To the compounder of the Oklahoma execution drug: Come out of the shadows

June 10, 2014

If a pharmacist has to hide what he is doing, then maybe he shouldn't be practicing pharmacy.

David StanleyThe letter at the top of the day’s mail pile immediately attracted my attention.The handwriting on the envelope looked almost childlike, and the return address was a state prison.

The inmate wanted to know about the use and potential side effects of lorazepam, risperidone, and benztropine. His letter, written at about a fourth-grade level, made it clear that he thought these medications were harmful. Denied answers by the people giving him the drugs, he probably got the store's address from the phone book and wrote to us for information.

“You didn't answer it, did you?” was the immediate reaction of my then, soon-to-be-ex-girlfriend.

Of course, I answered it. Providing information is the centerpiece of modern pharmacy, after all, and I don't remember any principle limiting our professional obligations only to good people, or only to those we approve of.

We all have a right to know what is being put into our bodies. At least, that is what I thought at the time.

 

No way of knowing

The Oklahoma Supreme Court recently ruled that two death-row inmates had no right to know the source of the drugs that would be used to kill them.

The standard three-drug cocktail used for years in executions is now in short supply, due in part to the manufacturers’ reluctance to see their products used as agents of death. Unable to secure any, Oklahoma then found a compounding pharmacy willing to provide drugs to be used in a new protocol, prompting the request for information that led to the court's decision.

That is to say, the state claims it is dealing with a compounding pharmacy, but it is divulging no details. So we really have no way of knowing whether it is in fact dealing with an amateur chemist cooking something up in his basement.

Oklahoma taxpayers have no way of knowing whether they got what they were promised or paid a fair price for it.

People who have a moral objection to the death penalty have no way of knowing whether the drugstore they patronize employs a pharmacist who has no problem overlooking the part of the Hippocratic oath that says, “I will never do harm.”  Or the part that follows it: “I will give no deadly medicine to anyone if asked.”

(Okay, before you start sending e-mails, I know that pharmacists are not medical doctors and they do not take the Hippocratic oath, but I believe that for all intents and purposes, pharmacists strive to live by it.)

For that matter, those who support capital punishment have no way of knowing whether they are giving their business to someone who shares their views.

We're all in the dark here … not just the two men who are sentenced to die.

 

Come forward

So I am issuing a challenge to that compounding pharmacist out there. Come forward and tell us what you have done.

Let the world know that at least you have delivered what you promised- that the drugs you provided had the quality and purity they were supposed to have.

Let the world know that as with any other contracts the state enters into with a business, the financial terms were reasonable.

After all, if you're comfortable with what you've done, why do you have to hide? I have never hidden my willingness to provide the morning-after pill, because to me, providing the morning-after pill is doing nothing wrong.

You, the anonymous compounding pharmacist, evidently have a different feeling about admitting to this aspect of your practice.

 

A step backward

I can't help but feel that when a pharmacist gives up his white lab coat for the anonymity of an executioner's black hood, the profession has taken a giant step backward.

Objections to capital punishment aside, secrecy goes against everything pharmacy is supposed to stand for. If a pharmacist has to hide what he is doing, then maybe he shouldn't be practicing pharmacy.

I'd love to have an honest and open discussion about this with the pharmacist involved, but until that pharmacist finds the guts to come out of the darkness, it will never happen.

And now, literally minutes before I turned in this story to meet deadline, news is breaking that the first execution was badly botched.

I’ll bet that life under that anonymous hood just got a little more uncomfortable. The public’s need for information, however, just became a whole lot more pressing.

David Stanley is a pharmacy owner, blogger, and professional writer in northern California. E-mail him at drugmonkeyrph@gmail.com.