161/13, 24th June 2013. Amnesty International, Death Sentences and Executions in 2014, Act 50/001/2015, April 2015. https://www.amnesty.org/en/documents/act50/0001/2015/en/, pp.7. After changing its method of execution from firing squad to lethal injection, the authorities of Viet Nam were compelled to suspend executions as they could not source the chemicals needed in lethal injection protocols. The production of these drugs began domestically and executions resumed in 2013. 113 Death Penalty Information Centre (DPIC), Lethal Injection, http://www.deathpenaltyinfo.org/lethal-injection-moratorium-executionsends-after-supreme-court-decision (accessed 14 May 2015); DPIC, State by State Lethal Injection http://www.deathpenaltyinfo.org/state-lethal-injection (accessed 14th May 2015). Amnesty International, Death Sentences and Executions in 2014, Act 50/001/2015, April 2015, https://www.amnesty.org/en/documents/act50/0001/2015/en/, p.21. Amnesty International May 2015 Index: EUR 01/1632/2015